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Periodontal disease is an infection of the tissues that surround and support your teeth. Our team at Jerry Martin, DDS wants you to know that this common ailment can be fixed with little worry if treated properly.

Periodontal disease is usually identified through dental X-rays, probe depths, and visual exams. If left untreated, it can lead to tooth sensitivity, premature tooth loss, or discomfort and pain in your mouth. Some common symptoms to watch for include bleeding or swollen gums, bad breath, teeth movement, or jaw displacement.

Factors that may increase your risk of developing periodontal disease may include poor oral hygiene, smoking/chewing tobacco, genetics, stress, inadequate nutrition, pregnancy, diabetes, and some medications. Some of these causes are avoidable, but others are not.

If you have diabetes, you may be more prone to periodontal disease due to the greater difficulty in controlling blood glucose levels. Studies have shown that once periodontal disease is treated, glucose levels become more responsive to control as well. If your risk for periodontal disease is heightened by one of these factors, make sure to watch for the signs and keep up with your daily oral hygiene routine.

How can you treat this common disease that affects almost half of the population? Depending on the severity, treatment can include a medicated mouth rinse, antibiotic treatment, laser therapy, or scaling and root planing. It’s useful to recall that this condition can vary from mild to severe, which is why you should make an appointment at our Granite Bay office if you notice any of the above symptoms.

Women using medication to treat a variety of medical conditions are often unaware of the potential side effects. One common side effect of medications such as blood pressure medication, birth control pills, antidepressants, and cancer treatments is dry mouth. The technical term for dry mouth is xerostomia.

Xerostomia can lead to undesirable effects in the oral cavity including periodontal disease and a high rate of decay. Many women who have not had a cavity in years will return for their routine exam and suddenly be plagued with a multitude of cavities around crowns and at the gum line, or have active periodontal disease. The only thing that the patient may have changed in the past six months is starting a new medication.

Saliva washes away bacteria and cleans the oral cavity, and when saliva flow is diminished harmful bacteria can flourish in the mouth leading to decay and gum disease. Many medications can reduce the flow of saliva without the patient realizing the side effect. Birth control pills can also lead to a higher risk of inflammation and bleeding gums. Patients undergoing cancer treatments, especially radiation to the head and neck region, are at a greatly heightened risk of oral complications due to the possibility of damage to the saliva glands.

There are many over the counter saliva substitutes and products to temporarily increase saliva production and help manage xerostomia. One great option for a woman with severe dry mouth or high decay rate is home fluoride treatments. These work in a number of ways, including custom fluoride trays that are worn for a short period of time daily at home, a prescription strength fluoride toothpaste, or an over the counter fluoride rinse. If you have more questions on fluoride treatments, make sure to ask Dr. Jerry Martin at your next visit to our office.

The benefits of many of the medications on the market outweigh the risks associated with xerostomia, however, with regular exams you can manage the risk and prevent many oral consequences of medications.

Our teeth are a lot more complicated than they look. Beneath that shiny white surface is an entire system of different cell tissues working together to keep each tooth vital and healthy.

• Enamel, the protective exterior of the crown (the visible part of the tooth), is the strongest substance in the body and the first line of defense against damage to our teeth.
• Dentin, the hard tissue under the enamel and cementum, has microscopic tubules that connect to the pulp.
• Pulp, the tissue at the center of the tooth, contains the nerves, blood vessels, and connective tissue that keep the tooth alive.
• Cementum, composed of connective tissue which forms the protective exterior of the root, also attaches to fibers in the periodontal ligaments which hold the teeth securely in the jaw.

Because cementum is below the gum line, it’s generally safe from the cavity-causing conditions that our enamel is exposed to every day. But there are still potential hazards that we should be aware of.

• Cementum Erosion

With a name like “cementum,” it’s logical to assume that this is the hardest tissue in the body. Actually, however, that distinction goes to our enamel. And if even our enamel can be damaged by bacteria and plaque, cementum doesn’t stand a chance!

How does cementum come in contact with cavity-causing bacteria? Gums often recede as a natural part of the aging process, leaving part of the root exposed. Gum disease, failure to brush and floss regularly, and heavy-handed brushing can lead to early gum recession. The newly exposed cementum is now exposed to the same conditions, which cause cavities in our enamel. But a root cavity can be trickier to treat and, because the cementum is not as strong as enamel, can progress more quickly. And if a cavity reaches the pulp, a root canal could be necessary.

