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Page 2 | The Practice SF Blog | News and perspective on periodontal healthcare and implant dentistry
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You’ve got your dental implant. To get home free, you have to be a Giant of maintenance.

We couldn’t resist.  We’re proud of our San Francisco Giants and we just had to work them into a blog post.

But we’re writing about something serious today:  how to preserve your beautiful new dental implant for life.  For many people, this means changing the bad habits that got you to a dental implant in the first place.

Here are the three things you must do to maintain your smile.

1     Remember that your implants look like teeth but they’re not.  Dental implants are made of titanium.  You’ll never get a cavity, but you could still get gum disease.  You have to brush and you have to floss.

2     Remember what your periodontist taught you about flossing around the implant:  go up under the gum and clean that pocket between the tooth and the gum.  Your gum does not attached to the implant, so how you care for it is different from your other teeth.  (With those, you just floss up to the gum line, not under it.)

3     Remember to pay attention to the little things, like bleeding when you brush and floss, a dull ache or soreness around the implant, or a bad odor or taste.  Visit your dentist immediately – you could be developing peri-implantitis, periodontal disease specific to the implant.

These three things are essential to protecting your investment in your dental implants – and keep you batting 1000 with that smile.

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Mayo Clinic Health Manager — a new trend in healthcare

Mayo Clinic has just released a web-based tool for tracking all the information associated with your healthcare.  Mayo Clinic Health Manager also enables you to upload all your family’s data.   Because it uses Microsoft as an “engine,” a signup there is required as well.  No sign of dental record keeping — that would be a nice feature.  Take a look at it here.  We’re interested in what you think of this.  Let us know.

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Join us on Facebook

We are posting links to articles about research and oral healthcare issues on our Facebook page, where we’re looking forward to questions and discussions about implants, surgery and hygiene.  Let us know what’s on your mind.  Whether or not you’re in San Francisco, we are happy to share our knowledge of periodontal healthcare with patients and other practitioners alike.

See you on Facebook!

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Periodontal surgery and your heart

There’s a new study that points to the risk of a heart episode during invasive dental treatment, such as periodontal surgery (operating on the gums).  It’s really important to read beyond the headlines and sound bites.

As Liam Smeeth, the study’s researcher, pointed out, the risk is small.  “Overall, the study provides more evidence that inflammation and infection may be triggers for cardiovascular events.  I’m pretty certain that the long-term treatment is far more beneficial for people than this very small increase (in risk) that we see just after the treatment.”

Overall, we can distill expert opinion on cardiovascular implications into one key conclusion:  it’s periodontal disease, not the surgery to treat it, that is linked to cardiovascular problems.

●     Periodontitis can be one of the key risk factors in the onset of cardiovascular disease.  Several studies have reported that periodontal bacteria in cardiovascular specimens were detected frequently.

●     The direct  association between oral disease and atherogenesis (the degeneration of the arteries) is still being studied; more work has to be done to confirm that oral disease is a direct cause of atherogenesis.

●     What we do know:  whether or not periodontal disease directly causes cardiovascular disease, when we treat periodontal issues, we reduce inflammation and its burdens – thus improving overall systemic health.  The negative environmental factors, like lack of good oral hygiene, that exacerbate periodontal issues relate directly to the inflammation that aggravates cardiovascular problems.

Chronic periodontal disease is widespread in the general population, and a significant proportion of adults suffer from the most severe form of the disease.  The more we treat it, the better chance we have of preserving our overall health.

That’s a sound bite we should remember.

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The questions to ask your dentist during your biannual checkups

We’re assuming that you are among the millions of people who go to the dentist every six months, without fail, for an exam.  (If you’re not, continue reading.  This should convince you to join the ranks of the regularly-examined.)

You take the time and make the effort to get poked and prodded by your dentist twice a year to make sure you do not have a problem with your teeth — and  to make sure you’re not displaying signs of periodontal disease.   Your dentist or the hygienist should probe your gums during your checkup, looking for some basic signs.  We’ve listed them below with the questions you can ask to ensure that your dentist is detecting a periodontal problem as early as possible.  If you do show symptoms, your dentist should recommend that you begin treatment right away.  With a periodontist.
  • Deep space between teeth and gums.  Ask:  Has the level of the tissue and bone around my teeth changed?  Are the pockets (where the gum attaches to the tooth) normal or are they getting larger?
  • Receding gums.  Ask: Are my roots showing? Do I have strong gum around my teeth?
  • Worn edges.  Ask:  Does it look like I’m grinding my teeth?
  • Diseased gums.  Ask:  Are my gums the right color, texture, size and shape?  Have they changed since my last exam?  Did they bleed during the exam?
  • Too much plaque.  If you’re brushing twice and flossing once daily, ask:  what’s causing the plaque?  (If you’re not practicing oral hygiene, that’s probably the reason you have too much plaque.)
  • Loose teeth.  Ask:  could the looseness be caused by periodontal disease? Am I griding or clenching?  If you already have missing teeth, ask:  do my missing teeth contribute to make the remaining teeth loose?
  • Abscesses in the mouth.  Ask:  Do I have an infection?
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Periodontal disease is more prevalent than originally estimated

Last month, the Journal of Dental Research reported that research conducted by the Centers for Disease Control (CDC) and the American Academy of Periodontology (AAP) indicates that there are 50 percent more cases of periodontal disease than originally estimated.  Click to read the press release.

