What Occurs During A Dental Examination

What Occurs During A Dental Examination

During a dental examination, the dentist examines the soft tissues of the mouth for any abnormalities or pathology (including oral cancer), the teeth for tooth decay or defects, the gum tissues for periodontal (gum) disease, the neck for swollen lymph nodes, the amount of plaque, tartar, and debris on teeth, as well as the need to replace any missing teeth or dental prostheses. Regular examinations by a dentistry professional are crucial to maintaining your dental health and are a necessity in any dental care plan.

Dentists begin the dental examination with a complete dental and medical history, including medications the patient is currently taking. The skin of the face and neck is examined for any abnormalities, especially pigment changes. The lymph nodes in front and behind the ears, under the floor of the mouth and chin, and the midline of the neck, sides, and back of the neck are palpated to determine if any swelling or tenderness is present.

Inside of the mouth, the lips, cheeks, gums, and roof of the mouth are inspected and palpated. During this process, the tip of the tongue is placed on the roof of the mouth just behind the upper teeth for inspection of the front floor of the mouth and sides of the tongue.

The back floor of the mouth, the area behind the lower wisdom teeth, and the back sides of the tongue are inspected by grasping the tip of the tongue with a small gauze sponge and pulling the tongue forward and toward the opposite side of the mouth.

To inspect the back of the throat, soft palate, and tonsil area (sides of the throat), the tongue is depressed with a dental mirror or tongue blade and then a deep breath is taken by the patient.

To detect swelling on the floor of the mouth, the area inside the mouth is felt with the finger of one hand while a finger of the other hand feels below the chin. Salivary gland enlargement, saliva flow, or xerostomia (dry mouth) are determined by milking the major salivary glands to assess the quantity and consistency of saliva.

Today's dentist has many analytic tools available to pinpoint dental and oral diseases. The basic tools are the dental instruments, lights, and radiographs (X-rays). Depending upon the dentist and the individual's dentistry needs, additional diagnostic tests are available. Testing for essential proteins and buffering capacity can evaluate the protective ability of saliva.

To determine tooth decay risks, microbiological testing of saliva can measure the level of decay-producing organisms. Periodontal susceptibility tests, which test for the DNA of gum disease-producing organisms, can be performed to assess an individual's risk for gum disease.

If removable dentures are present, dentists check them for bite, retention, stability, and overall fit. Dental impressions or models also may be taken to study the mouth and tooth structures to initiate fabrication of prostheses. Photographs may be exposed for a variety of reasons, including before and after treatment comparisons.

The level of oral hygiene and home dental care practices are assessed and reviewed. Recommendations for home care devices and products may be made. Instruction and methods for maintaining a good oral hygiene regimen can also take place.

Once basic information about dental health status is gathered, the dentist will be better able to discuss dental care plans that are available.


DR. GARY SIGAFOOS
LaJolla Periodontics
www.lajollaperiodontics.com

Follow @GarySigafoos on Twitter and do a “Like” at LajollaGumDiseaseCare Fanpage. If you're looking for an experienced periodontist to care for gingivitis and periodontial disease in La Jolla, contact Dr. Sigafoos,(858) 568-8941.

Dental Procedure, Pocket Depth Reduction

Dental Procedure, Pocket Depth Reduction

As the bacteria that cause periodontal disease (see article "Periodontics 101") release toxic substances, they trigger the breakdown of gum and bone. The gum then separates from the teeth, forming gaps that are called periodontal pockets. Bacteria settle in these pockets and because they cannot be removed by the patient's daily oral hygiene, they continue to accumulate and reproduce. Without proper treatment, the bacteria will continue to populate these pockets, creating further gum and bone destruction.

The first step in the treatment of periodontal disease involves the removal of the bacteria that inhabit the periodontal pockets in the form of plaque and tartar. The removal of the pocket irritants, scaling and root planing (see article "Scaling and Root Planing"), is combined with oral hygiene instructions that are aimed at improving the patient's ability to control plaque and avoid bacteria from reinfecting the periodontal pockets. Several weeks after completion of scaling and root planing, a periodontal re-evaluation should be completed to assess the healing response. If the periodontal pockets do not reduce to below 4 mm and the gums are still unhealthy, surgical treatment may be indicated.

