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Posts for: March, 2014

By Edward Joseph, D.D.S.
March 24, 2014
Category: Oral Health
Tags: gum disease  
TakeActionQuicklyAgainsttheAcuteFormofGingivitis

Periodontal (gum) diseases like gingivitis (inflammation of the gum tissues) can exist in a chronic form for some time, while gradually worsening. But given the right conditions, gingivitis could elevate quickly into an acute, painful condition known as Acute Necrotizing Ulcerative Gingivitis (ANUG). While it can be effectively treated, it’s important to diagnose ANUG early and begin treatment as soon as possible.

ANUG is also known as “trench mouth” as it was commonly recognized among soldiers in the trenches during World War I. Its name describes it as “necrotizing” and “ulcerative,” because when left untreated it kills (“necrotizes”) soft gum tissue, particularly the triangular tissue between teeth known as papillae, and causes severe and painful sores. A person with ANUG may also exhibit very bad breath and taste, with an odor peculiar to the disease. It’s believed that acute stress, poor nutrition and a lack of sleep can trigger the condition in individuals with pre-existing gingivitis.

As with other forms of gum disease, the first priority of treatment is to alleviate the symptoms. Besides initial cleaning (also known as scaling), we would also prescribe antibiotics (particularly Metronidazole, which is effective against the specific bacteria responsible for ANUG), an antibacterial mouthrinse like chlorhexidine, and a mild saline rinse. We would also control pain and inflammation with non-steroidal anti-inflammatory drugs like aspirin or ibuprofen.

As the symptoms come under control, it’s then necessary to treat the underlying gingivitis by continuing the thorough cleaning of the affected surfaces, including the roots, of as much plaque and tartar as possible. Good oral hygiene with semi-annual professional cleanings must become regular habits to inhibit future reoccurrences of the disease. Quitting smoking, eating a healthy diet and managing stress are also advisable.

Without treatment, ANUG symptoms will persist; you could eventually lose the affected papillae, and experience other detrimental effects to other periodontal tissue and bone structures. If you suspect you may have gingivitis or this acute form, you should visit us as soon as possible for a full evaluation and treatment. The earlier we diagnose and treat gum disease, the better your long-term outlook.

If you would like more information on painful gums, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Painful Gums in Teens and Adults.”


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By Edward Joseph, D.D.S.
March 21, 2014
Category: Dental Procedures
HowWeDeterminetheBestWaytoFixYourSmile

We all know that dentistry can do amazing things these days to give you the smile you've always dreamed of. With the latest cosmetic and restorative dental techniques, it is possible to achieve amazingly natural-looking results. But how do we map out the best route to a better smile? And how do we know that the results will hold up over time?

Every individual has a unique set of conditions in his or her mouth and it is our job to figure out how you have come to your present state, dentally speaking. We need to correct or at least manage any factors that could risk the success of your treatment. These risk factors fall into four basic categories:

Periodontal Risk — This involves the condition of the structures that support your teeth, including your gum and bone tissue. It's important to establish good periodontal health before we perform any restorative or cosmetic procedures.

Biomechanical Risk — This has to do with the structural integrity of your teeth. We will look at whether any tooth structure has been lost due to decay, and take steps to reduce your susceptibility to decay if necessary.

Functional Risk — This relates to your bite: how your teeth, muscles and jaw joints are functioning. For example, do you have excessive tooth wear or joint pain? If so, you are at a higher risk in this category and we need to figure out why.

Aesthetic Risk — This is the most subjective of the categories as beauty is in the eye of the beholder. Still, if you display a lot of your teeth and gums when you smile, any issues you have (gum recession, for example) will be that much more visible and affect your smile more. We will have to take this into account when we plan your treatment.

Only when we have determined how best to minimize your risk in all four of these categories can we restore or enhance your smile in a way that will not only look great but also last as long as possible.

If you have any questions about cosmetic or restorative dental treatment, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Successful Dental Treatment: Getting the Best Possible Results.”


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By Edward Joseph, D.D.S.
March 12, 2014
Category: Oral Health
Tags: oral health   dry mouth  
DryMouthFAQs

Dry mouth is a condition that many of us have experienced at some point in life. However, for some people it is a problem that can wreak havoc on their lives. This is why we have put together this list of questions we are most frequently asked about dry mouth.

