My Blog

Posts for: January, 2014

By Drake Tollefson DDS
January 28, 2014
Category: Oral Health
Tags: oral health   bleeding gums  
DontIgnoreBleedingGums-ASignofTroubleAhead

Ninety percent of people have noticed bleeding from their gums when they brush or floss their teeth at some time or other. You may wonder if this is a result of brushing too hard — but that's not usually the case.

If your gums don't hurt — even if they bleed easily — you may think the bleeding is normal, nothing to worry about, or you're brushing too hard.

Bleeding from your gums is not normal!

It is an early warning sign of gum disease. In fact ten percent of those who start with bleeding gums go on to develop serious periodontal disease affecting the support for the teeth leading to tooth loss.

Then why do my gums bleed?

The way you brush your teeth is indeed a factor! Bacteria that normally reside in the mouth (in fact you need them to stay healthy) collect along the gum line in a biofilm. When the biofilm is not removed effectively on a daily basis, over time the gums become inflamed and bleed when touched. Other signs of inflamed gums — gingivitis — are redness and swelling, and even recession.

SO — the problem is not that you are brushing too hard, but that you are not brushing and/or flossing effectively. Both are important.

Three ways to stop bleeding gums before they lead to serious problems

  1. It all starts with brushing your teeth correctly at the gum line. Use a soft multi-tufted toothbrush. Hold it in the gum line and wiggle it gently until the tooth surfaces feel clean to your tongue — just like when you've had a professional cleaning. It doesn't take force, be gentle.
  2. It's just as important to remove biofilm from between the teeth where the toothbrush won't reach. If you are having difficulty flossing, we've got some easy demonstrations and instructional tips.
  3. Remember, as we say, “It's not the brush, it's the hand that holds it.”

Contact us today to schedule an appointment or to discuss your questions about bleeding gums. Bring your toothbrush and floss with you to our office and ask us to demonstrate proper oral hygiene techniques. You can also learn more by reading the Dear Doctor magazine article “Bleeding Gums: A very important warning sign of gum disease.”


By Drake Tollefson DDS
January 24, 2014
Category: Oral Health
Tags: gum recession  
WhatIsGumRecession

If you have noticed that one or more of your teeth have lost some of the surrounding pink gum tissue so that part of the root surface is now uncovered, you are experiencing gum recession. It's a very common problem — in fact millions of Americans have some degree of gum recession. Fortunately, there are very effective methods of treating it.

Gum recession can be unsightly, but there are more serious concerns. Tooth root surfaces exposed by gum recession can become sensitive to temperature and pressure changes and can decay or wear away. In very severe cases, teeth can actually be lost. That's because gum or “gingival” tissue as it is medically known is supposed to encircle and firmly attach to the necks of the teeth and the underlying bone. This forms a protective barrier that is resistant to the abrasive action of foods during eating, biting and chewing.

Gum tissue is largely made of a fibrous protein called collagen, covered by a layer of another very resilient protein called keratin (nails and hair are also made of it). Yet it is still possible for this tough tissue to lose its grip on the teeth it protects. Here are some of the ways this can happen:

  • Ineffective oral hygiene — inadequate removal of dental bacterial plaque (biofilm) with daily brushing and flossing.
  • Excessive brushing (and flossing) — too hard, or for too long.
  • Habits — holding foreign objects between the teeth, such as bobby-pins, nails etc that press on the gum tissues.
  • Oral appliances and ornaments — badly fitting removable partial dentures and orthodontic appliances (braces), or tongue bolts and oral piercings can apply pressure to the gums.

Treatment will depend in part on whether the recession is stable or progressive. For example, an older person might have a few areas of gum recession but there are still adequate zones of attached protective gum tissue and the exposed tooth root surfaces are healthy. In this case, there may not be reason to do anything but monitor the situation. On the other hand, a teenager with a history of fairly rapid gum recession (over a period of months) usually requires immediate treatment. The dental specialty of periodontics (“peri” – around; “odont” – tooth) has developed predictable surgical techniques to deal with recession.

Free Gingival Grafting, for example, involves taking a very thin layer of skin from the palate, where the tissue is identical to gum tissue, and transplanting it to the area where gum has been lost. Both sites will heal in a very predictable and uneventful manner. The free gingival graft is so-called because it is “freed” from the donor (original) site completely. It is crucial to make sure individuals with gum recession correct faulty hygiene habits prior to this (or any) treatment so that they will not jeopardize their future results.

