Periodontics

Crown Lengthening

Crown lengthening is usually done to improve the health of the gums, prepare the mouth during a procedure, or correct a “gummy smile”. A “gummy smile” is used to describe a case in which the teeth are covered with an excess of gum tissue that results in a smile less aesthetically pleasing to the eye. The procedure involves the remodeling or recontouring of the gum tissue and the bone around the tooth in question to create a new relationship between the gum and the tooth. Crown lengthening can be performed on a single tooth, several teeth or the entire gum line.

Crown lengthening is often required when the tooth needs a new crown or other restoration. The edge of that restoration is far below the gum and not immediately. It is also necessary when the margin is too close to the bone or below the bone.
The lengthening of the crown allows us to reach the edge of the restoration, which guarantees an appropriate adjustment to the tooth. It must also provide enough dental structure so the new restoration will not be released in the future. This allows you to clean the edge of the restoration when brushing and flossing to prevent tooth decay and gum disease.

The crown lengthening lasts about an hour, but will depend in no small extent on the number of teeth involved and if any amount of bone is needed to be removed. The procedure is usually performed under local anesthesia and consists of a series of small incisions around the tissue to separate the gums from the teeth. Even if only one tooth requires the procedure, it is likely that it will be necessary to adjust the neighboring teeth to allow for greater uniformity remodeling. In some cases, it will be required to extract a small amount of bone as well.

Sutures and a protective bandage are placed to help secure the new relationship of the gum to the tooth. Your teeth will look noticeably longer immediately after surgery because the gums have now been repositioned. You will have to be seen in one or two weeks to remove the stitches and evaluate your healing. The place of surgery must be completely cured in approximately two or three months after the procedure.

Pre-Prothesic Surgery

The preparation of the mouth before the placement of a prosthesis is known as pre-prosthetic surgery.

To ensure the highest level of comfort, some patients require minor oral surgical procedures before receiving a partial or complete prosthesis. A denture sits on the crest of the bone, which is very important for the bone to have the proper shape and size. If a tooth needs to be removed, the underlying bone may be hard and uneven. For the best fit of a denture, the bony ridges may have to be smoothed or remodeled. From time to time, it may be necessary to remove excess bone before inserting the denture.

One or more of the following procedures may need to be performed to prepare the mouth for a prosthesis:

• Bone modeling and remodeling.
• The elimination of excess bone.
• Reduction of the bone crest.
• The removal of excess tissue from the gums.
• The exhibition of retained teeth.

We will review your particular needs with you during your appointment.

The Prophylaxis (Dental Cleaning)

Dental prophylaxis is a treatment performed to clean the teeth and gums. Prophylaxis is an important dental treatment to avoid diseases such as gingivitis, periodontitis, etc.

Prophylaxis is an effective procedure to keep the oral cavity in proper health and stop the progression of gum disease. The benefits include:

Removal plaque – Tartar (also known as calculus) and plaque buildup, both above and below the gum line, can lead to severe periodontal problems.

Unfortunately, even with a proper home brushing and routine flossing, it can be impossible to remove all debris, bacteria, and deposits from the rubber pockets. The expert eye of a dentist or dental hygienist using specialized equipment is necessary to catch potentially harmful accumulations.

A healthy looking smile – The calculations and yellowish teeth can drastically reduce the aesthetics of a smile. Prophylaxis is an effective treatment to rid the teeth of these unsightly spots otherwise.

Fresher Breath – Bad breath (or halitosis) is usually indicative of advancing periodontal disease. A combination of rotten food particles (possibly below the gum line) and the potential is derived from the results of gum infection in bad breath. The routine elimination of plaque, calculus, and bacteria in our office can markedly improve halitosis and reduce infections.

Prophylaxis can be performed in our offices or by your general dentist. It is recommended to perform the prophylaxis twice a year as a preventive measure but should be completed every three or four months for those suffering from periodontitis. It should be noted that periodontal disease cannot be completely reversible, but prophylaxis is one of the tools. An exam in Oralcorp ® can be used to stop its progress effectively.

Women And Periodontal Health

Throughout a woman’s life, hormonal changes affect the tissues of the entire body.

Fluctuations in levels occur during puberty, pregnancy, and menopause. At this time, the possibility of periodontal disease may increase, which requires special care of your oral health.

Puberty

During puberty, there is an increase in the production of sex hormones. These higher levels increase the sensitivity of the gums and lead to increased irritation of plaque and food particles. The gums can swell, become red and feel sensitive.

Menstruation

Similar symptoms sometimes appear several days before menstruation. There can be no bleeding from the gums, bright red swelling between the teeth and gums, or sores on the inside of the cheek. The symptoms disappear once the period has started. As the amount of sex hormones decreases, these problems too.

Pregnancy

Gums and teeth are also affected during pregnancy. Between the second and the eighth month, the gums can also swell, bleed, and become red or tender. Large growths may appear as a reaction to local irritants. However, these tumors usually do not present pain and are not cancerous. They may require professional removal but usually disappear after pregnancy. There is always the possibility of a reappearance in the next pregnancy.

