Periodontal (gum) diseases are sometimes called “silent” because those who have them may not experience painful symptoms. But certain signs point to the existence of these common diseases. If you are experiencing any of the symptoms below, it is time to visit our office so these problems can be treated before they lead to serious infection and loss of teeth.

Gums that bleed during the brushing of teeth. Some people think that gums bleed from brushing too hard. In fact, healthy gum tissues will not bleed with normal brushing. The usual cause of bleeding gums is an accumulation of dental plaque in the areas where your teeth meet your gums. Plaque is a film of bacteria, called a biofilm, which accumulates on your teeth. If you are not brushing and flossing effectively, plaque irritates your gum tissues and causes an inflammation and swelling called gingivitis. This causes your gums to bleed easily on contact with a toothbrush or floss.

Gum tissues that appear red and swollen. If plaque is allowed to accumulate for 24 hours or more, the inflammation in your gum tissues becomes chronic. The continuous presence of bacteria makes it impossible for your body's natural defenses to fight the infection. Chronic inflammation leads to a breakdown of the normal attachment between the teeth and the gums, causing the formation of “pockets.” Inside these pockets the infection continues to attack the tissues that support your teeth. Eventually this can lead to a breakdown of the bone that surrounds your teeth.

Bad breath. Bad breath is another sign of accumulated plaque. The bacteria in plaque may emit gases that have an unpleasant odor.

Gums that are sensitive to hot or cold. Chronic inflammation can also cause the gums to recede, exposing the roots of the teeth in which nerves may be close to the surface, leading to sensitivity to heat and cold.

Teeth that are getting loose, or a painful area in the gums. If you experience these symptoms, the infection has progressed a long way from the “silent” stage. It is time to seek immediate professional help.

If you answered “yes” to any of the above questions, a professional dental examination is in order. With daily removal of plaque by effective brushing and flossing, along with frequent professional cleanings to remove any plaque that you were unable to catch, you will go a long way to preventing periodontal disease. Also, be aware that smoking tends to mask the effects of gum disease. Generally, if you smoke your gums will not bleed when brushing or flossing, nor will they show signs of swelling.

Contact us today to schedule an appointment to discuss your questions about gum disease. You can also learn more by reading the Dear Doctor magazine articles “Bleeding Gums” and “Warning Signs of Periodontal (Gum) Disease.”

If you engage in frequent air travel, you have probably experienced pain in your ears and sinuses related to pressure changes. The pain is caused by “barotraumas” (from baro meaning pressure — also the root of the word “barometer” — and trauma meaning injury) and is also called a “squeeze.” Divers also sometimes experience this discomfort or pain.

The cause of barotraumas is air pressure (or water pressure, in the case of divers) on the outside of your body that is not equal to the pressure inside your body. Normally when pressure outside your body changes, your organs such as your blood, bones, and muscles transmit the changes equally from outside to inside. Some structures in your body, such as your middle ear spaces and your sinus cavities (spaces in the facial bones of the skull), don't transmit the pressure as well because they are filled with air and have rigid walls. The maxillary (upper jaw) sinuses are pyramid-shaped spaces in the bone located below your eyes, on either side of your nose.

You have probably tried to stop such pain in your ears by yawning, chewing, or moving your jaw back and forth. These maneuvers, called “clearing,” allow air to move from the back of your throat into your ear canals so that the pressure can equalize. Similarly, your sinuses have small openings near their lower borders, so that you can clear pressure changes within them. If you have a head cold or flu and the membranes lining your sinuses are swollen and inflamed, they may close off the openings and make it difficult to clear these spaces. This can sometimes lead to intense pain.

Because the lower walls of these sinuses are adjacent to your upper back teeth, these teeth share the same nerves as the maxillary sinuses. This sharing sometimes causes pain felt in your back teeth to be perceived as pain in the sinuses, or vice versa. Pain felt a distance from its actual stimulus because of shared nerves is called “referred pain.”

Be sure to make an appointment with us if you experience pain in any of your teeth. Any defect in a filling or tooth can allow air to enter the tooth. It could be referred pain from your sinuses, or the result of pressure changes on trapped air within a filling or a tooth. Such pain, called barodontalgia (from baro meaning pressure, don't meaning tooth, and algia meaning pain) is an early sign of injury in a tooth.

Contact us today to schedule an appointment to discuss your questions about tooth and sinus pain. You can also learn more by reading the Dear Doctor magazine article “Pressure Changes Can Cause Tooth & Sinus Pain.”

Temporomandibular Disorder (TMD), which was formerly known as Temporomandibular Joint Disorder (TMJ), is a condition that is unusual in that it frequently is quite hard to diagnose, because it often mimics many other conditions. For this reason, many healthcare professionals refer to it as “the great imposter.” The condition arises when there are problems inside the temporomandibular joint and the muscles that attach to it causing pain. The pain is most often due to muscle spasm, thereby limiting the ability to open and close the jaw and to function normally. TMD can impact anyone and has a wide range of similar symptoms.

