Re-Growing Lost Gum Tissue & Other Repair Techniques for Gum Loss

South Charlotte Dentistry sees many cases of periodontal disease, ranging from early mild stages to late severe stages, but mainly those moderate cases of gum degeneration. Our patients, alongside half of all American adults, are eager to find out about how or if they can re-grow lost gum tissue, or otherwise repair gum loss. South Charlotte Dentistry delivers the latest news on exciting findings in the dentistry field, and discusses gum repair techniques available to our patients to ensure that they have the best information available for advocating for a healthy, happy smile.

In March 2019, the American Chemical Society journal, Nano released an article titled, "New technique could help regrow tissue lost to periodontal disease." This report discussed exciting new findings where researchers have found that the development of a membrane can help periodontal tissue regenerate when implanted into the gums of rats.

What are the takeaways from this study?

Scientists have been trying to regrow lost gum tissue and bone from periodontal disease for ages. They tried implanting pieces of polymers (a small piece of mesh-like material) at the root of the tooth, in the aims of generating new gum and bone cells.

So what was the issue? A second surgery was required to remove the polymeric membrane that could get in the way of the healing process. When scientists developed more biodegradable membranes, they didn't work as well for re-growing that periodontal tissue.

The current study featured a new, nano-fibrous membrane of poly(ε-caprolactone), a biocompatible polymer. This was coated in polydopamine (PDA), which is a synthetic polymer with sticky consistency that can attach to wet surfaces. When this new membrane was implanted into the gums of rats with periodontal defects, bones at those defected sites regenerated to normal levels within weeks, and the membranes degraded. Researchers are now working to add more components to the membrane that further aid healing and prevent infection.
 

Why is this study so important?

We're not just nerding out at South Charlotte Dentistry, honest! As periodontal disease is associated with age, and Americans are living longer and keeping more of their natural teeth, more and more adults are suffering from the effects of the disease. This means that for our practice and for dental practices everywhere, periodontal disease will become a more prominent issue for the overall health of our population.

What is periodontal disease?

Periodontal, or gum disease, is an inflammatory condition of the gum and bone support (periodontal tissues) surrounding the teeth, in which the gums, ligaments, and bone become infected. This damages the soft tissue and the bone that supports your tooth. "Periodontitis" literally means "inflammation around the tooth."

On a scale of common to rare, where does periodontal disease fall?

Periodontal disease is very common. In fact, the US sees more than 3 million cases per year. According to the US Centers for Disease Control and Prevention, about half of all Americans will have periodontal disease during their lifetime.

A study titled "Prevalence of Periodontitis in Adults in the United States: 2009 and 2010" estimates that 64.7 million American adults (42.7% of the adult population, or one out of every two adults aged 30 and over) have mild to moderate or severe periodontitis. Of that 42.7 %, 30% have moderate periodontitis, with 8.7% being mild, and 8.5% severe. Among adults aged 65 years and older, the rates of periodontitis increase to 70.1%.

What is the main cause of periodontal disease?

Periodontal disease occurs when bacteria and plaque build-up around the tooth, and as a result, the immune system launches into action against it.

How do I know if I have periodontal disease, and how do dentists diagnose periodontal disease?

An annually comprehensive periodontal evaluation is the best way to identify the disease.
This happens once a year during one of your scheduled dental cleanings. A dental professional will examine each tooth above and below the gum line. You may not have realized this was happening beforehand, but the hygienist or dentist will use a periodontal probe (a tool with a ball end, a colored band at 3.5-5.5mm, and another colored band at 8.5-11.5mm) and call out a number between 0 and 4 for each tooth, measuring how deep the gum line is. This is the standard clinical examination of the periodontium or gums.

What are the symptoms of periodontal disease?

• inflamed or swollen gums, and recurrent swelling in the gums
• bright red, sometimes purple gums
• pain when the gums are touched
• receding gums, which make the teeth look longer
• extra spaces appearing between the teeth
• pus between the teeth and gums
• bleeding when brushing teeth or flossing
• a metallic taste in the mouth
• halitosis, or bad breath
• loose teeth

Who is at risk?

