My Blog

Posts for: September, 2014

By Dr. James Merlo and Dr. Mary A. Merlo-Murison
September 23, 2014
Category: Oral Health
Tags: gum disease  
RemovingBacterialPlaqueisCriticaltoHaltingAdvancingGumDisease

Treating periodontal (gum) disease is rather straightforward: remove the bacterial plaque that causes the disease. The techniques to accomplish this are varied, depending on how far the disease has advanced with an individual patient.

Plaque is a thin film of bacteria and food particles that build up on tooth surfaces due to inadequate oral hygiene. The bacteria that grow there can cause an infection that inflames and damages the gum and supporting bone tissues to the point they begin to lose their attachment to the teeth and form spaces known as periodontal pockets. In time, plaque becomes calcified due to the minerals in saliva, forming calculus or tartar. As the disease advances, it can ultimately cause tooth loss.

The most common technique for interrupting this progression of disease is known as scaling. Using hand instruments and/or an ultrasonic device, we remove as much plaque and calculus as we can detect on the outer surfaces of the teeth and gum tissues. Scaling, however, won’t address the plaque and calculus that has accumulated at the tooth root level, especially where pocket formation has taken place. This is where root planing may be necessary.

As the name implies, we use this procedure to literally “plane” plaque and calculus from the roots, a similar concept to removing thin layers of wood from a board. If necessary, we will first numb the affected area so that we can perform the procedure in a meticulous manner without causing discomfort. It’s essential we remove every bit of plaque and calculus that we can, especially where it has become lodged deep at the base of the pockets.

It’s common to start with ultrasonic therapy, using vibration to loosen the plaque while flushing the pockets with water. We then switch to delicate hand instruments known as curettes to physically remove any remaining plaque and calculus. An experienced touch helps us determine when the root surfaces have been properly cleaned; we can also “read the gum tissues,” as they will slightly change color as the offending plaque and calculus deposits are removed. As the gum tissues heal and become less inflamed, they return to a healthy pink color and the pocket depths generally become smaller as the inflammation leaves the area.

While a good portion of the treatment requires our professional skills, equipment and expertise, the bedrock for renewed periodontal health is effective daily oral hygiene on your part. Working together we can preserve the progress already made, while continuing to progress in restoring your oral health.

If you would like more information on root planing and other periodontal disease treatments, 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 “Root Planing.”


By Dr. James Merlo and Dr. Mary A. Merlo-Murison
September 08, 2014
Category: Dental Procedures
ChippedTeethHarmoniouslyMadeGoodasNew

“Break a leg” is a well-known theatrical expression for wishing good luck to an actor about to go on stage. Singers should have one of their own…“Chip a tooth”! Apparently collisions between microphones and pearly whites are an occupational hazard for crooners. Taylor Swift became one of the latest casualties during a concert in Pittsburgh while belting out her hit “I Knew You Were Trouble.” The consummate professional, she didn’t miss a beat and kept on singing despite seeing a tooth chip hit the floor.

After all, while chipping a tooth is an inconvenience, it’s not a permanent smile wrecker. Modern dentistry offers several options for restoring a damaged tooth to its original symmetry and luster, or even better!

Bonding
Dental cosmetic bonding is the quickest and lowest-cost option to repair a chip. This involves application of a composite filling material that is colored and shaped to match the original tooth. Bonding material can be used to replace the lost portion of tooth or to seamlessly reattach the lost portion if it has been preserved and is otherwise undamaged. Little to no removal of existing tooth surface is needed.

Veneers
A veneer can be used for slightly larger areas or discolored teeth. This is a thin, custom-made shell placed on the front of the tooth to give it a new “face.” Some removal of existing tooth surface may be necessary to fit a veneer so it is flush with the surfaces of surrounding intact teeth.

Crowns
When a relatively large portion of the tooth is missing, a crown is often the better choice. It fully encases the visible portion of the remaining tooth above the gum line and is shaped and sized to match the original. It can be made of tooth-colored porcelain fused to metal crowns or all-ceramic (optimal for highly visible areas). A small amount of the existing tooth surface will be removed to allow the crown to fit over it.

If you would like more information about repairing a chipped tooth, 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 “Artistic Repair of Front Teeth With Composite Resin.”