One of the common causes of TMD is stress, and it may manifest itself through clenching or grinding of teeth while awake or asleep. These habits are often completely subconscious until pointed out by a dental professional or sleeping partner. With stress-induced TMD, the pain often comes and goes in cycles. In other words, it may be present when you are stressed, seem to disappear for a while, and then reappear when you are stressed again. Another cause of TMD can be from an injury or trauma, such as a blow to the jaw. However, regardless of the cause of TMD, the pain is real and needs to be treated properly.

If you feel that you might have TMD, please let us know so that we can address your concerns, starting with a full history and conducting a thorough examination. Or if you are in constant or severe pain, contact us immediately to schedule an appointment. You can learn more about the signs, symptoms, and treatment options for TMD by reading “TMD — Understanding The Great Imposter.”

How good of a job are you doing with brushing and flossing your teeth? This is an important question, because a healthy mouth depends on regularly removing dental plaque (a whitish, sticky film of bacteria that grows near your gumline and on the surfaces of your teeth).

Daily Plaque Removal
Most people need to brush and floss at least once a day to remove plaque. Twice a day may be ideal, as plaque forms every 12 to 24 hours on your teeth, and it will also make your mouth feel fresher. Be thorough but gentle with your teeth — excessive brushing or flossing can cause damage.

The use of an antibacterial mouthrinse to help reduce the plaque you may have missed as well as to reduce bacteria that are clinging to soft tissues or membranes in your mouth, should be included in your daily hygiene routine.

Tongue Test
When you run your tongue around your mouth after a professional dental cleaning, you sense a smooth, slippery feeling. This is the way your teeth should feel after you brush your own teeth every day. The tooth surfaces should feel smooth and slick throughout your mouth and at the gum line.

Floss Test
After running floss up and down a tooth surface, notice whether there is blood on the floss or whether the floss has an odor. If the floss squeaks when you run it up and down a tooth surface, that indicates that the tooth is squeaky clean.

Check for Bleeding
Bleeding gums are a sign of inflammation, called gingivitis, in the gum tissue. Healthy gums do not bleed. If you have recently begun using more effective brushing and flossing methods, your gums may bleed at first but then stop as your gums become healthier.

Use Disclosing Solutions
Disclosing solutions are harmless dyes that can stain plaque and make it visible. Rinsing with these solutions may surprise you by revealing the plaque on your teeth you had no idea you missed.

Visit Our Office
We can check your mouth and tell you how well you are doing in your program of daily plaque removal. As a bonus, we will give you a toothbrush so that while you're here we can check your technique to make sure you are brushing correctly.

Contact us today to schedule an appointment to discuss your questions about oral hygiene. You can also learn more by reading the Dear Doctor magazine article “Oral Hygiene Behavior.”

When dentists talk to patients, they often use specialized vocabulary referring to various dental conditions. Do you understand what they mean when they use these words — or are you wondering what they are talking about?

Here's your chance to test your knowledge of ten words that have a particular meaning in the context of dentistry. If you already know them, congratulations! If you don't, here's your chance to learn what these words mean in the dental world.

Enamel
In dentistry, enamel is the hard outer coating of your teeth. It is the hardest substance produced by living animals. It is a non-living, mineralized, and composed of a crystalline form of calcium and phosphate.

Dentin
The dentin is the layer of a tooth that is just beneath the enamel. It is living tissue similar to bone tissue.

Pulp
When dentists speak of pulp, we mean the tissues in the central chamber of a tooth (the root canal) that nourish the dentin layer and contain the nerves of the tooth.

Bruxism
Many people exert excess pressure on their teeth by clenching or grinding them. This is called bruxism, a habit that can be very damaging to teeth.

Occlusion
By this we mean how the upper and lower teeth are aligned, and how they fit together. This can also be referred to as your bite.

Dental caries
This term refers to tooth decay. Dental caries and periodontal disease (see below) are two of the most common diseases known to man. Today, these diseases are not only treatable, but they are also largely preventable.

Periodontal disease
A term for gum disease, this term comes from “peri,” meaning around and “odont,” meaning tooth. It is used to describe a process of inflammation and infection leading to the progressive loss of attachment between the fibers that connect the bone and gum tissues to the teeth. This can lead to loss of teeth and of the bone itself.

Erosion
When you consume acidic foods or drinks, the acids in your mouth react directly with minerals in the outer enamel of your teeth, causing chemical erosion. This is not the same as tooth decay, which is caused by acids released by bacterial film that forms on your teeth (see below).

Dental implant
A dental implant is a permanent replacement for a missing tooth. It replaces the root portion of the tooth and is most often composed of a titanium alloy. The titanium root fuses with the jaw bone, making the implant very stable. A crown is attached to the implant and can be crafted to match your natural teeth.

Plaque
Dental plaque is the whitish film of bacteria (a biofilm) that collects on your teeth. Your goal in daily brushing and flossing is to remove plaque.

Contact us today to schedule an appointment to discuss any questions you may have about your teeth and gums. You can also learn more by reading Dear Doctor magazine article “How and Why Teeth Wear.”