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Periodontal disease is one of the most prevalent health issues in America, with the Centers for Disease Control reporting it affects approximately 65 million people, or roughly 47 percent of the population. People with periodontal disease have bacteria beneath the surface of the gums, which are responsible for tissue inflammation that can lead to pain, bleeding, gum recession, and even permanent tooth loss. Unfortunately, the chances of developing gingivitis and periodontitis only increase with age, with 70 percent of adults over age 65 having at least some degree of gum disease. However, a lot can be done to prevent periodontal disease and keep teeth and gums healthy.

Daily Hygiene

The process you take each day to clean your teeth and gums goes a long way towards preventing periodontal disease. Since gingivitis and periodontitis are caused by plaque build-up, the most important steps you can take to prevent them involve cleaning your teeth each morning, night, and after meals. Start by brushing your teeth and tongue, and follow up with mouthwash to kill any lingering bacteria. At least once per day, take time to floss thoroughly along the gum line to prevent gum infection from occurring in between teeth.

Periodontal Exams

In addition to caring for your teeth and gums at home, it is also important to see Dr. Rothstein for comprehensive exams. We can detect gingivitis in its earliest stages and treat it before it has a chance to progress. Everyone needs occasional periodontal exams, though people with certain risk factors may require them more often. Examples include individuals who smoke or have a personal or family history of gum disease.

Treating Periodontal Disease

See Dr. Rothstein right away if you suspect that you may be experiencing the warning signs of periodontal disease. Symptoms may include red, swollen, or bleeding gums, gum recession, pockets that have formed between the teeth and the gums, and even tooth loss. If you are diagnosed with periodontal disease, treatments are available to help restore your oral health depending on how advanced your gum disease has become. For example, gingivitis may require only a thorough cleaning and topical antibiotic. Periodontal disease that has been allowed to progress may require scaling and root planing, and in some cases, surgery to prevent tooth, bone, and gum loss.

Contact our Livingston office to schedule an appointment and learn about the ways we can help prevent and treat periodontal disease.

Just like that, it’s almost summertime. As the spring season ends, perhaps these lighter, brighter days are inspiring you to do a bit of last-minute spring cleaning. Or perhaps they’re not. No judgment here!

What Dr. Rothstein can recommend wholeheartedly is finishing the season with a clean, sparkling smile. And we have some bright ideas for you!

Refresh Your Cleaning Technique

Tooth brushing can become so automatic that we don’t think about the basics anymore. And suddenly, we’ve finished brushing in half the time we used to, and, hey, how long has that floss been sitting on the counter, anyway? We suggest some mindful cleaning for a healthier smile.

• Spend two minutes brushing, at least twice each day.
• Make sure you reach all the surfaces of your teeth, inside, outside, and on top of your molars.
• Use short, gentle brush strokes, covering a tooth or two at a time.
• Angle your brush to clean along the gum line. Plaque around the gums leads to irritation and inflammation, and is a common cause of gum disease.
• Use vertical strokes to clean the inside of your front teeth.
• Floss at least once each day.

Good Cleaning Requires Good Tools

Since we’re tidying up, let’s talk about some helpful cleaning tools. Is your toothbrush looking a bit—long in the tooth?  

After three to four months of brushing, your toothbrush bristles start to break down. Frayed and matted bristles can’t clean as effectively as a toothbrush in top shape. Each change of season is a good time to remind yourself to change brushes.

And, while you’re shopping, remember:

• Soft bristles are almost always all any brusher needs. Even medium bristles can be abrasive to tooth enamel and gums. And brush gently—scrubbing is also abrasive.
• If you use an electric toothbrush, those toothbrush heads need to be replaced, too! In fact, because these brushes often have shorter bristles, heads might need to be replaced every two to three months.
• Use fluoride toothpaste to clean and protect your teeth.
• Don’t forget the floss!

If you’re not a fan of your current floss, take another look at the dental aisle in your local store. There are lots of new flossing options out there just waiting to be sampled. Or consider a water flosser. Water flossers can be an effective and gentle means of cleaning bacteria from periodontal pockets for those with gum disease. Your periodontist can help you find just the right floss or water flosser for your one-of-a-kind smile.

And speaking of your dental team . . .

Some Cleaning Jobs Require Professional Help

If you suffer from gum disease, a twice-a-year cleaning with your dentist might not be enough to keep your teeth and gums their healthiest. In this case, your periodontist, a specialist in treating conditions of the gums, bones, and tissues surrounding the teeth, can perform a more thorough deep cleaning at our Livingston office. This procedure is non-surgical, and makes use of two types of cleaning:

• Scaling, to remove bacteria, plaque, and tartar above and below the gum line.
• Planing, to smooth the roots of the teeth. This process clears away bacteria and the rough spots where bacteria collect, and provides a smooth tooth surface for gum attachment.

Because periodontal cleanings are more thorough, they can take more than one appointment to complete and might require a local anesthetic. You might also be given medications to help the healing process. A follow up appointment will be scheduled to see whether further treatment is necessary.

Spring’s coming to an end, but taking care of your dental health is always in season! A clean smile isn’t just a more confident smile, it’s a healthier one. Talk to your periodontist for more tips to create your best and brightest smile at any time of year.

Injuries to our teeth and gums can have harmful effects on the bone tissue and structures that support them. In turn, this damage can impact both the appearance and the health of our smiles. One of the ways we can protect our dental health and restore our smiles is with a technique called bone grafting, available at our Livingston office.

What is Bone Grafting?

