DR. MEENA'S BLOG
Posts for tag: gum disease
My husband recently suffered from pericoronitis. Pericoronitis is a dental disorder in which the gum tissue around the molar teeth becomes swollen and infected. This disorder usually occurs as a result of wisdom teeth.
What Causes Pericoronitis?
Pericoronitis usually develops when the wisdom teeth only partially erupt (break through the gum). This allows an opening for bacteria to enter around the tooth and cause an infection. In cases of pericoronitis, food or plaque (a bacterial film that remains on teeth after eating) may get caught underneath a flap of gum around the tooth. If it remains there, it can irritate the gum and lead to pericoronitis. If the pericoronitis is severe, the swelling and infection may extend beyond the jaw to the cheeks and neck.
What Are the Symptoms of Pericoronitis?
Symptoms of pericoronitis include:
- Swelling in the gum tissue (caused by an accumulation of fluid)
- A "bad taste" in the mouth (caused by pus leaking from the gums)
- Swelling of the lymph nodes in the neck
- Difficulty opening the mouth
How Is Pericoronitis Treated?
If the pericoronitis is limited to the tooth (for example, if the pain and swelling has not spread), treat it by rinsing your mouth with warm salt water. You should also make sure that the gum flap has no food trapped under it.
If your tooth, jaw, and cheek are swollen and painful, see your dentist right away. He or she can treat the infection with antibiotics (usually penicillin, unless you are allergic). You can also take pain relievers such as aspirin, acetaminophen, or ibuprofen. The dentist may also prescribe a pain medication.
If the pain and inflammation are severe, or if the pericoronitis recurs, oral surgery to have the gum flap or wisdom tooth removed may be necessary. Your dentist can make the appropriate referral to the oral and maxillofacial surgeon. A low-level laser can be used to reduce pain and inflammation associated with pericoronitis.
If your teeth could talk - the mouth offers clues to disorders and diseases and dentists could play a larger role in patient care.
The eyes may be the window to the soul, but the mouth provides an even better view of the body as a whole. Some of the earliest signs of diabetes, cancer, pregnancy, immune disorders, hormone imbalances and drug issues show up in the gums, teeth and tongue - sometimes long before a patient knows anything is wrong. There's also growing evidence that oral health problems, particularly gum disease, can harm a patient's general health as well, raising the risk of diabetes, heart disease, stroke, pneumonia and pregnancy complications.
Such findings are fueling a push for dentists to play a greater role in patients' overall health. It's an opportunity to tell a patient, 'You know, I am concerned. I think you really need to see a primary care provider,' so you are moving in the direction of better health. Some of the most distinctive problems come from uncontrolled diabetes. The gum tissue has a glistening shiny look where it meets the teeth. It bleeds easily and pulls away from the bone. An estimated six million Americans have diabetes but don't know it - and several studies suggest that dentists could help alert them. It's not just that the same lifestyle habits contribute to both gum disease and high blood sugar; the two conditions exacerbate each other. Inflammation from infected gums makes it more difficult for people with diabetes to control their blood sugar level, and high blood sugar accelerates tooth decay and gum disease, creating more inflammation.
There is also growing evidence that the link between periodontal disease and cardiovascular problems is not a coincidence either. Inflammation in the gums raises C-reactive protein, thought to be a culprit in heart disease. Oral bacteria has been found in the plaques that block arteries. Bacteria from the mouth can travel through the bloodstream and cause problems, elsewhere, which is why people contemplatng elective surgery are advised to have any needed dental work performed first.
Many medications, from antidepressants to chemotherapy drugs can cause dry mouth, which can cause cavities to skyrocket, since saliva typically acts as a protective coating for teeth. The Centers for Disease Control and Prevention recommends that dentists offer HIV testing, because some of the first symptoms appear in the mouth., including fungal infections and lesions. Dentists can do the HIV test with a simple mouth swab and get test results in 20 minutes.
You may be tempted to buy over-the-counter teeth whitening kits, given their proliferation expecially on the Internet. Not only are they not made to fit your mouth exactly, it may be that bleaching isn't suitable for you, especially if you have gum disease or crowns. If your teeth are healthy and somewhat white, you may get a boost from such over-the-counter products, but again, they will not last long. The only home bleaching kits you should be using are the ones recommended by your dentist. The most important thing to look for in over-the-counter kits is that they fit the size and shape of your teeth. For example, whitening strips are straight across, while your teeth are curved. In addition, make sure that the at-home bleaching kits cover your whole tooth - otherwise you will have two toned teeth or irritated gums.
Professional tooth whitening from a dentist is always recommended. Your dentist will check for gum diseases, as well as loose fillings. She will be able to fit you for trays as well. In addition, she can monitor your teeth's response to the product - especially the reaction to your gums. A combination of in-office and at-home dentist prescribed whitening treatment will give you faster and longer-lasting results. It can provide maximum whitening with minimal effort and time while ensuring safety and effectiveness.
Some of my patients are surprised (or should I say, upset) when I suggest that they come in for a cleaning more frequently than six months. Their reply in most cases is "But my insurance company will pay only for a cleaning visit every six months" - which is a fair response. I would blame the insurance companies for this situation. The insurance companies like the steadiness of the six month recall concept. However, it is not in the best interests of the patient that is not yet inflicted with the disease but exhibits patterns that need more aggressive attention to prevent the disease. The dentist, in most cases, is seeing something completely different. She is seeing a huge group of patients (more than 80%) that need more than just six month recalls. It is extremely important to remember that gum disease is 100% preventable, but once seen in the mouth, it is not 100% curable, and in most cases, it is less than 100% arrestable. So the dentist needs to have the flexibility to be able to see the patients more frequently than six months. Our practice philosophy is that preventing gum disease is the better model both from a medical and economic perspective.
My sincere suggestion to patients is to seek out a more individualized perio treatment from your dentist based on your own unique periodontal issues. Disregard what your insurance is willing to pay. You may spend more or less initially, but in the long run you will save more money.
To summarize, if you take one message home after reading this, please remember one thing: Gum disease is like cancer. In the earliest form (Gingivitis) it is curable. After that, it’s only possible to achieve remission. Let your dentist help you to prevent gingivitis - so the next time your dentist asks you to come for a cleaning appointment that may be sooner than six months, don't give her grief!