Those who have a more weakened immune system or partake in the following risk factors are more susceptible to periodontal disease:

• Smokers
• Females undergoing hormonal changes (i.e. from puberty, pregnancy, or menopause)
• Diabetic people
• People with AIDS
• Cancer patients, or those undergoing cancer treatment
• People medicated with drugs such as antihypertensive, vasodilating agents, or immunotherapy, that reduce saliva and increase chances of gum disease
• People genetically predisposed to gum disease

What are the treatment options?

Good oral hygiene is part of both treatment and prevention. For moderate and severe cases of periodontitis, medicated mouthwashes and medications can be used to treat periodontitis, including:

• Prescription antimicrobial mouth rinse, such as chlorhexidine
• Antiseptic chip
• Antibiotic gel
• Antibiotic microspheres
• Enzyme suppressant
• Oral antibiotics

Periodontal scaling is a nonsurgical procedure to treat your teeth and gums against plaque, bacteria, and tartar deposits. The dental professional targets the area below the gum line and along the roots using an ultrasonic scaling device and/or manual instruments to gently remove plaque and tartar. Scaling can also involve delivering an antimicrobial agent into the pocket to treat and reduce bacteria.
Next, root planing goes deeper to remove cementum and surface dentin, smoothing out affected root areas in order to decrease gum tissue inflammation and allow your gums to reattach to your teeth. A properly planed root surface helps fight against bacteria, tartar, and plaque when they want to relocate under your gum line, and promotes root healing.

When good oral hygiene and non-surgical treatments aren't effective, sometimes surgery may be necessary. Those options can include:

• Flap surgery to lift and remove deep pockets, and remove tartar
• Bone and tissue grafts to regenerate bone or gum tissue that has been destroyed, using new natural or synthetic bone, which promotes growth
• Guided tissue regeneration (GTR), which as we mentioned before, uses barrier membranes to direct the growth of new bone and gum tissues to regenerate tissue and repair defects from periodontitis

Success in a periodontal treatment really can depend on how advanced the periodontal disease is, how well the patient adheres to a proper oral hygiene program, and other health and activity factors (i.e. smoking, or other preexisting conditions).

What happens if periodontal disease goes untreated? Can periodontitis kill you?

Because periodontitis is a chronic inflammatory disease, it has been associated with other chronic inflammatory diseases, such as diabetes and cardiovascular disease.

Is there a home remedy?

Sure there is! It may not be what you are picturing, it is not all that glamorous, and it definitely doesn't involve fancy polymers inserted in your teeth. Here it is:

• Brush your teeth with a suitable toothbrush and fluoride toothpaste at least twice daily for at least two minutes, carefully cleaning the chewing surfaces, sides of the teeth, and all of the hard-to-reach places (including—very gently!—on the gum line) around your mouth
• Consider using a manual or electric toothbrush with soft bristles, and replace this toothbrush every 3 to 4 months
• Do not share toothbrushes—bacteria can pass from person to person
• Floss every day! Consider using an interdental brush to clean gaps around the teeth and those small spots where a toothbrush cannot reach. Dental floss is great for small gaps, but a dental brush is really useful for larger spaces in your mouth
• Uneven surfaces are more susceptible to periodontal disease, so take extra care in cleaning around closely-packed teeth, crooked teeth, crowns, dentures, fillings, etc.
• Use an antibacterial mouthwash to help prevent bacteria from growing and reduce inflammatory reaction in the mouth. Plus, you'll be taking that extra step to freshen your breath after brushing and flossing!

What are the stages of periodontal disease?

There are two stages. First, gingivitis occurs. Gingivitis is basically gum inflammation, whereas periodontitis refers to gum disease, or the destruction of tissue and bone.

Gingivitis occurs when bacterial plaque builds upon the surface of the tooth and causes the gums to become red, inflamed, and susceptible to bleeding. With gingivitis, there is no irreversible damage occurring to the bone or tissue, just irritated and bothersome gums.

As gingivitis progresses, it leads to periodontitis. This is when the gum and bone pull away from the teeth and form large, deep pockets where debris and bacteria can collect. Bacteria between the gum and teeth leads to an infection, as the plaque is now below the gum line. But, it isn't just the plaque and bacterial toxins destroying bone and tissue—it's your immune system. Your immune system's response to the infection in the pockets is to fight the infection, all leading to the destruction of gum and bone.

What can periodontitis lead to?

