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Posts for tag: gum disease

By Dr. James Merlo and Dr. Mary A. Merlo-Murison
January 10, 2016
Category: Oral Health
DrTravisStorkDontIgnoreBleedingGums

Are bleeding gums something you should be concerned about? Dear Doctor magazine recently posed that question to Dr. Travis Stork, an emergency room physician and host of the syndicated TV show The Doctors. He answered with two questions of his own: “If you started bleeding from your eyeball, would you seek medical attention?” Needless to say, most everyone would. “So,” he asked, “why is it that when we bleed all the time when we floss that we think it’s no big deal?” As it turns out, that’s an excellent question — and one that’s often misunderstood.

First of all, let’s clarify what we mean by “bleeding all the time.” As many as 90 percent of people occasionally experience bleeding gums when they clean their teeth — particularly if they don’t do it often, or are just starting a flossing routine. But if your gums bleed regularly when you brush or floss, it almost certainly means there’s a problem. Many think bleeding gums is a sign they are brushing too hard; this is possible, but unlikely. It’s much more probable that irritated and bleeding gums are a sign of periodontal (gum) disease.

How common is this malady? According to the U.S. Centers for Disease Control, nearly half of all  Americans over age 30 have mild, moderate or severe gum disease — and that number increases to 70.1 percent for those over 65! Periodontal disease can occur when a bacteria-rich biofilm in the mouth (also called plaque) is allowed to build up on tooth and gum surfaces. Plaque causes the gums to become inflamed, as the immune system responds to the bacteria. Eventually, this can cause gum tissue to pull away from the teeth, forming bacteria-filled “pockets” under the gum surface. If left untreated, it can lead to more serious infection, and even tooth loss.

What should you do if your gums bleed regularly when brushing or flossing? The first step is to come in for a thorough examination. In combination with a regular oral exam (and possibly x-rays or other diagnostic tests), a simple (and painless) instrument called a periodontal probe can be used to determine how far any periodontal disease may have progressed. Armed with this information, we can determine the most effective way to fight the battle against gum disease.

Above all, don’t wait too long to come in for an exam! As Dr. Stork notes, bleeding gums are “a sign that things aren’t quite right.”  If you would like more information about bleeding gums, please contact us or schedule an appointment. You can read more in the Dear Doctor magazine article “Bleeding Gums.” You can read the entire interview with Dr. Travis Stork in Dear Doctor magazine.

By Dr. James Merlo and Dr. Mary A. Merlo-Murison
May 08, 2015
Category: Oral Health
DiabetesandGumDiseaseWhatstheConnection

The increasing rates of obesity and diabetes in Americans have been getting a lot of attention lately. Most people know that the two are clearly linked. But did you know there's also strong evidence of a link between diabetes and gum disease?

Both diabetes and periodontal (gum) disease are chronic inflammatory conditions. That means they are disorders that develop over time (chronic), and are characterized by problems with a function of the immune system (inflammation). In diabetes, problems with the hormone insulin lead to abnormal levels of sugar in the blood. This can bring about a number of complications which, if not treated, may result in kidney failure, coma and even death. In many people, however, it's a condition that can be managed with drugs and lifestyle changes.

You may not think of gum disease (periodontitis) as a serious illness. But here's something you should know: If you have diabetes, having gum disease is a risk factor for worsening control of blood glucose levels, and may also increase the risk of complications. Likewise, having diabetes puts you at greater risk for developing more severe forms of periodontal disease.

What is gum disease? It's actually a group of diseases caused by many types of bacteria in the mouth, which affect the tissues around the teeth. Initially, it often causes swelling and redness of the gum tissue. Left untreated, it may result in bone loss, abscess formation, and ultimately the loss of teeth. But its ill effects aren't limited to your mouth.

Periodontal inflammation is associated with a higher systemic (whole-body) inflammatory state. That means it may increase your risk for cardiovascular diseases like heart attack and stroke, and adverse pregnancy outcomes — as well as complicating the management of blood-sugar levels in diabetics.

Now, here's the good news: Treatment of periodontal disease which reduces inflammation has a beneficial impact on the inflammatory status of the whole body. For people who have both diabetes and periodontal disease, that means that periodontal therapy can lead to improved blood sugar control.

How do you know if you have periodontal disease? Bleeding gums and bad breath are both possible symptoms, as are redness and soreness of the gum tissues. But these warning signs may be masked by any number of other factors — or may not be noticed at all.

