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Patient Resources

Periodontal disease

Our oral cavity is such a important aspect in our overall health. Your mouth is like the gateway for the rest of your body. Everything you consume has to pass those gates; if the gates are in bad condition and diseased, this can lead to other complications in your overall health not just your teeth.

 

 

What is Periodontal Disease?

Periodontal disease (gum disease) is an infection which effects the periodontium (the gums and bones that support the teeth). There are 2 main stages of periodontal disease that you've probably heard about from advertisements on TV commercials or on dental products. If you leave your periodontal disease untreated, it eventually can/will get worst. Once it becomes periodontitis, that will lead to permanent damage to your gums and bone that supports you teeth; eventually you can have tooth loss.

 

Gingivitis is the first stage of periodontal disease. This is the ONLY stage the periodontal disease can be reversed. At this stage, the gums are more inflamed due to the biofilm on the calculus or the plaque. Biofilm is like natures double sided sticky tape. The biofilm attaches to surfaces on your teeth, while the bacteria attaches to the biofilm. Biofilm is not made up of only one type of bacteria, but there are millions and millions types of bacteria in the oral cavity. This bacteria that is on the biofilm releases acids and toxins which causes the irritation and harm to the gums. When you don't brush or floss, the bacteria is basically having party in your mouth at night and multiply. With this irritation occurring, our gums natural response is to become inflamed. Once the gums are inflamed they are more prone to bleeding (this is why it is so common we bleed when we first start flossing). Healthy gums do not bleed upon flossing, this is the first sign that you might have some type of periodontal disease.

 

The second stage is periodontitis; also the stage that is NOT reversible and permanent damage has been done. If the gingivitis is not treated and the disease progresses, this is where the permanent damage starts to occur. Our bodies immune response is to protect the life of the host (us) not to tooth. Since the tooth has the biofilm and bacteria on it, our body tries to get rid of the cause of the problem. The gums start to recede away from the problem area and the bones that support the teeth start to become damaged; that's when you have periodontal pockets and low bone levels. Once bone is loss it is gone and cannot be "regrown" or "remade", it's gone forever. That's why it is so important to keep our teeth clean and healthy, and if you have periodontal disease to get it stabilized before it will lead to worst things down the road.

 

There can be many factors that put some people at a higher risk/more susceptibility.

This can all depend on:

- age

- smoking and tobacco use

- genetics

- stress

- medications

- other systemic diseases

Dental Tooth Decay / Cavities

Tooth decay is the most common dental disease that effects all ages; It can start as young as 2 years old. This is why it is recommended for children to come in as soon as they have their first few teeth. Tooth decay starts off when the superficial layer is disrupted by bacteria. The bacteria releases acids that starts to destroy the tooth starting from the outside and goes inward towards the nerve. The most common types of cavities are the "in-between" cavities which most people get from not flossing. Cavities can also re-occur under old existing fillings.

The enamel is the first layer to be effected. If the cavity is just starting out, the enamel may feel soft and have a chalky appearance (incipient caries) this can be detected by a dental instrument and dental x-rays. As it progresses the area will start to change into a darker appearance. This is when it is more apparent, the instrument will fall into the cavitation and become something we call "sticky". If the cavity gets into the more deeper layers (dentin) this is where it can cause irritation to the nerve. We want to stop the decay in the earliest stages possible, this is why regular check ups are beneficial for detecting diseases at the early stages. Cavities can be fixed using resin material (composite), our dental office uses composites to match the shade of your tooth.

Why do I need a Root Canal and what is it?

In certain cases, when a tooth gets infected through various of ways (cracks, deep cavities etc) the tooth becomes infected and "abscessed". Sometimes trauma as well can cause the tooth to die and discolouration may occur.

When the pulp is infected it will cause tooth pain (sometimes enough to wake you up at night) and this pain can radiate to our jaw, sinuses, lymph nodes or ears. There can be pain when biting down or sensativity to heat, and the tooth can be sensative to cold that it can linger after the source has been removed. There can be an abscess in the area above the tooth that looks like a "pimple" on the gum; that "pimple" can be filled with fluid and pus which can be tender to touch. In most trauma cases the tooth starts to darken in colour in result to the tooth dying. In rare cases there can be no symptoms that show up, but xrays can tell if the area might need a root canal. The root canal treatment itself is treated usually within 2 appointments.

 

The first appointment is opening up the tooth and cleaning out the pulp chamber and removing the nerve. This is done with complete freezing and isolation in the localized area. After the nerve is removed, files are placed to measure the canal lenght (using the machine to confirm where the apex is) as well as xrays to confirm the lenght of each canal (depends how many roots there are). After this, paper points are placed in to dry up the area and prep it for the medicine to be placed in the pulp canal. After the pulp canal is all filled with medicine, a temp material is placed over top which completes the first appointment.

 

The second appointment involves removing the temp material and the medicine. Then we fill the chamber with something called gutta percha. Once that is placed in the chamber a permanent restoration is placed on top. In some cases, some patients down the road are recommended to get crowns; since root canal treated teeth are usually more brittle and susceptible for cracks and fractures later on.

Why do I need an Extraction?

Every extraction is different depending on the person and the situation; people get extractions for many different cases.

1) baby tooth not coming out and there's a tooth underneath growing already

2) baby tooth effecting the growth of neighboring teeth

3) orthodontic treatment

4) decay past the extent of saving the tooth or a root canal (keeping the tooth may cause more harm than trying to save it)

5) decay that has caused a significant infection

6) fractured or broken teeth that cannot be saved

7) wisdom teeth that can effect teeth in front or abnormal eruption of wisdom teeth

8) extraction for dentures or plates (prosthodontics)

Gingivitis
Perio
Tooth decay
Root Canal
Extraction
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