If only I could count all the times I have had a patient sit in the chair and tell me that their teeth are bad because they have bad genetics or a family history of bad teeth. They are sure that genetics are the only factor that plays into their poor oral health and all the cavities they have. I try to be as impartial as one can be when I am talking with my patients, but this topic is one that I feel needs to be addressed. Patients need to be aware of the truth between genetics and their own personal oral health care.
Yes, genetics play a role in the make up of your teeth and without question, genetics play a significant role in the people we ultimately grow to be. So yes, there are different genetic variations among people and there are even some genetic anomalies that will completely alter the shape, size and consistency of the enamel causing malformation of the entire tooth. These are factors that can play into making you more susceptible to cavities, but it’s not the only thing. Genetics determines the make up and composition of the enamel. It lays out a blueprint for how the structure of the tooth is to be assembled. Because of this make up it is imperative to be diligent on your home care.
Just because a person may have “bad genetics” or a “family history of bad teeth” doesn’t mean that person will have bad oral health but it could make them more susceptible to having cavities or periodontal issues. However it only reinforces how necessary diligent home care is. It sets the precedence for how they should care for their teeth and how important their dental exams and cleanings truly are. Brushing twice a day and flossing is the recommended care that we have always been taught but, if someone is aware of “bad genetics” doing more is the best thing you can possibly do.
What are some things someone with “soft teeth” could do? Good question, maintaining a healthy diet. Cutting down on sugar, which is the main food source for bacteria. Cutting out acidic foods that erode the already soft enamel and increasing fluoride intake, which will help to provide re-mineralization to teeth that are damaged. Rinsing with a good mouthwash that contains antimicrobial elements and fluoride. Getting into your dentist and hygienist every 6 months, or more, is a major factor.
So I agree, while genetic factors can create an environment in which tooth problems can take root. A proper dental care routine will go a long way in maintaining the healthy teeth you desire.
Last time we talked about what periodontal disease was and some of the factors that are involved in the disease. Today we will discuss who may be at risk and some things to look out for. We will discuss the stages involved and severities that go along with the stages and how is periodontal disease different from gingivitis.
Plaque is a film that acquires on the surface of your tooth. When we brush our teeth that biofilm containing proteins, sugars, and bacteria are removed. If we miss the opportunity to remove that plaque biofilm it accumulates on the tooth surface and will eventually build up. The build up will cause more material to make its way below the gum surface interrupting the peaceful life our gums are enjoying causing our gums to become red and puffy. This is gingivitis or inflammation of the gums.
If we do not stop the gingivitis stage the material already on your teeth will continue to accumulate starting the process of calcification in the biofilm that is present. When the calculus begins to accumulate it is then impinging on the attachment of the bone and gum tissue around the tooth leading to recession. Recession is the factor leading to mobility and loose teeth. Recession is the factor that causes sensitivity. Recession that is not arrested will lead to loss of the teeth.
Am I at risk? Well let’s check! If you do not brush regularly you are at risk. If you have a systemic disease such as diabetes, HIV or other autoimmune diseases you are at risk. If you are a smoker you are at risk. Lastly, yes genetics can also put you at risk. Does a risk mean you will get periodontal disease? No, the risk factor merely means you must be more diligent in your home care as well as maintaining your dental appointments. A true periodontal evaluation is the only true way to diagnose periodontal disease and set up to begin treatment.
There are 3 stages of periodontal disease outside of the healthy gums and gingivitis. Early, moderate, and advanced periodontal disease. There are differences in the signs and symptoms between the 3 stages and as such there are differences in the treatments you may receive with each stage as well. We will discuss each stage in detail on the next post.
Periodontal disease is an infection of the attachment that holds and supports the teeth. That attachment is known as the bone and gum around your teeth. That infection causes an inflammation of the gingiva as well as recession of the bone around your teeth. This can lead to tooth mobility, shifting of the teeth and eventually loss of the teeth. As the bone recedes the root surface is exposed and can cause sensitivity or pain.
If you are wondering, do I have this? Here are a few things you can look for.
Bleeding gums that are red, swollen and puffy in appearance, bad breath, loose teeth and possible even your smile doesn’t line up like it use to. All of these are possible symptoms of periodontal disease. When you come in for your appointment we will take x-rays and do a thorough exam to determine your periodontal health.
Early stages of periodontal disease may not hurt, but you still have the disease and damage is being done. So the best advice that I can offer is, don’t wait until you are experiencing these symptoms and be diligent with your oral health. I know people hate flossing but, it is one of the cheapest, most effective way to ward of periodontal disease. But if you are already experiencing these symptoms come in for an evaluation and get your mouth the care it needs to prevent further damage and get you back on track.
Next session we will talk about the risk/causative factors, the stages of periodontal disease and how gingivitis is different but a Segway into periodontal disease.
Dr. Carl Graves
Throughout my time practicing I have been confronted from some patients questioning if they really need a filling. Their argument is that it doesn’t hurt so I don’t need it. Truth be told why would you wait until it hurt? Do baseball players wait until a ball has incapacitated them before they put on a cup? NO! they put it on before they go one the field.
Prevention is the key to everything we try to achieve in dentistry! Even trying to prevent further damage or decay. The further along the decay encroaches on the tooth, the more structure of the tooth that has to be removed. When we take away the structure we make the tooth weak and that’s what we are trying to prevent. If we wait until there is pain, we are increasing the chance that more work will need to be performed on the tooth. This could include the possibility of root canal therapy and a crown to the possible need to extract the tooth. All of this could be PREVENTED if you will just let me fill that tooth.
Now lets look at the pocket book aspect of this. A two surface filling that doesn’t hurt would cost around $200. Root canal therapy would be approximately $900 to $1100. And then a crown would be another $1100. Lets talk the extraction route…The extraction would cost approximately $200. After the extraction we would need to fill that space. Implant, bridge, or partial denture now becomes the treatment choices to fill the gap and the fees for these procedures can reach $5,000.
So when your dentist tells you that you have a cavity but you feel that it’s ok and it doesn’t hurt, remember it may not right now but it will in more ways than one it you wait to get it taken care of.
Dr. Carl Graves D.D.S.