Periodontitis can lead to serious medical issues and even death. For example, when someone with periodontitis chews or brushes their teeth, bacteria can potentially enter the bloodstream, which increases the clotting risk and risk of stroke. Healthy teeth and gums can also decrease the chances of cardiovascular disease, diabetes, preterm pregnancies, prostate cancer, and breast cancer.

Will I lose my teeth if I have periodontal disease?

Not in a mild or moderate case, but left untreated, this chronic inflammatory disease badly affects the gum tissue and structures supporting the teeth, leading to eventual tooth loss.

Can South Charlotte Dentistry tell me more about gum loss and gum repair?

Absolutely! Our team is always here at South Charlotte Dentistry, located conveniently in the Ballantyne area of South Charlotte to help you with any questions you might have. You may also be interested in our limited-time New Patient Special that includes a comprehensive dental exam and full x-rays for only $69.00. Our existing patients can tell you all about our friendly and welcoming team that ensures a low-stress, but high-quality dental experience.

If you're looking for a highly rated, clean, and patient-centered dentist in the South Charlotte area, then look no further! South Charlotte Family and Cosmetic Dentistry will provide you the best dental care in South Charlotte—whether you're in the market for gum regrowth and repair, or just a simple dental cleaning!


-Tayler Green

Symptoms & Solutions: Maintaining Good Oral Health

Unexpected dental pain can be alarming, not to mention painful! The level and length of pain vary and there are also ongoing issues (such as bad breath) that may have underlying causes that need to be addressed. Fillings, crowns, dentures, and orthodontic work can come loose or occasional break as well. The following is a guide of common dental issues to be on the lookout for.

Top Ten Dental Symptoms from www.mouthhealthy.org and the American Dental Association:

1) Symptom: Toothache

If your mouth or jaw hurts, it could be from a toothache. Toothaches usually indicate a cavity but they can also signal gum disease. In some cases, a toothache is a sign of an abscess or impacted tooth. A toothache should be evaluated by a dentist right away to determine the cause of the problem and prevent the tooth from dying.

An abscessed tooth (toothache) is an infection caused by tooth decay, periodontal disease, or a cracked tooth. These problems can let bacteria enter the pulp (the soft tissue of a tooth that contains nerves, blood vessels, and connective tissue) and can lead to pulp death. When pus builds up at the root tip in the jaw bone, it forms a pus-pocket called an abscess. If the abscess is not treated, it can lead to a serious infection in the jawbone, teeth, and surrounding tissues.
Symptoms of an abscess include:

• pain
• swelling
• redness in the gums
• bad taste in the mouth
• fever

An abscessed tooth can be treated with various treatments, depending on the severity of the infection.


2) Symptom: Sensitive Teeth

If your teeth hurt when you drink hot or cold beverages, you may have sensitive teeth. This can be the result of tooth decay, fractured teeth, worn fillings, gum disease, worn tooth enamel, or an exposed tooth root due to gum recession. Treatment will depend on the source of sensitivity.
Possible causes include:

• tooth decay (cavities)
• fractured teeth
• worn fillings (or damaged dental work)
• gum disease
• worn tooth enamel
• exposed tooth root

In healthy teeth, a layer of enamel protects the crowns of your teeth—the part above the gum line. Under the gum line, a layer called cementum protects the tooth root. Underneath both the enamel and the cementum is dentin.

Dentin is less dense than enamel and cementum and contains microscopic tubules (small hollow tubes or canals). When dentin loses its protective covering of enamel or cementum these tubules allow heat and cold or acidic or sticky foods to reach the nerves and cells inside the tooth. Dentin may also be exposed when gums recede. The result can be hypersensitivity.
Sensitive teeth can be treated. The type of treatment will depend on what is causing the sensitivity.

3) Symptom: Bleeding or Sore Gums

Bleeding or sore gums can be a sign of gingivitis, an early and reversible stage of gum disease, or simply the result of brushing too hard or starting a new flossing routine. If your gums bleed regularly, or enough to worry you, make an appointment with your dentist or physician, it could be a sign that something else is wrong.