If you are concerned about gum recession, please contact us or schedule an appointment for a consultation. You can also learn more about gum recession and gingival grafting by reading the Dear Doctor magazine article “Periodontal Plastic Surgery.”


By Drake Tollefson DDS
January 16, 2014
Category: Oral Health
Tags: tmj  
ChronicJawPainWhattodoAboutTMJDisorders

Many people suffer from problems with the temporomandibular joint (TMJ); this can result in chronic pain and severely limit the function of the jaw. Yet exactly what causes the problems, how best to treat them… and even the precise number of people affected (estimates range from 10 million to 36 million) are hotly debated topics.

There are, however, a few common threads that have emerged from a recent survey of people who suffer from temporomandibular joint disorders (TMJD). Some of them are surprising: For example, most sufferers are women of childbearing age. And two-thirds of those surveyed say they experienced three or more associated health problems along with TMJD; these include fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, rheumatoid arthritis, chronic headaches, depression, and sleep disturbances. The links between these threads aren’t yet clear.

The survey also revealed some interesting facts about treating TMJD. One of the most conservative treatments — thermal therapy (hot or cold compresses) — was found by 91% to offer the most effective relief of symptoms. By contrast, the most invasive treatmentâ??surgeryâ??was a mixed bag: A slightly higher percentage reported that surgery actually made the condition worse compared to those who said it made them better.

So what should you do if you think you may have TMJD? For starters, it’s certainly a good idea to see a dentist to rule out other conditions with similar symptoms. If you do have TMJD, treatment should always begin with some conservative therapies: moist heat or cold packs, along with over-the-counter anti-inflammatory medications if you can tolerate them. Eating a softer diet, temporarily, may also help. If you’re considering more invasive treatments, however, be sure you understand all the pros and cons — and the alternatives — before you act. And be sure to get a second opinion before surgery.

If you would like more information about temporomandibular joint disorders (TMJD), call our office for a consultation. You can learn more in the Dear Doctor magazine articles “Chronic Jaw Pain And Associated Conditions” and “Seeking Relief from TMD.”


By Drake Tollefson DDS
January 08, 2014
Category: Dental Procedures
Tags: root canal  
RootCanalTreatmentAFirst-TimersGuide

It’s often said that thereâ??s a first time for everything: Driving a car by yourself; getting your first “real” job; even… having a root canal?

Now don’t get us wrong — we’re not wishing that anyone should go through a medical procedure, no matter how minor. Yet the fact remains: A root canal procedure is one of the most common treatments performed in many dental offices… and, especially for first-timers, it’s one of the most misunderstood.

Let’s start off with the biggest misconception of all. Have you heard that a root canal is an exceptionally painful treatment? Get ready for some news: It just isn’t so. The fact is, in the vast majority of cases, having a root canal procedure is comparable to cavity treatment in terms of discomfort. Yet it brings immediate relief to the intense pain that can result from an infection in the pulp of the tooth. To understand how this works, we need to look a little closer at a tooth’s anatomy.

The hard outer surface of the tooth doesn’t have nerves, so it can’t “feel” any sensations. But deep inside of the tooth lies a bundle of nerves, blood vessels and connective tissue called the pulp. Safely sealed off from the outside world, pulp tissue is needed for proper tooth development, but has no essential function in adults. Sometimes, however, a deep cavity or a crack in the tooth allows bacteria to infect this soft tissue. That’s when the tooth’s pulp will let you know it’s still there — by causing the sensation of pain.

Pulp tissue fills a branching network of tiny canal-like passages, which can be compared to the roots of a plant. When infection develops in the root canals, the best treatment is to remove the diseased and dying tissue, clean out and disinfect the passageways, and seal up the area against further infection. This, in essence, is a root canal procedure. It is performed under local anesthesia, so you won’t feel any pain as it’s being done. When it’s over, a crown (cap) will be needed to restore the tooth’s appearance and function.

What happens if you need a root canal but don’t get one? If you can manage to ignore it, the pain may (or may not) eventually cease: This signals that the nerves have died — but the disease still persists. Eventually, it may lead to further infection… a pus-filled abscess… even tooth loss. And that’s a truly bad outcome.

It’s normal to feel a little apprehension before any medial procedure. But don’t let faded myths about the root canal procedure keep you from getting the treatment you need. Remember, root canal treatment doesn’t cause pain — it relieves it!

If you would like more information about root canal treatment, call our office for a consultation. You can learn more in the Dear Doctor magazine articles “A Step-By-Step Guide To Root Canal Treatment” and “Tooth Pain? Don't Wait!