The sure-fire way to diagnose and treat periodontal disease is by getting regular dental checkups, followed by specialized periodontal treatment when necessary. If you presently have diabetes, or may be at risk for developing the disease, those check-ups and treatments are even more important.

If you have concerns about diabetes and gum disease, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Diabetes & Periodontal Disease” and “Understanding Gum (Periodontal) Disease.”

By Dr. James Merlo and Dr. Mary A. Merlo-Murison
February 12, 2015
Category: Oral Health
Tags: oral health   gum disease  
PayAttentiontoGumDiseaseWarningSignsforanEarlyDiagnosis

Periodontal (gum) disease is a devastating infection that eventually causes tooth loss if not treated. Plaque removal, antibiotics and possible surgical intervention have proven quite effective in stopping the infection and restoring diseased tissues; however, the more advanced the disease, the more difficult it can be to treat. It’s important then to know the warning signs of gum disease.

Bleeding gums are the most common early sign of gum disease. The infection triggers tissue inflammation, the body’s defensive response to isolate and fight bacteria. As the inflammation becomes chronic, however, it can weaken the gum tissues, which will then bleed easily.

Bleeding, though, is often overlooked as normal, perhaps from brushing too hard. In actuality, bleeding gums is not normal: if your gums routinely bleed during normal brushing and flossing, you should contact us for an examination as soon as possible. Similarly, if your gums are red, swollen or tender to the touch, this is also a sign of inflammation and an indication of infection.

Gum disease is often called a “silent” disease, meaning it can develop without any indication of pain or discomfort. Sometimes, though, bacteria can concentrate in a particular portion of the gum tissue to form a periodontal abscess. In this case, the abscessed tissue can become very painful, swollen and red, and may even discharge pus.

There are also advanced signs of gum disease. If your teeth are painfully sensitive when you brush, consume something hot or cold, or when you bite down, this may mean the gums have pulled back (receded) from the teeth and the highly sensitive dentin and roots are now exposed. Teeth that appear to have moved or that feel loose may mean the gum tissues have significantly detached from the teeth as increasing amount of bone loss occurs. If you see any of these signs you should contact us without delay.

Regardless of the level of disease advancement when diagnosed, prompt treatment should begin as soon as possible. This is the only way to bring the infection under control and give the gum tissues a chance to heal and rejuvenate. From then on, it’s a matter of renewed dental hygiene, frequent cleanings and checkups and an ever vigilant eye for signs of returning infection.

If you would like more information on the diagnosis and treatment of gum disease, 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 “Warning Signs of Periodontal (Gum) Disease.”

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
November 15, 2013
Category: Oral Health
Tags: loose teeth   gum disease  
TreatingLooseTeethandtheUnderlyingCauses

Adult teeth aren’t meant to be loose — it’s a sign that something is wrong. And while there are treatments, time is of the essence before permanent tooth or bone loss occurs.

Loose teeth can occur for many different reasons. Bite-related problems are fairly common, referred to as occlusal trauma (“occlusal” – bite; “trauma” – injury). This could be the result of excessive force placed on otherwise normal teeth and jaws — chronic clenching or grinding habits, for example. On the other hand, even normal biting or chewing can cause teeth to loosen if bone loss from gum disease has become excessive, reducing the remaining attachment to bone to inadequate levels. In some cases it can be a result of both excessive force and weakened bone levels.

Of these reasons, the most common cause is the weakened attachment of the teeth to the bone due to gum disease. If this is the case, it’s important first to treat the gum disease by an appropriate strategy for the disease present and then implement an effective dental hygiene program to inhibit reoccurrence.

As for the problem of loose teeth, there are measures to address it. Occlusal bite adjustment reduces the degree of force when biting or chewing by reshaping the biting surfaces through selective grinding. Splinting is another technique in which the teeth are joined together to make them more rigid and to redistribute the biting force among several teeth. This can be done with material bonded across the outside of several teeth or with a metal splint affixed within a pre-cut channel across the teeth. A more permanent option is to create a series of crowns to affix to the teeth and then fuse them together.

Although more complex, orthodontics to correct misaligned teeth is another option. Not only will it improve the bite and potentially reduce bite forces, it may also improve the health of the supporting periodontal attachment.

Before undertaking any treatment, you should first undergo a thorough exam to determine the true cause of your loose teeth and any underlying conditions. From there we can recommend the best approach for treating and preserving your teeth.

If you would like more information on treatments for loose teeth, 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 “Treatment for Loose Teeth.”