There are many reasons your gums could bleed. In some cases, bleeding gums can be a sign of gingivitis, the early stage of periodontal disease. If your gums bleed easily or bleed when you brush, talk to your dentist about your oral health. Gingivitis is reversible and preventable.
If you’ve just started a new flossing routine, for instance, your gums may bleed at first as they get used to cleaning between the teeth. This usually goes away on its own in about a week. Some pregnant women develop a condition known as “pregnancy gingivitis,” an inflammation of the gums that can cause swelling and tenderness. Gums may also bleed a little when brushing or flossing. If you take blood thinners, these medications may cause your gums to bleed as well. Contact your physician if the bleeding does not stop quickly. Your gums could also be bleeding if you brush too hard. Use an extra-soft or soft-bristled toothbrush when brushing your teeth.
If your gums bleed regularly or enough to worry you, make an appointment with your dentist or physician. It could be a sign something else is wrong.

4) Symptom: Mouth Sores

Types of mouth sores include canker sores, cold sores, leukoplakia, and candidiasis. These vary in their severity and causes. Mouth sores could be the symptom of a disease or disorder; infection from bacteria, viruses or fungus, or result from irritation caused by braces, dentures or the sharp edge of a broken tooth or filling. Your dentist should examine any mouth sore that lasts a week or longer.

5) Symptom: Bad Breath

Bad breath can be caused by what you eat, not cleaning your mouth, dry mouth, smoking, or other medical conditions. Persistent bad breath can also be one of the warning signs of gum disease. Brushing twice a day and flossing daily are essential to reducing bad breath and preventing gum disease. Brushing your tongue can help too. If you’re concerned about what’s causing your bad breath, see your dentist.

Bad breath happens. If you’ve ever gotten that not-so-fresh feeling on a date, at a job interview, or just talking with friends, you’re not alone. Studies show that 50 percent of adults have had bad breath, or halitosis, at some point in their lives.

What Causes Bad Breath?

There are a number of reasons you might have dragon breath. While many causes are harmless, bad breath can sometimes be a sign of something more serious.

Bacteria
Bad breath can happen anytime thanks to the hundreds of types of bad breath-causing bacteria that naturally live in your mouth. Your mouth also acts like a natural hothouse that allows these bacteria to grow. When you eat, bacteria feed on the food left in your mouth and leave a foul smell behind.

Dry Mouth
Feeling parched? Your mouth might not be making enough saliva. Saliva is important because it works around the clock to wash out your mouth. If you don’t have enough, your mouth isn’t being cleaned as much as it should be.  Dry mouth can be caused by certain medications, salivary gland problems, or by simply breathing through your mouth.

Gum Disease
Bad breath that just won’t go away or a constant bad taste in your mouth can be a warning sign of advanced gum disease, which is caused by a sticky, cavity-causing bacteria called plaque.

Food
Garlic, onions, coffee… The list of breath-offending foods is long, and what you eat affects the air you exhale.

Smoking and Tobacco
Smoking stains your teeth gives you bad breath and puts you at risk for a host of health problems. Tobacco reduces your ability to taste foods and irritates gum tissues. Tobacco users are more likely to suffer from gum disease than non-tobacco users.

Medical Conditions
Mouth infections can cause bad breath. However, if your dentist has ruled out other causes and you brush and floss every day, your bad breath could be the result of another problem, such as a sinus condition, gastric reflux, diabetes, or liver or kidney disease. In these cases, see your healthcare provider.

6) Symptom: Jaw Pain or Popping/Clicking in the Jaw

Many things can cause these symptoms, which can make it difficult to diagnose. Possible causes include sinus problems, toothaches, arthritis, injury, teeth grinding, gingivitis, or problems with your jaw like TMJ. Your dentist will conduct a thorough exam, which may include X-rays, to determine the source of the pain.

Many adults suffer from chronic jaw and facial pain. Some common symptoms include pain in or around the ear, tenderness of the jaw, pain when biting, or headaches. Many things can cause facial pain, which can make it difficult to diagnose and treat. Your dentist will conduct a thorough exam, which may include X-rays, to determine the cause of the pain.
Possible causes of jaw pain or facial pain include:

• sinus problems
• toothache
• infections
• arthritis
• injury
• tooth grinding
• periodontal disease
• problems with your jaw or the temporomandibular joint

7) Symptom: Dry Mouth
If you have dry mouth it may be the symptom of a medical disorder or a side effect of certain medications. Saliva is the mouth’s primary defense against tooth decay. It washes away food and other debris, neutralizes acids produced by bacteria in the mouth, and provides disease-fighting substances throughout the mouth. Your dentist can recommend ways to restore moisture.