Bone grafting is a type of periodontal surgery. Bone tissue for grafting may be taken from your own body, or a graft material composed of donor tissue or synthetic substitutes can be used. This kind of graft will be absorbed gradually by the body as your own new, healthy bone tissue replaces it.

If you decide a bone graft is your best option, we will discuss the options for grafting with you beforehand, and use imaging to map out the area of bone loss and to create the best individual treatment plan for you. After anesthesia, an incision will be made in the gum tissue to reveal the damaged bone. Grafting material will be shaped and secured to the affected area, and sutures are generally used to close the incision. We will give you careful instructions for after care and follow-up visits. The time it takes for you to heal completely will depend on the type and size of the graft.

Why Consider a Bone Graft?

The bone structure that supports our teeth can be compromised in a number of ways. Dr. Rothstein might recommend a bone graft as your best option for treating many conditions which have both medical and cosmetic impacts.

• Tooth Loss Can Cause Bone Loss

The bone tissue which supports our teeth needs the stimulation of biting and chewing to stay healthy. Without that stimulation, the bone area under the missing tooth gradually shrinks. The bone tissue is resorbed into the body, which, in a relatively short amount of time, can lead to a noticeable sunken spot where the tooth used to be. A dental implant will provide the tissue stimulation that a natural tooth would, and will prevent future bone loss in the jaw. But if too much bone tissue has already been lost, you might need surgical bone grafting to achieve the right bone area and density to hold an implant.

• Gum Disease

As gum disease progresses, the gums pull away from the teeth, leaving the bone and connective tissue exposed to infection and bacteria. Infection and the body’s own response to bacteria can cause deterioration in the bone structure supporting the teeth, leading to loose teeth, a change in your normal bite, or even tooth loss. Bone loss cannot be reversed, but a graft can replace lost bone and allow healthy tissue to regenerate.

• Other Uses

Bone grafting can also be used to correct deformities in the jawbone, as part of nerve repositioning, to restore bone after trauma or long-term denture wear, and for other restorative and cosmetic uses.

Dr. Rothstein will recommend bone graft surgery when it will provide the best possible outcome for your individual needs. Because this is surgery, we are here to answer any questions you might have about the process and how we can provide the most skillful, gentlest, and least invasive treatment available. Above all, we want not only to protect your smile now, but to restore the strength and function of the bones which make it possible—for a lifetime of future smiles.

Have you been having trouble getting a good night’s rest?

Sometimes the reason for a poor night’s sleep is obvious. A midnight horror movie. A bedtime espresso. That anchovy and pineapple pizza you had for dinner. Not much we can do about these problems.

Sometimes, though, the cause of your sleep difficulties is dental in origin, and that is something Dr. Rothstein can help with.

Teeth grinding, or bruxism, is a very common dental problem. When people with this condition sleep, their jaws clench and their teeth grind against each other throughout the night. When to suspect you might suffer from bruxism?

• You wake with a sore jaw, or you hear pops or clicks when you move your jaw
• You suffer from frequent headaches or facial pain
• Your teeth are chipped, cracked, flattened, worn down, or sensitive
• You wake up tired, because grinding affects the quality of your sleep
• Partners, siblings, or roommates complain about nocturnal grinding noises affecting the quality of their

Pain and fatigue are unpleasant enough, but there are additional serious consequences for those who suffer from bruxism. Our jaws are extremely powerful, and clenching and grinding can put hundreds of pounds on pressure on teeth and jaws over hours of sleep. These forces can lead to:

• Damaged teeth. Cracked, chipped, and worn down teeth can mean veneers, crowns, and root canals. Seriously compromised or broken teeth might need to be extracted.
• Damaged dental work. Bruxism can lead to fractured veneers and damaged fillings and crowns. If the damage is too serious for repair, replacement might be necessary.
• Damaged jaw joints. Severe cases of bruxism can lead to injury to the temporomandibular joint, or TMJ, the complex hinge that allows our jaws to move up and down, back and forth, and side to side.

Why are periodontists concerned about bruxism? Because tooth grinding, over time, can also cause problems for your gums. Grinding your teeth doesn’t cause periodontitis, or advanced gum disease, but it can make the effects of the disease worse.

Periodontitis, left untreated, breaks down the bones and ligaments which support our teeth and hold them firmly in place. The extreme forces generated by tooth grinding put even greater pressure on these already compromised support structures, which can accelerate their breakdown.

While tooth, jaw and periodontal damage can be treated with restorations, or root canals, or implants, or surgical procedures, prevention is clearly a much better option for a healthy smile. And one of the simplest and most effective treatments for preventing the damage caused by bruxism is a night guard.

Night guards fit over the affected teeth to prevent them from touching directly, saving tooth and enamel from injury and wear. Not only do night guards prevent contact, they spread the biting forces of the jaw over the surface of the guard to greatly reduce their impact. And because they also stop the jaw muscles from clenching tightly, there’s no excess stress placed on the temporomandibular joint.

While over-the-counter products are available, a dental professional is the best person to see for the most effective night guard. A custom night guard is designed to fit your individual teeth and mouth perfectly. Impressions or 3D scans are taken in our Livingston office, and a guard is fabricated with the precise shape, strength, and thickness you need to protect your teeth. And, as a bonus, custom night guards offer the most comfortable fit for the most comfortable night’s sleep.

Scary movies, late night caffeinating, creative food combinations—not much we can do about those! But if you’re suffering lost sleep and painful mornings because of tooth grinding, give your dentist a call. In many cases, a night guard just might be the key to sweet dreams.