502 Jefferson Highway N. Champlin, MN 55316

763 427-1311 www.moffittrestorativedentistry.com

MOUTH OWNER’S MANUAL

Preventing and Controlling Gum Disease

YOUR GUMS MAY BE IN TROUBLE

Periodontal, or gum, disease is one of the most common and serious dental problems today. People of all ages may experience symptoms of this disease, which can lead to tooth loss if not detected early. “Perio” means around, and “dontal” means tooth. Periodontal disease is an infection that gradually destroys the tissue surrounding your teeth and the jawbone that supports them. So whether you have healthy gums and want to keep them that way, or you already have gum disease and want to control it better, find out more about gum disease, and know that it can be treated.

Notice Any Little Changes Things you may have thought were normal, like swollen gums, tenderness in the mouth, or bad breath, may be signs of gum disease. Bleeding, although not always a symptom, is a signal that your mouth is trying to heal something, and needs your help. Even if you don’t notice any symptoms or experience pain, you may still have an early stage of gum disease.

Team Up With Moffitt Restorative Dentistry The best thing to do is to understand gum disease, and find out if you need professional treatment in addition to regular checkups. Our dental team may suggest a treatment plan, and then we will strongly urge you to follow a dedicated self-care program of flossing and brushing. This, combined with regular cleanings and maintenance, is the key to fighting gum disease.

Do You Have Gum Disease? Answer the following questions. The more times you check “yes,” the more likely it is that you need professional treatment.

Yes No 1. Are your gums swollen or puffy? ____ ____

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Yes No 2. Do your gums bleed when you floss or brush? ____ ____

3. Do your teeth and gums seem sensitive or sore? ____ ____

4. Do you have bad breath no matter what you eat? ____ ____

5. Are the tips of your gums a color other than pink? ____ ____

6. Have your gums pulled back from your teeth? ____ ____

7. Have the spaces between your teeth become bigger? ____ ____

8. Do some or all of your teeth feel loose? ____ ____

9. Has the way you bite down changed? ____ ____

GET TO KNOW YOUR MOUTH

Sounds funny, doesn’t it? After all, you’ve had your mouth your whole life. But it’s good to know how your mouth works so you can take care of it better. It’s also helpful to know how gum disease starts so that you can slow down or even stop the process. If you can manage this, your teeth, gums, and jawbone will be healthier. Nothing looks or feels quite like clean, white teeth and a bright, wholesome smile.

A Lesson in Anatomy To understand your mouth better, let’s go back to basics. Compare your teeth to a house, with your gums and jawbone as the foundation. To keep your house in good condition, your foundation has to be solid. Let’s look a little deeper.

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Gingival pockets (also called sulcus troughs) are small spaces between your teeth and gums where debris collects. If plaque isn’t removed from these pockets every day, gums can become inflamed. Pockets become deeper and gum disease begins.

A Simple Equation Dentists believe bacteria in plaque cause gum disease. But other things, like stress, smoking, illness, poor nutrition, genetics, and changing hormone levels, may contribute to gum disease.

Food, especially sugary and starchy food, helps plaque form very fast.

Bacteria collect on your teeth and quickly turn into plaque. This is your mouth’s number-one enemy.

Saliva allows plaque to stick to your teeth.

Time is crucial because plaque can form in as little as 4 to 24 hours.

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Plaque is a bacterial film found above and below the gumline. Usually invisible, it sometimes looks white or yellow. Plaque can be removed with good self-care

PLAQUE HARDENS OVER TIME

Calculus is a destructive yellow or brown crust that can only be removed by a professional. Calculus, or tartar, may form after only a few days if you don’t remove plaque every day. Calculus is also a natural process formed by our bodies. It is a buildup that forms on our teeth from minerals in our saliva. Much like our hair and nails grow, tartar builds. The best way to control tartar buildup is to have it removed at a dental cleaning every 6 months, or sooner, by one of our hygienists. GUM DISEASE COMES IN STAGES Although it has three stages, gum disease is one continuous process. Each stage is characterized by what you see and feel in your mouth, and by what’s happening under your gumline. Remember, even if you don’t notice any symptoms, you may still have a form of periodontal disease, and it’s possible to have more than one stage of gum disease around different teeth at one time. Dr. Moffitt will determine its progression in your mouth during each visit.

Stage 1 Gingivitis

You may experience some swelling, bleeding, tenderness, or bad breath. At this point, gums may be loose, but are still attached high on the teeth.