Dry mouth—also called xerostomia—results from an inadequate flow of saliva. It is not a disease, but a symptom of a medical disorder or a side effect of certain medications, such as antihistamines, decongestants, pain killers, diuretics and many others.

Saliva is the mouth’s primary defense against tooth decay and maintains the health of the soft and hard tissues in the mouth. Saliva washes away food and other debris, neutralizes acids produced by bacteria in the mouth, and provides disease-fighting substances throughout the mouth, offering first-line protection against microbial invasion or overgrowth that might lead to disease. Without saliva, extensive tooth decay can also occur.

Some of the common problems associated with dry mouth include a constant sore throat, burning sensation, trouble speaking, difficulty swallowing, hoarseness, or dry nasal passages.

8) Symptom: Oral Piercing Infections
Oral piercings can create a wide range of problems for your health, oral and otherwise. Your mouth is home to huge amounts of bacteria, creating an ideal place for infection to start.

9) Symptom: Cracked or Broken Tooth
A cracked or broken tooth can happen for a variety of reasons—brittle teeth, teeth grinding, injury. The crack may be invisible to the naked eye and even an X-ray, but it can be incredibly painful and create bigger problems if left untreated. If you experience pain when chewing see your dentist.

10) Symptom: Stained or Discolored Teeth
Over time your teeth can become stained and change color. This is often the result of taking in certain liquids, such as coffee or tea, smoking, aging, genetics, injury, or certain medications. Whitening options can include over the counter or in-office treatments.

Causes:

Food and Drink
Coffee, tea, and red wine are some major staining culprits, due to their intense color pigments called chromogens that attach to the white, outer part of your tooth (enamel).

Tobacco Use
Two chemicals found in tobacco create stubborn stains: tar and nicotine. Tar is naturally dark. Nicotine is colorless until it’s mixed with oxygen.

Age
Below the hard, white outer shell of your teeth (enamel) is a softer area called dentin.  Over time, the outer enamel layer gets thinner with brushing and more of the yellowish dentin shows through.

Trauma
If you’ve been hit in the mouth, your tooth may change color because it reacts to an injury by laying down more dentin, which is a darker layer under the enamel.

Medications
Tooth darkening can be a side effect of certain antihistamines, antipsychotics, and high blood pressure medications. Young children exposed to antibiotics when their teeth are forming may have discoloration of their adult teeth later in life. Chemotherapy and head and neck radiation can also darken teeth.

What if you are having a Dental Emergency?
Accidents and sudden toothaches happen and knowing what to do when one occurs can mean the difference between saving and losing a tooth.

Here are some tips for common dental emergencies:

• For a knocked-out permanent or adult tooth, keep it moist at all times. If you can, try placing the tooth back in the socket without touching the root. If that’s not possible, place it in between your cheek and gums, in milk, or use a tooth preservation product that has the ADA Seal of Acceptance. Then, get to your dentist’s office right away.
• For a cracked tooth, immediately rinse the mouth with warm water to clean the area. Put cold compresses on the face to keep any swelling down.
• If you bite your tongue or lip, clean the area gently with water and apply a cold compress.
• For toothaches, rinse the mouth with warm water to clean it out. Gently use dental floss to remove any food caught between the teeth. Do not put aspirin on the aching tooth or gum tissues.
• For objects stuck in the mouth, try to gently remove with floss but do not try to remove it with sharp or pointed instruments.

Until you can get to the dentist:
If you are having issues with loose or broken dental work (like a crown or veneer) or orthodontia, avoid chewing in the area if possible. If a piece of dental work has come unattached entirely, save it for the dentist to inspect. Avoid hard and sticky foods, such as candy or chewing gum, as well as straws or any food that requires sucking (like a lollipop or popsicle). You may have a sensitivity to hot or cold during this time as well. Over the counter pain relievers and topical pain relievers may help until you see your dentist.

Here at South Charlotte Dentistry, we know it’s scary when you have a dental issue or emergency and we’re here to help. Call our office for an appointment as soon as possible if you have any of these symptoms or an emergency.