By Bradford J. Rhodes D.M.D.
November 09, 2021
Category: Oral Health
Tags: gum disease   gum recession  
GumRecessionCouldHaveLong-RangeConsequencesForYourDentalHealth

We're all familiar with optical illusions, which our brain visually perceives in a way different from the actual reality. A kind of optical illusion may also happen in your mouth: Your teeth appear to have gotten "longer." They haven't actually grown—instead, the gums have shrunk back (or receded) to reveal more of the tooth.

Unfortunately, this isn't an amusing visual trick! Gum recession isn't healthy, and it could endanger your teeth.

Receding gums occur for a variety of reasons. Some people are simply more genetically disposed to recession because they've inherited thinner gum tissues from their parents. You can also damage your gums through over-aggressive brushing.

But the most common cause for gum recession is periodontal (gum) disease, caused by bacteria inhabiting a thin biofilm on tooth surfaces called dental plaque. The more plaque present on your teeth, the more plentiful the bacteria, which can sharply increase your risk of infection. Unless treated, gum disease can eventually weaken the gums' attachment to teeth that can then cause the gums to recede.

Normally, the gums cover and protect the tooth roots from bacteria and other hazards, similar to the way enamel protects the tooth's visible crown. But teeth lose this protection when the gums recede, exposing them to disease-causing bacteria and other oral hazards.

Fortunately, there is hope for receded gums. The primary way is to first treat the gum disease that caused it: If the recession has been mild, this may help the tissues regain their former coverage. More severe recession, however, may require highly technical grafting surgery with donor tissue to promote new tissue growth at the site.

But the best approach is to avoid recession in the first place by preventing gum disease. This requires removing bacterial plaque daily through brushing and flossing, as well as regular dental visits for more thorough cleanings. Dental visits are also important if you have a higher risk profile for gum recession like thinner gum tissues.

Gum recession isn't just an inconvenience. It can put your oral health at long-term risk. But you may be able to avoid its occurrence by practicing daily oral hygiene and seeing your dentist regularly.

If you would like more information on gum recession, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Gum Recession.”

By Bradford J. Rhodes D.M.D.
October 30, 2021
Category: Dental Procedures
Tags: gum recession  
GumRecessionDoesntHavetobePermanent

The worst outcome of periodontal (gum) disease is tooth loss—but it isn't the only form of misery you might suffer. One of the more troublesome results associated with gum disease is gum recession.

Normal gum tissue covers teeth from just above the visible crown to the roots, providing protection against bacteria and oral acid similar to the enamel on the crown. But advanced gum disease can weaken these tissues, causing them to pull away or recede from the teeth.

Not only can this diminish your smile appearance, but the exposed areas are more susceptible to further disease and painful sensitivity. And it certainly can accelerate tooth loss.

But there are some things we can do to reduce the harm caused by gum recession. If we're able to diagnose and treat a gum infection early while the gums have only mildly receded, the tissues could stabilize and not get worse.

The chances for natural regrowth are unlikely, especially the more extensive the recession. In such cases, the gums may need some assistance via plastic periodontal surgery. Surgeons reconstruct gum tissues by grafting like tissues to the area of recession. These grafts serve as a scaffold for new tissues to gradually grow upon.

There are two general types of grafting procedures. One is called free gingival grafting. The surgeon completely removes a thin layer of skin from elsewhere in the mouth (such as the palate), then shapes and attaches it to the recession site. Both the donor and recession sites heal at approximately the same rate, usually within 14-21 days. This procedure replaces missing gum tissue, but doesn't cover exposed tooth roots to any great extent.

In cases of root exposure, dentists usually prefer another type of procedure, known as connective tissue grafting.  The donor tissue is usually taken again from the palate, but the design of the surgery is different. A flap of tissue at the recipient site is opened so that after the connective tissue from the palate is placed at the recipient site to cover the exposed roots, the flap of tissue covers the graft to provide blood circulation to the graft as it heals.

Both kinds of procedures, particularly the latter, require detailed precision by a skilled and experienced surgeon. Although they can successfully reverse gum recession, it's much better to avoid a gum infection in the first place with daily oral hygiene and regular dental care.

If you would like more information on treating gum recession, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Periodontal Plastic Surgery.”

By Bradford J. Rhodes D.M.D.
October 20, 2021
Category: Dental Procedures
Tags: celebrity smiles   crown  
WhatChrissyTeigensInaugurationNightCapMishapCouldMeanForYou

Inauguration night is usually a lavish, Washington, D.C., affair with hundreds attending inaugural balls throughout the city. And when you're an A-List celebrity whose husband is a headliner at one of the events, it's sure to be a memorable night. As it was for super model Chrissy Teigen—but for a slightly different reason. During the festivities in January, Teigen lost a tooth.

Actually, it was a crown, but once she told a Twitter follower that she loved it “like he was a real tooth.” The incident happened while she was snacking on a Fruit Roll-Up (those sticky devils!), and for a while there, husband and performer John Legend had to yield center stage to the forlorn cap.

But here's something to consider: If not for the roll-up (and Teigen's tweets on the accident) all of us except Teigen, her dentist and her inner circle, would never have known she had a capped tooth. That's because today's porcelain crowns are altogether life-like. You don't have to sacrifice appearance to protect a tooth, especially one that's visible when you smile (in the “Smile Zone”).