The best way to avoid becoming a periodontal statistic is to make sure you’re doing an outstanding job in the oral hygiene department.  This means brushing and flossing, of course, but also visiting your dentist every six months.

Your relationship with your dentist is key to catching any signs of periodontal disease early.  In the next post, we’ll cover what you should expect from your dentist in the way of examination and counsel – and what to do if you’re not getting it.

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The five most-asked questions about periodontal disease, Part 5

Dr. Guglielmoni answers the five questions about periodontal disease The Practice SF hears most frequently.

Number 5:  How do I avoid periodontal disease?

First, one thing has not changed in dentistry for decades, and that is the prescription for oral health:  brush your teeth at least twice daily and floss them at least once daily.  This is also the prescription for avoiding periodontal disease.

Second, we recommend visiting your dentist every six months.  He or she not only will be more familiar with your oral health and general systemic health, which are factors in causing the plaque that leads to periodontal disease, your dentist can detect a periodontal threat earlier.  Your dentist may recommend more than one cleaning every six months; he or she may suggest a cleaning every three months.

Third, we recommend a well-balanced diet of foods that boost your immune system.  Avoid snacking on processed sugars every day – they contribute greatly to the formation of plaque.

Finally, don’t begin smoking, and if you do, quit.  Recent research shows that smoking increases the risk of periodontal disease seven-fold.

To view Part 1, click here.  To view Part 2, click here.  To view Part 3, click here.  To view Part 4, click here.

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The five most-asked questions about periodontal disease, Part 4

Dr. Guglielmoni answers the five questions about periodontal disease The Practice SF hears most frequently.

Number 4:  Why is a dental implant the best solution for the tooth I lost to periodontal disease?

If periodontal disease has caused the loss of a tooth, the best option is generally a replacement via a dental implant.  A periodontist can determine if a dental implant is appropriate for your situation.  (To learn more about the differences between a dental implant and older forms of tooth replacement – like bridges and dentures – visit this section of our website.)

Factors affecting the dental implant option include your general health and the health of the supporting tissues – bone and gums – where the implant will go.  A periodontist determines whether your bone and gum are in a condition that will ensure the success of the implant, including how it will look.

In cases where periodontal disease caused the loss of a tooth, a periodontist focuses on restoring the supporting tissues to health before inserting a dental implant.  Afterwards, the periodontist helps to maintain the health of the tissues so that the longevity of the implant is protected.

Coming up next:  How do I avoid periodontal disease?  To view Part 1, click here.  To view Part 2, click here.  To view Part 3, click here.

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The five most-asked questions about periodontal disease, Part 3

Dr. Guglielmoni answers the five questions about periodontal disease The Practice SF hears most frequently.

Number 3:  Why do I need a periodontist to treat periodontal disease?

Dentistry is like any other branch of medicine.  You have general practitioners, and you have specialists.

A periodontist is a dentist who specializes in the prevention, diagnosis and treatment of periodontal disease. Periodontists receive extensive training in these areas, including three additional years of education beyond dental school. Periodontists are familiar with the latest techniques for diagnosing and treating periodontal disease.

In the same way  your family physician handles your systemic health, referring you to specialists as needed, your general dentist acts as the conductor of your oral healthcare orchestra.  He or she knows when you have a situation that requires treatment by a specialist.  When you show symptoms of periodontal disease, the specialist to see is a periodontist.

Coming up next:  Why is a dental implant the best solution for the tooth I lost to periodontal disease?  To view Part 1, click here.  To view Part 2, click here.

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The five most-asked questions about periodontal disease, Part 2

Dr. Guglielmoni answers the five questions about periodontal disease The Practice SF hears most frequently.

Number 2:  Can periodontal disease go away on its own?

One of the first questions that is likely to cross your mind when you receive a periodontal disease diagnosis is, “will periodontal disease go away?”.  The answer:  not a chance.

Periodontal disease requires treatment. As the most common dental problem among adults, untreated periodontal disease will cause loose teeth, receding gums, and potentially, tooth loss.

Fortunately, there are periodontal disease cures that have proven to be very successful. But you must undergo treatment.  After an initial consultation with your periodontist, you’ll receive a detailed treatment plan to treat your condition, to reestablish oral health, to replace missing or hopeless teeth, and to maintain periodontal health.

Coming up next:  Why do I need a periodontist to treat periodontal disease?  To view Part 1, click here.

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