Stage 2 Periodontitis

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You may experience bright red or receding gums, spaces between your teeth, calculus along the gumline, and some symptoms that occur in Stage 1.

Stage 3 Advanced Periodontitis

You may experience receding gums, which expose root, darker calculus, pus if you press on your gums, and some symptoms from Stages 1 and 2.

A periodontal probe is the instrument your dentist uses to measure your gingival, or gum, pockets. Healthy gums shouldn’t bleed or feel tender when you floss or brush. They are tight against the teeth and have pink tips. Gingival pockets measure less than three millimeters, and no bone loss shows on x-rays. In Stage 1, you may have 1- to 3-millimeter pockets, plaque, and calculus forming along the gumline. Plaque may be advancing below the gumline. No bone or ligament damage has occurred at this stage. Plaque under the gumline Loose gums 1- to 3-mm pocket

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In Stage 2, you may have pockets measuring 3 to 5 millimeters, calculus beginning to progress below the gumline, and some bone loss. Ligaments may become damaged at this stage, which loosens teeth.

Calculus below gumline 3- to 5-mm pocket Bone loss

In Stage 3, you may have pockets of 5 millimeters or more, and swelling around the root of the tooth. Pus pockets may begin to form, and there may be more bone loss. You may lose your teeth during this stage. Exposed root 5 mm or deeper pocket Increased bone loss A FULL DENTAL EVALUATION Our dental team takes your medical and dental history and performs a dental exam to make an evaluation of your mouth’s health. The most essential part of this is pocket charting, which measures the health status around each tooth in your mouth. The ultimate goal of early detection is to determine if you have gum disease and, if so, to

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develop a treatment program specially suited to your needs. A dental cleaning is usually performed sometime during this visit. Your Dental History Usually during your first dental visit, you’ll be asked about dental problems you’ve had, if you’ve ever been treated for gum disease, and what your current symptoms are. You may also be asked about your eating habits, and your flossing and brushing routine. We will also take a medical history because some conditions can affect dental treatment. We may ask you about current medical problems, past surgeries, allergies, and medications. Your Dental Exam An examination determines whether you have gum disease and need professional treatment. Dr. Moffitt and one of our hygienists will examine your teeth and gums to see how healthy your mouth is, and measure your gingival, or gum, pockets. You may be asked to open your mouth to evaluate your bite (occlusion). Your exam may also include a head and neck evaluation. X-rays may be taken during this exam to determine bone loss and chart your progress.

No Bone Loss Bone Loss Pocket Charting One way to diagnose gum disease is by pocket charting. Several measurements may be taken for each tooth and the deeper the pocket, the more care it needs. We may keep a record of these areas. Setting up a Treatment Plan After your evaluation, Dr. Moffitt will discuss whether you have gum disease and, if so, will recommend some treatment options. These can range from a combination of excellent self-care and deep dental cleanings to surgery. In some cases, we may refer you to a periodontist, a dentist specializing in the treatment of gum disease. If you do have gum disease, arrange your treatment immediately. Gum disease can be fatal to your teeth! SELF-CARE: A HOW-TO GUIDE If Dr. Moffitt were stranded on a deserted island and had to choose between dental floss and a toothbrush, he would probably pick the floss. Why? Because brushing only gets rid of a fraction of the plaque in your mouth. Flossing takes care of the majority. Ask your Dr. Moffitt or our hygienists to give you hands-on instruction but remember that everyone does it differently. You may need to practice at first, but, in time, you can develop a pattern that works for you.

Five-Star Flossing

1. Take eighteen inches of recommended floss and wrap it securely around your middle fingers.

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2. Hold your index fingers firmly, and allow only about a half-inch length of floss between them.

3. Gently tease the floss between your teeth and be sure to press tightly against each side.

4. Ease the floss up and down several times, and go below your gumline where all the bacterial action is.

Floss comes in waxed, unwaxed, flavored or tape varieties. Dr. Moffitt or our hygienists may suggest a particular type for you. When you first learn, it may take longer, but you should floss once a day, for 1-2 full minutes.

Blue-Ribbon Brushing

1. Use a fluoride paste, point brush at a 45° angle toward gumline, and brush in gentle, circular motions. Always be sure to use a Soft Bristled Toothbrush to prevent damage to the gums.

2. Work the tip of your brush around the inner, front surfaces. Don’t forget the back areas of your mouth.

3. Clean inner and outer surfaces by rolling down for the upper teeth, and up for the lower teeth.

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4. Clean the biting surfaces by using a scrubbing motion. Brush gums and tongue, then rinse well.