Pocket depth reduction is a term used for a series of different surgical procedures (gingivectomy, flap surgery, osseous surgery). The purpose of these procedures is to gain access to the root surface to effectively remove calculus and to reduce the size of the pockets to help prevent bacteria from settling in.

What to Expect

Pocket depth reduction is done in the dentist's office with local anesthesia (lidocaine). After lifting the gum back, the bacterial plaque and tartar are removed from the root surfaces. It also may be necessary to remove the infected gum tissue and to smooth the bone surface. Stitches (sutures) are placed to aid in healing. The stitches are usually removed five to ten days after the surgery. Follow-up appointments are scheduled as necessary to evaluate healing and plaque control.

Post-surgical discomfort may last a few days and is usually minimal. It can be easily managed with commonly available over-the-counter medications such as aspirin, acetaminophen, or ibuprofen. Patients can expect to follow their normal routine the day after surgery. A dentist will provide special instructions related to diet, exercise, and medications.

After pocket depth reduction, patients may experience heightened tooth sensitivity. This is temporary and usually resolves within a few weeks. There are chemical aids available that help reduce sensitivity.

Some people also may experience looser teeth after periodontal surgery. This also is a transient finding that occurs as part of the normal healing process. With proper plaque control and bite adjustment, the teeth usually tighten up in a few weeks.

Another concern after pocket depth reduction is that the teeth may appear longer and that there are spaces in between the teeth. Actually, longer teeth are the result of periodontal disease, not of periodontal surgery. As periodontal disease infects and destroys the bone that encases the roots, the root surfaces become exposed. They do not appear exposed because they are covered by the inflamed, swollen gums that form the periodontal pocket. Without proper treatment, the periodontal pockets continue to deepen, giving way to more infection, bone loss, and eventually tooth loss and systemic complications.

There are treatments that can help improve esthetics after periodontal treatment. In addition to periodontal plastic surgery procedures, orthodontic tooth movement (braces) or restorative treatment (crown and bridges) can help create a more pleasing smile line.

Benefits

If periodontal pockets do not resolve after scaling and root planing, a dentist may recommend pocket depth reduction. Whether a dentist performs a gingivectomy, periodontal flap surgery, or osseous surgery, the patient will benefit from the reduction in pocket depth and the reattachment of the gums to the root surface. Pocket depth reduction, when followed by supportive periodontal treatment, is a predictable procedure that can help keep teeth healthy and reduce the risk of serious health problems related to periodontal disease. If a general dentist does not frequently do surgeries, he or she may refer the individual to a periodontist that specializes in this technique.

DR. GARY SIGAFOOS

LaJolla Periodontics

www.lajollaperiodontics.com

Follow @GarySigafoos on Twitter and do a “Like” at LajollaGumDiseaseCare Fanpage. If you're looking for an experienced periodontist to care for gingivitis and periodontial disease in La Jolla, contact Dr. Sigafoos,(858) 568-8941.

How To Beat Bad Breath With A Cheap, Delicious Snack You Probably Have In Your Fridge Right Now (It's NOT What You Think!)

How To Beat Bad Breath With A Cheap, Delicious Snack You Probably Have In Your Fridge Right Now
(It's NOT What You Think!)

By Tomas Caomhanach

In a study detailed at the 83rd General Session of the International Association for Dental Research, Dr. Kenichi Hojo of Tsurumi University in Yokohama, Japan, found that sugarless yogurt significantly reduced the levels of oral hydrogen sulfide (which smells like rotten eggs, and is one of the main components of bad breath) in 80% of participants.

The 24 volunteers who partook in the study followed strict instructions on oral hygiene, diet and medication intake. The participants first avoided all yogurts for 2 weeks and then had samples of VSCs taken from their mouths. They then ate 90-grams (about 3 ounces) of sugarless yogurt twice-a-day for 6-weeks.

At the end of the study, more samples were taken and a significant reduction in hydrogen sulfide levels was discovered in 80% of participants.

It was postulated that active bacteria in the yogurt, specifically Lactobacillus bulgaricus and Streptococcus thermophilus effectively drowned-out the bacteria responsible for producing the hydrogen sulfide.