It wasn't always like that. Although there have been tooth-colored materials for decades, they weren't as durable as the crown of choice for most of the 20th Century, one made of metal. But while gold or silver crowns held up well against the daily grind of biting forces, their metallic appearance was anything but tooth-like.

Later, dentists developed a hybrid of sorts—a metal crown fused within a tooth-colored porcelain shell. These PFM (porcelain-fused-to-metal) crowns offered both strength and a life-like appearance. They were so effective on both counts that PFMs were the most widely used crowns by dentists until the early 2000s.

But PFMs today make up only 40% of currently placed crowns, down from a high of 83% in 2005. What dethroned them? The all-ceramic porcelain crown—but composed of different materials from years past. Today's all-ceramic crowns are made of more durable materials like lithium disilicate or zirconium oxide (the strongest known porcelain) that make them nearly as strong as metal or PFM crowns.

What's more, coupled with advanced techniques to produce them, all-ceramic crowns are incredibly life-like. You may still need a traditional crown on a back tooth where biting forces are much higher and visibility isn't an issue. But for a tooth in the “Smile Zone”, an all-ceramic crown is more than suitable.

If you need a new crown (hopefully not by way of a sticky snack) or you want to upgrade your existing dental work, see us for a complete exam. A modern all-ceramic crown can protect your tooth and enhance your smile.

If you would like more information about crowns or other kinds of dental work, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Porcelain Crowns & Veneers.”

By Bradford J. Rhodes D.M.D.
October 10, 2021
Category: Oral Health
Tags: tooth decay  
StopToothDecayBeforeItDerailsYourChildsDentalDevelopment

From birth to early adulthood, your child's teeth, gums and jaws develop at a rapid pace. And, for the most part, nature takes its course without our help.

But tooth decay can derail that development. The result of bacterial acid eroding enamel, tooth decay is the top cause for premature primary tooth loss in children. One particular form, early childhood caries (ECC), can rapidly spread from one tooth to another.

Many parents assume prematurely losing teeth that are destined to fall out soon anyway is inconsequential. But primary teeth play a critical role in the proper eruption of permanent teeth, serving as both placeholders and guides for those teeth developing just below them in the gums. A permanent tooth without this guidance can erupt out of alignment to create a poor bite that may require future orthodontics.

Being proactive about tooth decay lessens that risk—and the best time to start is when the first teeth begin to erupt. That's when you should begin their regular dental visits sometime around their first birthday.

Dental visits are an important defense against tooth decay. Besides routine dental cleanings, your child's dentist can offer various preventive treatments like sealants to stop decay from forming in the biting surfaces of back molars or topically applied fluoride to strengthen tooth enamel.

Daily home care is just as important in the fight against tooth decay. Oral hygiene should be a part of your child's daily life even before teeth: It's a good habit to wipe an infant's gums with a clean cloth after nursing. As teeth arrive, oral hygiene turns to brushing and flossing—perhaps the best defense of all against dental disease.

It's also important to watch their intake of sugar, a prime food source for bacteria that produce harmful acid. Instead, encourage a "tooth-friendly" diet of whole foods to keep teeth and gums healthy.

Even if they do develop tooth decay, there are effective treatments to minimize any damage and preserve affected primary teeth until they've served their purpose. By adopting these prevention strategies and prompt treatment, you can stay ahead of this destructive disease.

If you would like more information on preventive dental care for children, please contact us or schedule an appointment for a consultation.

By Bradford J. Rhodes D.M.D.
September 30, 2021
Category: Dental Procedures
Tags: x-rays  
HeresWhyX-RaysareaSafePracticeWithChildren

X-rays are so interwoven into dental care that we often don't think twice about them. Even so, we shouldn't take this invisible form of radiation lightly—regular exposure at high levels can affect the human body, especially in children.

The ability of x-rays to pass through tissue greatly improves our ability to diagnose tooth decay and other dental diseases. But x-rays can also potentially harm those same tissues. Because children are more sensitive to x-ray energy, they run a greater risk for cellular damage that could lead to cancer later in life.

In reality, though, these potential risks from x-rays are extremely low—so low, in fact, dental professionals regard their use as altogether safe for children. Here's why.

The ALARA principle. Dentists and other healthcare providers perform x-ray diagnostics based on a principle known as ALARA (“As low as reasonably achievable”). This means dentists only utilize x-rays to gain the most diagnostic benefit at the lowest amounts of radiation exposure. As such, ALARA guides both the development of x-ray equipment and the protocols involved in using them.

Equipment advances. Today's x-ray devices are safer and more efficient, restricting x-ray emissions to a single beam without scattering radiation into the environment. A child's radiation exposure is further lowered with the use of digital x-rays, which produce images in less time than conventional film. Because of these and other advances, children are exposed to less radiation during x-rays than what they typically receive in a day from the outside environment.

Safe practices. Following the ALARA principle, dentists are quite conservative in their use of x-rays in children. The most common means of x-ray is the bitewing, which captures images primarily of the back teeth that are more prone to decay. Bitewings, which require a lower x-ray dosage than a full mouth x-ray, are usually spaced at least six months apart or longer depending on a child's risk for dental disease.

The efficiency of modern radiographic equipment coupled with their judicious use has drastically reduced the amount of x-ray radiation to which a child may be exposed, thus lowering their risk of future health issues. The benefit for saving a child's teeth from disease is well worth their use.

If you would like more information on x-ray safety, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “X-Ray Safety for Children.”





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Bradford J. Rhodes D.M.D.

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1110 SE 122nd St Portland, OR 97233