A small, soft, angled brush with rounded bristles is best. Replace it every three months or sooner if the bristles are worn out.

When you first learn, it may take longer, but you should brush for 2-3 minutes, twice a day. Special Aids for Special Needs Your dentist may recommend these or other dental extras for implant or denture wearers, children, orthodontic or arthritic patients, or any one else with special dental needs. Interdental brushes clean between large spaces. Gum toners massage gums and firm up problem areas. Dental picks help loosen debris. Special floss with a foam or gauze coating can be used for difficult areas.

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Oral irrigators help flush out debris using water pressure.

Disclosing tablets use a harmless dye to show areas of plaque you missed.

PROFESSIONAL TREATMENT OPTIONS Because different areas of your mouth can be in different stages of gum disease, you may need several types of treatment. One of our hygienists may perform treatment in the office, or you may be referred to a periodontist. The primary goals of all professional treatment are to promote reattachment of healthy gums to teeth, to reduce swelling, the depth of pockets, and the risk of infection, and to stop further damage. But professional treatment is not a cure for gum disease: it needs your dedication. Our team will urge you to begin a self-care program now, and continue it for the rest of your life. Nonsurgical Treatment

o Smoothing the Tooth –Dr. Moffitt or your hygienist may smooth some teeth because a cleaner surface attracts less debris. Scaling removes calculus and plaque from the root, and root planning smooths and polishes it. These are usually performed at the same time, and may simply be called “deep cleaning.” You may have to visit the dentist’s office several times for this treatment.

o Smoothing the Gums – Dr. Moffitt may remove a small amount of infected gum

tissue with a procedure called soft tissue curettage. The gum is lifted up slightly, and a small amount of diseased inner gum lining is gently scraped out. This treatment is often performed with scaling and root planning, and may require additional visits.

Surgical Treatment

o Trimming the Gum – During a procedure called flap surgery, an incision is made, a “flap” is lifted to give your dentist visual access, and any calculus and infected gum is removed. The gum is then replaced on the tooth near the original gumline.

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o Reshaping the Bone – We may send you to a specialist to perform osseous (bone) surgery to reshape the bone. The infected gum and bone are removed, then the gums are sutured below the original gumline to reduce areas that trap plaque. Your tooth may look longer than it did before treatment.

Antibiotics are prescription drugs in pill, gel, or cord-like forms. Used to fight off the bacteria that collect in your mouth and lead to gum disease, antibiotics may be prescribed before, during, or after treatment. Future treatment trends are constantly being developed in all areas of dentistry. Soft tissue and bone grafting replace infected gum and bone, and bite guards and adjustments reduce the pressure put on teeth and gums. Their long-term use has not been fully tested, but you may want to ask Dr. Moffitt about them. TIPS TO KEEP YOUR TEETH Whether you’ve had extensive professional treatment or are simply fighting gum disease with self-care, here are some general guidelines for you and your family. Ask Dr. Moffitt if you have questions, and start your children’s good dental habits early. Practice Good Self-Care To help stop the process of gum disease, begin your self-care program today. Good habits take time, and bad habits are hard to break. If you do miss a flossing or brushing,

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just start up again the next day. Your body wants to be well, so it will respect your efforts. Keep plenty of floss and a new toothbrush on hand for everyone in your home. And always eat plenty of fruits, vegetables, grains, and vitamin-enriched foods. A good diet now helps avoid health problems later. Keep Your Appointments After you visit our office or the periodontist, schedule your next follow-up appointments for needed maintenance. Write down the appointments in your date book, and try your best to keep them. If you can’t, reschedule as soon as possible. You may be asked to come in as often as every couple of months for cleaning or other treatment. The more often you visit the dentist, the less likely it is that you will have dental problems. The success of fighting gum disease is in your hands! Watch For Sensitive Teeth Sometimes after you’ve had professional treatment, your mouth may feel sensitive or sore. Over time, your teeth will become less sensitive because when you’re cleaning, your mouth is healing. But for a couple of weeks, we may suggest that you take a nonaspirin pain reliever a half-hour before self-care and rinse with warm water afterward. Avoid sugary and starchy foods because they attract plaque, and avoid smoking, citrus, and spicy foods because they may cause your mouth some discomfort. A TEAM EFFORT Your dental team—Dr. Moffitt, hygienist, and perhaps periodontist—is part of the ongoing effort of controlling gum disease. They can teach you a good self-care program and help you chart your progress. But to chart progress, you have to make progress. To make progress, you have to practice good self-care. It’s the easiest form of dental insurance, and it’s that simple.