While that doesn’t effectively address the root cause of bad breath, it does show fighting bad breath doesn’t have to be unpleasant. After all, what could be more pleasant than a pot of tasty yogurt every day!?

To apply findings of this study, simply eat about 3-ounces of sugar-free yogurt containing live

cultures of Lactobacillus bulgaricus and Streptococcus thermopholis (check the labels) every day.

The Bad Breath Report
Scientifically-Proven Method To
Cure bad breath At Home
www.TheBadBreathReport.com

 

DR. GARY SIGAFOOS

LaJolla Periodontics
http://www.lajollaperiodontics.com/

FAQs on Dentures, Seniors Dentistry and Woman's Oral Health Needs

FAQs on Dentures, Seniors Dentistry and Woman's Oral Health Needs

Q. How do you clean your dentures?

A. In cleaning your dentures you should first rinse away loose food particles thoroughly. Then moisten your toothbrush and apply denture cleanser. Brush every surface, scrubbing gently to avoid damage.

Q. Why do your teeth seem darker as you age?

A. Your teeth may seem darker because plaque can build up faster and in larger amounts as you age. Changes in dentin can cause your teeth to appear a little darker as well.

Q. Why does your mouth seem dry?

A. Dry mouth is a common problem among seniors. It is caused by certain medical disorders and is often a side effect of some medications.

Q. Are seniors more susceptible to gum disease?

A. Yes. The severity of gum disease may be increased due to ill-fitting dentures or bridges, poor diets, poor oral hygiene, other medical diseases, and even some medications.

Q. Why do seniors lose their sense of taste?

A. Seniors tend to lose their sense of taste because age decreases the sense of taste and smell. Certain diseases, medications and dentures can also contribute to the decrease of your sense of taste.

Q. Should seniors be worried about cavities?

A. Yes. The majorities of seniors have tooth-root decay and are more susceptible to cavities.

Q. Why should women be more careful with their oral health?

A.For many women, dental care depends on their different stages of life that are directly related to surges in sex hormone levels. Your dentist may request to see you more frequently during hormonal surges.

Q. How do oral contraceptives affect women’s oral health?

Gingivitis may occur with long-term use of oral contraceptives because they contain estrogen or progesterone. Women who use oral contraceptives are two times as likely to develop dry sockets and require dental care more often.

Q. How does pregnancy affect oral health?

A. There is an increase in the amount of plaque on your teeth due to pregnancy because there is an increase in estrogen and progesterone.

Q. How does morning sickness affect oral health?

A. The acid in vomit causes tooth erosion. Women can neutralize the acid by using a baking soda and water paste and rubbing it on their teeth. Rinse the paste off after 30 seconds and then brush and floss.

Q. What is the likeliness of having tumors during pregnancy?

A. Women are at risk for developing pregnancy tumors that are benign growths that develop when swollen gums become irritated. The tumors usually shrink soon after the pregnancy is over.

Q. How does plaque build-up affect pregnant women?

A. If plaque is not removed it can cause gingivitis and women with periodontal disease may be at risk for pre-term, low-birth weight babies.

Q. What problems occur for girls experiencing puberty?

A. The surge in hormones that occurs during puberty may cause swollen gums, especially during menstruation. Herpes-type lesions and ulcers can also develop. They may also experience sensitive gums that react more to irritants.

Q. What are intraoral cameras?

A. An intraoral camera is a miniature video camera that the dentist places in the patient’s mouth so that together they can view any dental problems that the patient is having. The image from the camera is enlarged and sent to a monitor for viewing.

Q. What is the purpose of intraoral cameras?

A. The purpose behind intraoral cameras is to allow the patient to see the specific area that needs treatment so that they are more likely to understand the dentist’s recommendation and accept it.

Q. How can CD-ROM be beneficial in dentistry?

A. CD-ROM is beneficial in dentistry because patient education will be much simpler with information stored on CD-ROM. Procedures can be explained to patients in advance and post-operative instructions can be provided for them to take home.