But the erosion of cementum doesn’t have to result in a cavity to cause discomfort. When cementum is removed, the dentin beneath is exposed. Dentin, you’ll recall, contains tiny tubes that connect to the pulp of the tooth. The result? Conditions such as heat, cold, even an intake of air can cause tooth sensitivity as they stimulate the nerves in the pulp. If your hot coffee or ice cream cone is suddenly causing you pain, let us know. There are treatments, which can reduce tooth sensitivity.

• Gum Disease (Periodontitis)

In more severe cases of gum disease, the gums pull away from the teeth leaving pockets, which harbor plaque and bacteria. Left untreated, these pockets can become home to infections, which attack and destroy bone structure and connective tissue. Caught early, a treatment called tooth scaling and planing can help. In this type of deep cleaning, your dentist or endodontist will remove plaque and tartar and then smooth the root surface to make it harder for bacteria and plaque to stick. If the gums have receded too far, a gum graft might be necessary to protect the exposed roots.

• Trauma

The same traumas that can damage teeth above the gum line can result in injuries below it. Chewing on hard objects (ice, hard candies, wooden pencils), bruxism (tooth grinding), and sports injuries or accidents can cause cracks in the cementum. If your root is split or fractured, it might be possible to save your tooth, but sometimes extraction is the best option.

So how do you protect your cementum, hidden as it is under your gum line? The same way you protect the more visible parts of your teeth!

• Keep to a healthy daily routine of brushing and flossing. This will help prevent gum disease and keep gum recession at bay. Using a soft brush and brushing firmly but gently will remove plaque while protecting both enamel and cementum. If you notice tooth sensitivity, give us a call!
• Come in to our Granite Bay office for regular dental exams. The best treatment for gum disease is prevention. When you come in for regular checkups, we are able to discover early signs of gum disease before it becomes a serious problem. If you are suffering from more advanced periodontitis, there are treatments available.
• Safety first when it comes to your smile. If you chew on hard objects, talk to Dr. Jerry Martin about how to break the habit. If you grind your teeth, see us for solutions. If you play sports, let us know—often a mouthguard can help protect your teeth from injuries that could otherwise lead to more complex procedures or even tooth loss.

Maintaining your healthy dental habits is a lot like cementum—the foundation of a beautiful smile. Nothing complicated about that!

A dental crown is often called a “cap.” A dental crown covers all of the visible parts of the tooth and has many functions and reasons for placement.

There are several different types of crowns available at Jerry Martin, DDS. They vary in their material, appearance, and functionality. A PFM, or porcelain fused to high-noble metal, is the most common. A full cast, high noble metal crown is a gold crown, and a stainless-steel crown is meant to be temporary. The most natural-looking crown is one that is all porcelain. These are often used for front teeth.

Getting a crown typically requires two appointments. The first is a preparation with impressions, shaping, and placing a temporary. The impressions are either sent to a dental lab, where the process generally takes two weeks, or done in-office with a machine that can make a crown without needing a second appointment. These crowns are made from a high-quality solid block of porcelain. The shape of the tooth is constructed from a digital 3D image of your tooth.

To accurately determine which type of crown is best, you must first know why you need the crown and in what area of your mouth is it needed, which can be answered when you visit us at Jerry Martin, DDS. For instance, if you have a gold crown on the lower right and need a new crown directly above on the upper right, the best durability and long-lasting relationship is another gold crown.

If you need a crown on a front tooth, a gold crown may not be the best choice. A PFM has strength but is not ideal, as a dark line will appear at the gum line. A full porcelain crown is going to look as close to a natural tooth as possible, but will have less strength than a gold crown.

There are two types of porcelain crowns, depending on how they are made. A dental lab makes a full porcelain crown by baking layer upon layer to make the porcelain look like natural enamel. A full porcelain crown made in-office out of a solid piece of porcelain will have increased strength. However, the natural layered appearance is extremely difficult to achieve.

A crown is placed on a tooth when added strength is needed. Cracks, large broken-down fillings, or previous root canal treatment are all conditions where a crown is the standard care. The type of crown that is most appropriate depends greatly on location.