My Blog
By Sirisha Pulapaka, DDS
July 23, 2021
Category: Oral Health
Tags: gum disease  
GumDiseaseCouldbeMakingOtherDiseasesWorse

Half of adults over age 30, and an astounding 70% over 65, have had some form of periodontal (gum) disease. Unchecked, a bacterial gum infection can spread into the supporting bone and destroy attachments between the teeth and gums. Because of its rapidity and aggressiveness, gum disease is the number one cause of tooth loss among adults.

But there may be even more harm caused by gum disease beyond losing teeth: There's growing evidence gum disease may worsen other diseases like diabetes, heart disease or rheumatoid arthritis. Patients with gum disease are also more likely to suffer from one or more of these systemic conditions.

The link between gum disease and these other diseases appears to be inflammation. When tissue becomes injured or diseased, swelling (inflammation) occurs to isolate these tissues from the rest of the body. Under normal circumstances, this is a critical defense mechanism to protect the body overall.

But this response is a temporary measure—if it becomes chronic, it can actually damage the tissues it's trying to protect. This often happens with gum disease as inflammation can't overcome the gum infection, and both sides settle into a kind of trench warfare. The same story plays out with other diseases with an inflammatory response. And if the body is waging war with a gum infection, it can worsen these other conditions.

It's important then to take care of your gums and the rest of the body to minimize chronic inflammation. You can help prevent a gum infection by brushing and flossing every day and getting your teeth cleaned professionally at least every six months. You should also see your dentist if you notice swollen, reddened or bleeding gums, often the first signs of gum disease.

It can also benefit your gums if you're addressing other inflammatory issues in your body. Besides regular medical care, you can reduce your risk for other systemic diseases by eating a healthy diet, keeping your weight at an optimum level and avoiding smoking.

The individual parts of your body aren't isolated islands: Diseases that affect one can eventually affect all. By preventing or treating gum disease as early as possible, you'll also help reduce the effects of other systemic diseases.

If you would like more information on preventing gum disease, please contact us or schedule an appointment for a consultation.

By Sirisha Pulapaka, DDS
July 13, 2021
Category: Oral Health
Tags: tmj disorders  
3TipstoMakeMealtimesMoreEnjoyableWithTMD

Dinnertime is a great opportunity to enjoy not only your meal, but also the company of friends and family. But a temporomandibular joint disorder (TMD) can drain the pleasure from these dining experiences if the mere act of chewing is a painful ordeal.

Besides curbing pleasure while dining, eating difficulties caused by TMD can also affect your health: You may find yourself limiting your choices to only those that cause the least amount of discomfort. But those restricted choices may deprive you of a balanced diet essential to overall well-being.

But there are ways to reduce your discomfort and enjoy a greater abundance of healthy foods, as well as your dining experience. Here are 3 tips to make eating easier if you have TMD.

Prepare your food. Easing TMD discomfort starts while you're preparing your food to cook. First off, remove the tougher peel or skin from apples, potatoes or similar fruits and vegetables. And, be sure to chop foods into small enough pieces to reduce how much your jaws must open to comfortably chew your food.

Choose “wetter” cooking methods. One of the best ways to soften foods is to moisten them, either during the cooking process or by adding it in some form to the dish. Use braising techniques when you cook as much as possible. And try to incorporate sauces or gravies, especially with leaner meats, for added moisture.

Modify your eating habits. Food prep is only one aspect of a more comfortable dining experience with TMD—you can also benefit from modifying how you eat. Concentrate on taking smaller bites of food and slow down your chewing motion. You should also limit how much you open your jaw while chewing to keep it within your comfort range as much as possible.

With a little experimentation, you can find the right balance between a wide variety of foods and more comfortable eating. If you have TMD, using these tips could help mealtime become a delightful—and more nutritious—experience.

If you would like more information on managing TMD, 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 “What to Eat When TMJ Pain Flares Up.”

PeriodontalProbingCanTellUsaLotAbouttheSeverityofaGumInfection

The red and puffy gums that sometimes accompany the onset of periodontal (gum) disease don't always catch your attention. You may not even get any symptoms at all, in fact, until the disease has become well advanced.

That's why regular dental visits are so important for gum health: For while you may not notice anything abnormal about your gums, we have a simple procedure known as periodontal probing that can help diagnose the condition of your gums.

Gum disease is a common bacterial infection that affects millions of people worldwide. It most often begins with plaque, a filmy, bacterial buildup on teeth. These bacteria feed and multiply on the remnant food particles in the film, increasing the chances for an infection.

As it grows—as well as the inflammation the body initiates to fight it—the infection weakens the gum attachment to teeth. This can cause the miniscule gap between gums and teeth at the gum line to widen, forming a void called a periodontal pocket. The deeper and wider the pocket, the more advanced the gum infection.

We may be able to verify the presence of a periodontal pocket by using a long, thin probing instrument with millimeter gradations. We gently insert the probe at various locations around a tooth as far as it will comfortably go. We then record the depth by reading the gradation measures lined up with the top of the gums, as well as observing how snug or loose the probe feels within the gum space.