DR. GARY SIGAFOOS

LaJolla Periodontics

www.lajollaperiodontics.com

Follow @GarySigafoos on Twitter and do a “Like” at LajollaGumDiseaseCare Fanpage. If you're looking for an experienced periodontist to care for gingivitis and periodontial disease in La Jolla, contact Dr. Sigafoos,(858) 568-8941.

5 Quick & Easy Bad Breath Tests You Can Do Right Now... As You're Reading This!

5 Quick & Easy Bad Breath Tests You Can Do Right Now... As You're Reading This!

By Tomas Caomhanach

Unfortunately (or, perhaps, fortunately!), you can't smell your own bad breath. Even if you cup your hand over your mouth and nose, and take a sniff right after you breath out, you're really only smelling your own hand, not your breath.

That's because, despite the fact that bad breath contains all kinds of nasty stuff that would make you wretch if it came from someone else, the problem usually develops so slowly and so gradually that you simply become used to the smell from yourself. Your body becomes so acclimatized to the specific concentrations of nasty stuff in your bad breath, that you simply don't notice it anymore!

That's not true for other people though! They absolutely notice it. Even if they have bad breath themselves, their body is only acclimatized to the specific concentrations of nasty smells they themselves emit - not the stuff you exude! In most cases, people only become aware of having a bad breath problem by the reactions of those around them. If you notice people suddenly stepping back when you come near, it's a good indicator that something is wrong.

That's a pretty embarrassing way to find out though. So, if you think you have bad breath, but don't want to go around asking people if you can breathe on them to find out for sure, you might be interested in some simple bad breath tests you can do right now...

1. The Hand Test:

Probably the easiest and best-known way is to simply lick the back of your hand, and let it dry for 5 or 10 seconds. Then sniff it. This works because you've transferred some of the 'stuff' that makes your breath smell on to your hand, while removing your actual breath (which you can't smell) from the equation.

2. The Gauze Test:

You could also wipe your tongue with a large piece of gauze or cotton wool, and let that dry in the same way as above. This works for the same reason (as licking your hand) but has the added advantage of allowing you to check for a yellowish stain on it. If you notice that, it's a very strong indicator of a bad breath problem.

3. The Spoon Test:

Take a regular spoon from your kitchen, turn it upside down, and gently scrape it along the surface of your tongue. Again, let it dry and smell it. This also works for the same reason as above.

4. The Floss Test:

You can also take a piece of dental floss (or dental tape) and run it between some of your back teeth. Let that dry too, and then smell it. Although, in virtually all cases, the (bad breath) problem doesn't actually originate from the teeth, there is still enough 'stuff' that produces the bad smell between them to give a good indication of a problem. This method will also give you an idea of what your bad breath smells like to other people.

5. The Mirror Test:

Look into a mirror, and stick your tongue out as far as you can. Does your tongue have a white coating on it? The intensity of this coating will give a reasonably good idea of the intensity of your bad breath. Also, in general, the farther back (towards your throat) that white coating extends, the worse the problem.

Also, another good indicator of a bad breath problem is if different foods and drinks (like dairy foods, alcohol, soda, and sugar) affect your taste. This includes alcohol-based mouthwash.

It's possible to undergo a very accurate scientific test at a specialist bad breath clinic too. There, doctors will use special instruments, such as a 'Halimeter', to examine and classify the chemical compounds present in your breath. However, these will cost you several hundred (and, in some cases, several thousand) dollars, and are unlikely to be covered by any health or dental insurance plans. They also have other drawbacks too: Certain foods such as garlic and onions produce sulfur in the breath for as long as 48 hours and can result in false readings. The instruments are also very sensitive to alcoholic drinks, so much so that even using alcohol-bases mouthwashes will give inaccurate results. They also lose sensitivity over time anyway, and require periodic recalibration to remain accurate.

While all of the above are excellent ways to test for bad breath, the simple truth is, if you think you have bad breath, then you probably do: As mentioned earlier, most people become aware of the problem by the reaction of those around them. Humans are highly social animals and, as such, can detect a negative reaction in another person from a mile away (even if, as is the case with bad breath, that reaction is involuntary). If people turn away... step back... and cover their nose and mouth when you're near them, then the above tests probably aren't even necessary... you can make a pretty safe assumption that you do have a problem!

