My Blog

Posts for: May, 2020

By J. Viana Paiva, Jr., D.D.S., P.A.
May 22, 2020
Category: Dental Procedures
PracticeDailyHygienetoAvoidGumSwellingWhileWearingBraces

Straightening your smile doesn't happen overnight—it can involve months or even years of orthodontic treatment. And although the end result is well worth it, the long process can make it difficult to keep your gums healthy, especially while wearing braces.

Gum swelling in particular is a common problem for braces wearers with two potential sources. First, orthodontic hardware makes it difficult to keep teeth clean of dental plaque, a thin bacterial film that can cause gum disease. Plaque and its hardened counterpart tartar can trigger a gum infection, which in turn triggers inflammation. As a result, affected gums appear swollen and red, and can easily bleed.

Gum tissues may also react to braces pressing against them and develop hypertrophy (or hyperplasia), an increase in individual tissue cell growth. If this overgrowth occurs, it may not get resolved until after your braces have been removed.

As long as the hypertrophy doesn't appear to have weakened gum attachment with the teeth, it's usually not a big concern. But what is a concern is that hypertrophy could increase a braces wearer's difficulties with oral hygiene and give rise to a true gum infection that could endanger dental attachment. Advanced cases could require surgical correction or removal of the braces altogether to adequately treat the infection.

The best way to avoid a worst case scenario is to be as diligent as possible with daily brushing and flossing. Fortunately, there are several tools that can make it easier with braces. Interproximal brushes, tiny brushes that can fit into the narrow spaces between the teeth and the braces, can be used in conjunction with your regular toothbrush.

Flossing is also easier if you use a floss threader or a water flosser. The latter utilizes a pump to emit a pulsating jet of water to break loose plaque between teeth and flush it away. Clinical studies have shown the effectiveness of water flossers for removing plaque in braces wearers as opposed to not flossing at all.

A faithful daily hygiene practice and twice-a-year cleanings and checkups with your regular dentist can help minimize your chances of gum swelling. Doing so will help ensure you'll complete your orthodontic treatment on the way to healthier and more attractive smile.

If you would like more information on teeth and gum care while wearing braces, 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 “Gum Swelling During Orthodontics.”


By J. Viana Paiva, Jr., D.D.S., P.A.
May 12, 2020
Category: Oral Health
InstillTheseHabitsinYourChildforaLifetimeofGreatDentalHealth

As a parent, you strive to instill good habits in your children: looking both ways for traffic, doing chores or washing behind the ears. Be sure you also include sound habits for teeth and gum care.

Daily brushing and flossing should be at the top of that habit list. These hygiene tasks remove dental plaque, a bacterial film that builds up on teeth and is most responsible for diseases like tooth decay or periodontal (gum) disease.

Although you'll have to perform these tasks for them early on, your aim should be to teach them to do it for themselves. The best approach is to teach by example: If your child sees you're serious about your own oral hygiene, they're more likely to do so as well.

You should also help them form habits around the foods they eat. Like other aspects of our health, some foods are good for our teeth and gums, and some are not. The primary food in the latter category is sugar: This popular carbohydrate is also a favorite food source for disease-causing oral bacteria.

It's important, then, to minimize sugar and other processed foods in your child's diet, and maximize their consumption of whole grains, fresh fruits and vegetables, and other foods rich in calcium and phosphorous. Instilling good eating habits at an early age can boost both their dental and general health throughout their lives.

Finally, help the budding star athlete in your family develop the habit of wearing a protective mouthguard during contact sports. Your best choice is a custom-made mouthguard by a dentist: Although they cost more than the more common “boil and bite” mouthguard, they tend to offer more protection and are more comfortable to wear. A mouthguard could help your child avoid a costly dental injury that could affect them the rest of their life.

Adopting good dental hygienic, dietary, and safety habits at an early age can have a huge impact on your child's teeth and gum development. And if those early habits “stick,” it could mean a lifetime of disease-free dental health.

If you would like more information on helping your child develop sound dental habits, 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 “How to Help Your Child Develop the Best Habits for Oral Health.”


By J. Viana Paiva, Jr., D.D.S., P.A.
May 02, 2020
Category: Oral Health
Tags: gum disease  
WithoutPromptInterventionGumDiseaseCouldDamageToothRoots

Periodontal (gum) disease often involves more than gum inflammation. The real danger is what this bacterial infection may be doing to tissues beneath the gum line—including tooth roots and supporting bone.

Gum disease can do extensive damage to the forked areas where the roots separate from the main tooth body. If one of these areas, known as a furcation, becomes infected, the associated bone may begin to diminish. And you may not even know it's happening.

Fortunately, we may be able to detect a furcation involvement using x-rays and tactile (touch) probing. The findings from our examination will not only verify a furcation involvement exists, but also how extensive it is according to a formal classification system that dentists use for planning further treatment.

A Class I involvement under this system signifies the beginning of bone loss, usually a slight groove in the bone. Class II signifies two or more millimeters of bone loss. Class III, also called a “through and through,” represents bone loss that extends from one side of the root to the other.

The class of involvement will guide how we treat it. Obviously, the lower the class, the less extensive that treatment will be. That's why regular dental checkups or appointments at the first sign of gum problems are a must.

The first-line treatment for furcation involvements is much the same as for gum disease in general: We manually remove bacterial plaque, the main source of infection, from the root surfaces using hand instruments and ultrasonic equipment. This is often followed by localized antibiotics to further disinfect the area and stymie the further growth of the furcation involvement.

We also want to foster the regrowth of lost tissue, if at all possible. Classes II and III involvements may present a challenge in this regard, ultimately requiring grafting surgery to stimulate tissue regeneration.

The best approach by far is to prevent gum disease, the ultimate cause for a furcation involvement. You can reduce your chances of gum disease by brushing and flossing daily to remove disease-causing plaque. Regular dental cleanings and checkups, at least every six months, help round out this prevention strategy.

A furcation involvement could ultimately endanger a tooth's survival. We can stop that from happening—but we'll have to act promptly to achieve the best results.

If you would like more information on treating 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 “What are Furcations?




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