What is dry mouth?
The medical term for dry mouth is “xerostomia” (“xero” – dry; “stomia” – mouth) and it affects millions of people in the US alone. It is caused by an insufficient flow of saliva, the liquid produced by the salivary glands. These glands are located in the inside cheeks of the mouth by the back top molars and in the floor (under the tongue) of the mouth. When functioning properly, they produce two to four pints of liquid every 24 hours.

Can drugs contribute to dry mouth?
Yes, both prescription and over-the-counter (OTC) drugs can cause dry mouth. This is one reason we so often find it in senior citizens, as they are typically on more medications than younger, healthier people.

What about diseases...can they cause dry mouth?
Certain systemic (general body) and autoimmune (“auto” – self; “immune” – resistance system) diseases, in which the body reacts against its own tissue, can cause dry mouth. Other diseases that can be the culprit include: diabetes, Parkinson's disease, cystic fibrosis, and AIDS (Acquired Immune Deficiency Syndrome). Radiation and chemotherapy used to treat head and neck cancers can inflame, damage or destroy the salivary glands—thus causing dry mouth.

Are there any remedies for dry mouth?
Yes! If medication is the primary cause of your dry mouth, there may be other, similar drugs that can be substituted that do not produce the same side effect. If you feel this describes your situation, discuss your concerns with the prescribing physician. Another option is taking an OTC or prescription saliva stimulant to temporarily relieve the dryness. Or, you can suck on a candy made with xylitol, a natural sugar substitute, four to five times a day. Xylitol has been shown to help stimulate the production of saliva with the added benefit of reducing the odds of getting cavities.

To learn more on this subject, continue reading the Dear Doctor magazine article “Dry Mouth.” You can also contact us today with any questions or to schedule an appointment.


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By Edward Joseph, D.D.S.
March 04, 2014
Category: Oral Health
Top5SymptomsofGumDisease

Do you have gum disease? According to the U.S. Centers for Disease Control, about half of the adults in America have a mild, moderate or severe form of this disease. But if you’re 65 or older, your chance of having it goes up to 70 percent! Periodontal (gum) disease is sometimes called a “silent malady” because major symptoms may not appear until it has reached an advanced stage. How can you recognize the early warning signs? Here are some clues to look for:

  1. Redness and irritation of gums. Having red, swollen or sore gums can be a sign of gum disease; however, it could also result from brushing your teeth too vigorously, or using a brush with hard bristles. That’s why we recommend using a soft-bristled brush and a gentle cleaning stroke. If you’re doing this but you still have irritated gums, it could be an early signal of gum disease.
  2. Bleeding when you brush. Despite what you may think, this is never a normal occurrence. If your gums regularly bleed after brushing, it’s usually an indication that gum disease is present. You should come in for an examination as soon as possible.
  3. Bad breath or a bad taste in your mouth. Bad breath or unpleasant tastes could be caused by what you ate last night — or they could result from gum disease. If the odor or taste is persistent — that is, if it doesn’t seem to go away over time — it could indicate a problem with your gums.
  4. Gum recession. When you have gum recession, the healthy, pink tissue surrounding the teeth begins to pull back, or recede. This exposes more of the tooth’s structure — even its roots — and makes teeth look longer. While gum recession is a common condition that is primarily caused by periodontal disease, many people don’t realize they have it because it occurs so gradually. They also may not realize that by the time it is noticed, some underlying bone tissue has already been lost. Gum recession is a condition you shouldn’t ignore: If left untreated, it can result in the destruction of more gum and bone tissue, and even tooth loss.
  5. Tooth Sensitivity or pain when chewing. Many things can cause tooth pain or sensitivity: an old filling, tooth decay, even a cracked tooth or a root canal problem. Gum disease can also cause this unpleasant sensation. Receding gums may expose the tooth’s roots, which aren’t as well protected from the mouth’s harsh environment as the chewing surfaces; this may cause a sensation of pain when chewing or brushing. If this sensation persists, it’s time for an examination to find out what’s causing it.

Gum disease is a widespread problem — but it’s also very treatable. If you would like more information, call our office to arrange a consultation. You can learn more in the Dear Doctor magazine articles “Warning Signs of Periodontal (Gum) Disease” and “Understanding Gum (Periodontal) Disease.”


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Burbank, CA Dentist
Edward C. Joseph, D.D.S.
2701 West Alameda Ave, Suite #403
Burbank, CA 91505
(818) 842-7628

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