The Bad Breath Report
Scientifically-Proven Method To
Cure Bad Breath At Home
www.TheBadBreathReport.com

 

DR. GARY SIGAFOOS

LaJolla Periodontics
http://www.lajollaperiodontics.com/

Self-Care Toothbrush Tips for Special Needs

Self-Care Toothbrush Tips for Special Needs

Maintaining good oral hygiene can be a challenge, especially if you have developed a health condition that makes brushing and flossing more difficult, or have been in an accident that created new limitations. Dental professionals want to help all dental patients keep their mouths healthy, and they offer these suggestions about oral hygiene.

Dental Brushing Tips

Problems in hands, wrists, arms, and shoulders can hinder a person's ability to brush and floss. While each situation is different, there are some suggestions that have been effective in making dental care easier:

• Use a wide elastic band to attach the toothbrush to your hand for extra gripping power.
• Attach a small rubber ball, a sponge, or a rubber grip to the toothbrush handle with strong tape. This enhances gripping power and is often useful when hand or arm movement is weakened or limited.
• Use a longer wooden dowel, a ruler, or plastic rod to lengthen the toothbrush handle, wrapping it securely with strong tape. This longer length may help in more easily reaching your mouth.
• Use an electric or sonic toothbrush.

Dental Flossing Tips

If limitations make brushing and oral hygiene harder, flossing may be an even bigger challenge. Depending on your limitations, try these techniques:

• Use a piece of floss, about 18" long, and wind one end of floss around each finger instead of holding it. This will increase your grip and prevent the floss from dropping out of your fingers with each tooth you floss.
• Hold the floss tightly and seesaw it back and forth between the teeth, instead of pushing the floss right through.
• Tie the floss into a long circle instead of using one long piece, which may make it easier to hold and less likely to drop from your hands.
• Try using a floss holder, available wherever oral hygiene products are sold.

DR. GARY SIGAFOOS

LaJolla Periodontics

www.lajollaperiodontics.com

Follow @GarySigafoos on Twitter and do a “Like” at LajollaGumDiseaseCare Fanpage. If you're looking for an experienced periodontist to care for gingivitis and periodontial disease in La Jolla, contact Dr. Sigafoos,(858) 568-8941.

Who To See When Thinking About Getting Dental Implants

Who To See When Thinking About Getting Dental Implants

If dental implants are what you need to replace your missing teeth, you should select an implant dentist with in-depth knowledge of, and prior experience with all aspects of the treatment. It is important to know that treatment with tooth implants consists of two components: a surgical phase and a restorative phase.

Traditionally, a dental surgeon, like an oral surgeon or a periodontist, performs the surgical component. A general dentist, or prosthodontist and laboratory technician, performs the restorative component.

As dental implant dentistry has become more sophisticated, the restorative dentist, at times, also has become the one that places the dental implants. However, each clinician involved in implant treatment must be aware that the type of final restoration a patient wants dictates the position, size, and number of the tooth implants within the jaws.

What Types of Dental Implants Are There?

For each unique missing tooth situation, there is an equally unique way to use dental implants for tooth replacement. However, all of the treatments can be placed in two categories: removable or fixed prostheses.

Implant dentists use removable implant dentures when a patient is missing all of their teeth. Fewer tooth implants are necessary when used in conjunction with a removable denture.

Conversely, more dental implants are necessary when used in conjunction with a fixed bridge. Fixed bridges feel most like your natural teeth and are usually more desirable than removable dentures.

Mastering new surgical and restorative techniques as they are developed is the mark of an excellent tooth implant dentist as well as overall implant dentistry. An implant dentist's meticulous attention to fine detail conveys a feeling of confidence to the patient. The dentist should be committed to restoring full function to the missing teeth as well as recreating natural-looking teeth. These are the qualities a patient should look for in an implant dentist.

DR. GARY SIGAFOOS

LaJolla Periodontics

www.lajollaperiodontics.com

Follow @GarySigafoos on Twitter and do a “Like” at LajollaGumDiseaseCare Fanpage. If you're looking for an experienced periodontist to care for gingivitis and periodontial disease in La Jolla, contact Dr. Sigafoos,(858) 568-8941.