Category Archives: Periodontal Disease


Orthodontics for Adult Patients

Contrary to common thought, malocclusion – or “bad bite” – is not just a problem facing children and adolescents. As many as three quarters of adults have some form of orthodontic problem like crowding or drifting teeth, and today about one out of every five orthodontic patients is an adult.

There are many reasons to consider orthodontic treatment as an adult. It is never too late to boost your self-confidence and even enhance your career opportunities with a great looking smile. Furthermore, straightening teeth can make chewing more comfortable and teeth easier to clean.

Are you a good candidate for orthodontic treatment?

Orthodontics involves moving teeth through bone to relocate them in better places for both appearance and function. The process actually removes bone in front of the moving teeth and lays new bone down behind as the result of light forces applied by either wires or appliances.

Periodontal health is an important factor when considering orthodontic treatment for older patients. Gum disease, which is more prevalent in adults than in adolescents, can lead to the loss of tooth-supporting bone.

Because orthodontic treatment can aggravate periodontal disease, it is essential to bring any existing periodontal disease under control before treatment begins. This does not mean, however, that people who have had periodontal disease treated and controlled cannot undergo orthodontic procedures. In fact, treatment is desirable because it moves teeth to positions that are more easily cleaned.

If you are an adult considering orthodontic treatment

  1. Work with your periodontist to understand any risks before starting treatment. Be sure to discuss the removal of unstable teeth and any future plans for dental implants.
  2. Do not start orthodontics until you have approval from your periodontist.
  3. Commit to more frequent supportive care from your periodontist during orthodontic treatment.
  4. Follow up with a comprehensive periodontal evaluation after orthodontic treatment to see if any new problems have developed.

The relationship between orthodontics and periodontal disease is complex. Be sure to consult both a periodontist and an orthodontist before beginning any course of treatment.

Chronic Bad Breath and Periodontal Disease

Believe it or not, Americans spend more than $1 billion a year to fight bad breath. Unfortunately, over the counter treatments like toothpaste and mouthwash only mask the odor.

So what causes bad breath?
Chronic bad breath (halitosis) does not originate in the stomach. In most cases bad breath is caused by leftover food that collects bacteria on the teeth, surface of the tongue, below the gum line, between the teeth and other hard to reach areas. Naturally occurring anaerobic bacteria feed on this oral debris and produce foul-smelling volatile sulfur compounds (VSC) as a by-product.

While everyone has some level of VSC in their mouth, they cannot be detected by the nose at low levels. Saliva plays a key role in fighting chronic halitosis by flushing away debris. The dryer your mouth and the thicker your saliva, the less rinsing that takes place. Lower oxygen levels create environment in which the bacteria that produce sulfur compounds thrive.

Other major contributors to bad breath can include

  • oral stagnation from mouth breathing and/or snoring
  • alcohols that dry oral tissue
  • medications for high blood pressure, depression, and antihistamines
  • general dehydration
  • stress
  • proteins, acidic foods, and dairy products
  • genetics that determine the shape of your tongue

Fighting Bad Breath
Regular professional cleanings in conjunction with daily brushing and flossing normally take care of unpleasant breath. If bad breath persists, make extra effort to remove bacteria that accumulates in the cracks and crevices of your tongue.

Use a metal or plastic tongue scraper to gently scrape from the back of the tongue to the front or wrap a soft cotton washcloth around a finger and gently wipe from the back to the tip. Be sure to clean the back of your tongue where the most bacteria accumulates.

If bad breath continues, consider altering your diet or medications. Note that sudden bad breath can also be a sign that you have a health problem, such as a respiratory tract infection, chronic sinusitis, or postnasal drip.

If you suffer from chronic halitosis, you are not alone — over forty-million Americans have persistent bad breath. Regular professional cleanings combined with a robust daily oral care routine should significantly ease the burden.


Tissue Regeneration: Allograft vs. Free Gingival Grafts

Periodontal disease often destroys the bone and tissue that support teeth. Gum recession can make eating hot and cold foods uncomfortable and alter the aesthetic appearance of a smile.

Today’s sophisticated tissue regeneration techniques allow periodontists to reconstruct and regenerate lost and destroyed gingival tissues. The main goal is to cover an exposed root or to thicken the existing gum tissue and prevent further tissue loss.

Periodontists often use a free gingival graft to increase the thickness existing gum tissue. A small layer of tissue is removed from the palate of the patient’s mouth and stitched into place at the site of gum recession. Both sites heal in a very predictable, uneventful manner in two or three weeks.

When treating a larger area or root exposure, periodontists may recommend an allograft to create new gum tissue. With this option, tissue is surgically transplanted from one person to another. The science is not new — allografts have been used successfully for more than 150 years. In face, approximately one million allografts are transplanted each year in the United States alone.

Whether your doctor recommends a free gingival grafts or an allograft, the result will be new zones of gum tissue covering formerly exposed roots. Patients are often surprised by the relatively painless recovery process after either of these procedure.

When considering a tissue grafting for medical or cosmetic purposes, it is important to speak with a specialist to determine the best treatment method. Call 404-815-4800 today to schedule a consultation with Dr. Bartruff.

Periodontal Disease and Long Term Care

by Sam Morgan, Practice Administrator

Recently, I had a patient that had been in for a consultation over one year ago call to schedule his procedure. The patient had been diagnosed with progressive Periodontal Disease and severe bone loss. Since the patient was already missing several teeth, the doctor recommended a more aggressive treatment plan that included Osseous Procedure and then, after a period of healing, the placement of Implants.

Much to my amazement, the patient only had interest in placing the implants. I explained that the doctor would not place implants with out a healthy environment that would support osseointegration, giving the patient and his implants the chance for success. As I discussed the situation with the patient in more detail, he explained to me all of the research he had done on the recommended Osseous Procedure. He was concerned because there was no guarantee of success.

My response was that he was absolutely correct, but I took it one step further. I explained to the patient that he has Periodontal Disease and that there is no “cure” for the disease. I compared Periodontal Disease to Heart Disease, Diabetes, HIV or a diagnosed Mental Disease. There is no “cure” for any of these, only the ability to manage or attempt to manage the disease. Every human being is unique and the circumstances surrounding Periodontal Disease for that individual will more than likely be different from another individual. It could be genetic, it could be caused from poor hygiene, or it could be linked to another disease such as Diabetes.

I also explained that usually, we see a patient for a procedure like Osseous and then we see them 2-4 times per year for Periodontal Maintenance Procedures. A strong majority of our patients who maintain a strong regimen between our office and their primary dentist don’t revisit more drastic procedures. A person who has been diagnosed with Periodontal Disease is really no different than an individual who has had a heart attack and now has must visit their cardiologist for testing and monitoring on a routine basis.

Unfortunately, I believe this patient — like many others — will let fear keep him from receiving the care he so desperately needs to keep his mouth healthy and keep his teeth. We believe in preventative care and the least invasive treatment for any patient. Our ultimate goal is to help our patients keep their teeth and keep them as comfortable as possible while providing the care needed.

If you have been told you have Periodontal Disease or you suspect you may have symptoms, seek a professional to help you understand your options and what the future may look like for you and your teeth.