One to three millimeters signifies a healthy attachment between the tooth and gums—anything more than that usually indicates gum disease. Measurements of 5mm indicates a problem, the higher the number, the more advanced is the periodontal disease.

We use these probe readings and other factors to guide our treatment approach in individual cases of gum disease. With a less-advanced infection we may only need to remove plaque and calculus adhering to the crown and just below the gum line. More advanced gum disease infecting the root area may require surgical access through the gums.

All in all, keeping up with regular dental visits can increase the chances of early diagnosis, when the disease is still in its initial stages. And daily oral hygiene to remove harmful plaque may help you avoid gum disease altogether.

If you would like more information on treating gum disease, 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 “Understanding Periodontal Pockets.”

By Sirisha Pulapaka, DDS
June 23, 2021
Category: Dental Procedures
HowAFVsAlfonsoRibeiroSavedHisTooth

Remembered fondly by fans as the wacky but loveable Carlton on The Fresh Prince of Bel-Air, Alfonso Ribeiro is currently in his fifth year hosting America's Funniest Videos. It's the perfect gig for the 48-year-old actor, who loves to laugh and make others laugh as well. This is quite the opposite experience from one he had a few years ago that he remembers all too well: a severely decayed tooth.

After seeing his dentist for an intense toothache, Ribeiro learned he had advanced tooth decay and would need root canal treatment. Ribeiro wasn't thrilled by the news. Like many of us, he thought the procedure would be unpleasant. But he found afterward that not only was the root canal painless, his toothache had vanished.

More importantly, the root canal treatment saved his tooth, as it has for millions of others over the last century. If you're facing a situation similar to Alfonso Ribeiro's, here's a quick look at the procedure that could rescue your endangered tooth.

Getting ready. In preparation for root canal therapy, the tooth and surrounding gums are numbed, often first with a swab of local anesthesia to deaden the surface area in preparation for the injection of the main anesthesia below the surface. A dental dam is then placed to isolate the infected tooth from its neighbors to prevent cross-contamination.

Accessing the interior. To get to the infection, a small access hole is drilled. The location depends on the tooth: in larger back teeth, a hole is drilled through the biting surface, and in front teeth, a hole is drilled on the backside. This access allows us to insert special tools to accomplish the next steps in the procedure.

Cleaning, shaping and filling. Small tools are used to remove the diseased tissue from the interior tooth pulp and root canals. Then the empty spaces are disinfected. This, in effect, stops the infection. Next, the root canals inside the tooth are shaped to allow them to better accept a special filling called gutta percha. The access hole is then sealed to further protect the tooth from future infection, and a temporary crown is placed.

A new crown to boot. Within a couple weeks, we'll cap the tooth with a long-lasting lifelike crown (or a filling on certain teeth). This adds further protection for the tooth against infection, helps strengthen the tooth's structure, and restores the tooth's appearance.

Without this procedure, the chances of a tooth surviving this level of advanced decay are very slim. But undergoing a root canal, as Alfonso Ribeiro did, can give your tooth a real fighting chance.

If you would like more information about root canal treatments, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “A Step-By-Step Guide to Root Canal Treatment” and “Root Canal Treatment: How Long Will It Last?

YouCanHaveaSuccessfulImplantOutcomeifYourDiabetesisUnderControl

Around one in ten U.S. adults have diabetes, a metabolic disease that can disrupt other aspects of a person's health like wound healing and vision. It could also cause complications with dental implants, the premier replacement choice for missing teeth.

There are two basic types of diabetes. In type 1 diabetes, the pancreas stops producing insulin, a hormone needed to regulate the amount of sugar glucose in the bloodstream. With the more prevalent type 2 diabetes, the body either doesn't produce enough insulin or doesn't respond efficiently to the insulin produced.

Uncontrolled diabetes can contribute to several dangerous health conditions. In addition to vision impairment and poor wound healing, diabetics are at higher risk for other problems like kidney disease or nerve damage. Drastic swings in blood glucose levels can also cause coma or death.

Many diabetics, though, are able to manage their condition through diet, exercise, medications and regular medical care. Even so, they may still encounter problems with wound healing, which could complicate getting a dental implant.

An implant is composed of a titanium metal post imbedded into the jawbone. Because of its affinity with titanium, bone cells naturally grow and adhere to the implant's metal surface. Several weeks after implant surgery, enough bone growth occurs to fully secure the implant within the jaw.

But this integration process may be slower for diabetics because of sluggish wound healing. It's possible for integration to not fully occur in diabetic patients after implant surgery, increasing the risk of eventually losing the implant.

Fortunately, though, evidence indicates this not to be as great a concern as once thought. A number of recent group studies comparing diabetic and non-diabetic implant patients found little difference in outcomes—both groups had similar success rates (more than 95 percent).

The only exception, though, were diabetic patients with poor glucose control, who had much slower bone integration that posed a threat to a successful implant outcome. If you're in this situation, it's better if you're first able to better control your blood glucose levels before you undergo surgery.

So, while diabetes is something to factor into your implant decision, your chances remain good for a successful outcome. Just be sure you're doing everything you can to effectively manage your diabetes.

If you would like more information on diabetes and dental health, 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 “Dental Implants & Diabetes.”





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