Dental Retainer in Saint James

James had orthodontic treatment as a child in order to correct his protruding teeth. He is now in college and wears a bonded retainer fixed to the inside of his lower teeth.  This is a fixed wire attached with composite bonding.  It is a common way for orthodontists to fix the teeth in position without the patient having to wear a removable retainer.  The problem is: when does the retainer get removed, if ever?  The patient has long since stopped seeing the orthodontist for checkup appointments.  The retainer may not be serving its purpose; the teeth may be stabilized.

 

I recommend that the patient return to the orthodontist to have the retainer checked and to see if it is still needed or if it can be replaced with a removable retainer.  I am unhappy when a patient has been wearing a retainer for years without supervision.  The patient often has difficulty cleaning the teeth under and around the fixed wire.  The retainer is a plaque and calculus collector.  This leads to decay and gum disease – much more serious than crooked teeth.

 

I performed periodontal scaling for James in order to remove the hardened calculus deposits.  Because of the plaque accumulation which harbors bacteria, he has gingivitis, or inflammation of the gum tissue around the teeth.  The gingivitis will subside now that the teeth are clean, provided that he can keep them clean. I showed him how to use a floss threader to clean in between the teeth and also gave him a Go-Between brush by GUM Industries – a new brush that is excellent for cleaning between the teeth, when space allows. We will see James again in three months, to see how he is doing, keeping those teeth clean!

 

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Look at the calculus around this retainer. The patient thought this was part of his teeth.

 

 

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Look how we removed the calculus.  Now you can see his teeth.

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Look at all of the calculus (tartar) and plaque on the inside of these front teeth (top photo).  See how we removed the deposits with an in-office scaling and polishing (bottom photo).  Calculus like this can build up very quickly with improper homecare.  The deposits on the teeth attract harmful bacteria and their acidic byproducts.  This causes irritation and inflammation of the gum tissue.  See how red and swollen the gums are in the top photo. These gums will bleed as soon as touched.  The bone is also attacked and begins to resorb, or dissolve.  The tooth then has less bony support and, in time, the tooth will loosen and fall out.

The bottom photo was taken on the same visit after scaling and polishing. The gums look healthier – less red and swollen.  If caught in time, if the patient develops meticulous brushing and flossing habits,  if he returns for regular dental maintenance visits, the gums and bone will heal and he will keep his teeth.  If not, he will be a candidate for implants or a denture.  Don’t let this happen to you!

 

I recently attended a dental lecture presented by Dr. Ed Brant, the Saint James periodontist with whom I often work with when a dental patient requires periodontal  treatment or dental implant placement.  His website is http://www.longislandreconstructiveperiodontics.com/.  The lecture was about the PerioLase for the Laser Assisted New Attachment Procedure (LANAP), which Dr. Brant has recently incorporated into his periodontal practice.

The PerioLase from Millennium Dental Technologies is a specialized Nd:YAG (Neodymium: Yttrium Aluminum Garnet) laser which performs soft tissue procedures to treat some kinds of periodontal disease  (http://www.lanap.com//).  The Periolase is an exciting laser modality.  It is minimally invasive, doesn’t require surgery, produce discomfort or a period of healing.  The laser is bacteriocidal and removes the diseased sulcular lining around the tooth.  The protocol includes antibiotic treatment, occlusal adjustment, a night guard and periodic professional cleanings at regular intervals.  The results are impressive.  I look forward to referring patients to the periodontist for laser periodontal therapy when appropriate.

A new study shows that pregnant women can safely undergo essential dental treatment and receive local anesthesia at 13 to 21 weeks’ gestation. Obstetricians generally consider dental care safe for pregnant women but supporting clinical trial evidence had been lacking. To address this issue, researchers at the U. of Minnesota School of Dentistry compared safety outcomes from a trial in which pregnant women received scaling and root planning (deep cleaning) and essential dental treatment. The women’s medical records were reviewed to monitor for adverse reactions. The results of the study showed that periodontal treatment, essential dental treatment and use of local anesthetics were not associated with an increased risk of adverse outcomes. So if you are pregnant or thinking of becoming pregnant, it’s a good time to visit my Long Island dental office for an examination and tooth cleaning.

During pregnancy, the body’s hormone levels rise considerably. Gingivitis, especially common during the second to eighth months of pregnancy, may cause red, puffy or tender gums that tend to bleed when brushed. This sensitivity is an exaggerated response to plaque and is caused by an increased level of progesterone in the system. We may recommend more frequent cleanings during the second trimester or early third trimester to help you avoid problems.

It’s especially important to maintain good oral health during pregnancy. Studies indicate that pregnant women who have severe periodontal (gum) disease may be at increased risk for pre-term delivery, which in turn increases the risk of having a low-birthweight baby.

If you are planning a pregnancy, be sure to schedule a dental checkup. If you are pregnant, don’t forget to continue your regular dental visits, and call our Long Island Dental office if you notice any changes in your mouth during your pregnancy.

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