Posts for category: Periodontal
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.
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!
Plaque is a sticky colorless deposit of bacteria that is constantly forming on the tooth surface. Saliva, food and fluids combine to produce these deposits. Plaque forms 4-12 hours after brushing which is why it is so important to brush at least twice a day and floss daily. Tartar or calculus is a crusty deposit that can trap stains on teeth and cause discoloration. Calcium and phosphate bind to form crystals on the teeth. These calcium phosphate crystals eventually harden with plaque to form calculus. For many folks, these deposits build up faster as we age. Factors that contribute to periodontal diseases are diabetes, genetic disorders, blood diseases, emotional stress, tobacco use and HIV injection.
OK, what is the treatment? This involves periodontal or deep cleaning. Scaling coupled with root planing is used to remove plaque and tartar beneath the gum lines. A local anesthetic is given to reduce any discomfort. A scaler or an ultrasonic cleaner is used to carefully remove plaque and tartar down to the bottom of each periodontal pocket. Root surfaces are then smoothed or planed. This helps pockets to shrink. This procedure also makes it difficult for plaque to accumulate along the root surfaces. Once treatment is completed, regular dental cleanings are required every three months so that the pockets can be maintained.