Periodontal health should be part of your prenatal care. Any infection during pregnancy, including periodontal diseases, can put baby’s health at risk.

The best way to prevent periodontal infections is to start with healthy gums and continue to maintain your oral health with proper care and careful periodontal monitoring.

Oral Contraceptives

Swelling, bleeding, and tenderness of the gums can also occur when you are taking oral contraceptives, which are synthetic hormones.

You should mention the medications you are taking, including oral contraceptives, before medical or dental treatment. This will help eliminate the risk of interaction with other drugs, such as antibiotics with oral contraceptives – where the effectiveness of the contraceptive can be diminished.

Menopause

Changes in the appearance and sensation of your mouth can occur if you are menopausal or postmenopausal. They include a feeling of pain and burning in the tissue of the gums and the salty, spicy or acidic flavors.

Careful oral hygiene at home and professional cleaning can alleviate these symptoms. There are also saliva substitutes to treat the effects of dry mouth.

Guided Bone and Tissue Regeneration

Periodontal Disease has traditionally been treated by removing periodontal pockets by trimming away the tissue from infected gums and by re-contouring uneven bony tissue. Although this is still an effective way of treating gum disease, new and more sophisticated procedures are commonly used today. One of these advances is Guided bone regeneration; tissue regeneration is also referred to as guided. This procedure is used to stabilize the teeth in danger of being extracted or to prepare the maxilla for dental implants.

As periodontal disease progresses, degenerated bone pockets develop in the maxilla. These pockets can promote the growth of bacteria and the spread of infection. To deal with these bags, in Oralcorp ® can recommend the regeneration of tissues. During this surgical procedure, the pockets are thoroughly cleaned, and a membrane is installed between the soft tissue and the pocket in the bone. Some of these membranes are bioabsorbable, and some require removal. The membrane covers the bag so that the rapidly growing soft tissue is blocked, and the slower growing bone can begin to grow, or “regenerate” itself.

The effectiveness of the procedure generally depends on the patient’s willingness to follow a strict postoperative diet and careful oral care. Oralcorp will help you determine if bone regeneration surgery is right for you.

Periodontal Support Therapy

Also known as PERIODONTAL MAINTENANCE THERAPY. It is performed at the end of active periodontal treatment, after a period established by the specialist. Periodontal maintenance visits should include:

1. Medical and dental history update
2. Evaluate the soft tissues intra and extraoral, periodontal and peri-implant; as well as dental tissues and derive if necessary.
3. Evaluate oral hygiene and if necessary re-instruction.
4. Mechanical dental cleaning to disorganize/remove dental plaque, biofilms, stains, and calculus. Local or systemic chemotherapeutic agents as complementary treatment for recurrent or refractory diseases.
5. Elimination or mitigation of etiological or risk factors, new or persistent.
6. Identification and treatment of new, refractory or recurrent areas of pathogenicity.
7. Establish the appropriate individualized interval for the treatment of periodontal maintenance.

Periodontal Treatment

In the oral cavity live, various microorganisms that constitute the normal microbial flora. It is estimated that more than 500 different species of microorganisms can colonize the mouth. Usually, these microorganisms are in equilibrium due to the regulation given by various internal and external factors. Therefore, in general terms, in a healthy mouth, there is a benign relationship between the microbial flora and its host, since they do not cause damage in the PERIODONTO, which is formed by the structures that support and protect the tooth (alveolar bone, ligament periodontal, gum, root cement)

The predictability and possibilities of success in the periodontal treatment are directly proportional to the integrity and forcefulness of its diagnosis. Several obstacles that the general dentist faces on a daily basis are the difficulty of establishing a proper diagnosis, posing an opportune diagnosis of the disease in its incipient stages or underestimate the severity of this disease.

The diversity of criteria, parameters, as well as a large number of types of periodontal diseases, make the periodontal diagnosis a challenge and confuse the general dentist. Therefore, within the branches of Specialization of Dentistry, we find Periodontics which is the specialty that seeks to prevent, diagnose and treat diseases that affect the surrounding tissues and that support the tooth or implants.

To establish an ideal periodontal treatment plan, a definitive diagnosis must be reached through a complete periodontal examination that includes multiple tools that allow the specialist to develop a diagnosis and prognosis according to the patient’s condition.

TREATMENT PLAN

The treatment plan should be used to establish the methods and sequence in the periodontal treatment, and should include:

• Patient education: Train him in personal oral hygiene and advise on the control of risk factors (e.g., smoking, general health, stress).
• Scraping and Radicular Smoothing: It manages to remove bacterial plaque and accessible supragingival and subgingival calculus, correct irregularities of the root surface. In some cases, these procedures can be performed together with a surgical approach.
• Periodic post-treatment checks and reinforcement of the patient’s oral hygiene if necessary.
• Depending on each case and in a personalized way, it may be required to use Antiseptics and Antibiotics as treatment adjuvants: To reduce, eliminate or alter the quality of microbial pathogens.

In addition to the above, the following treatment alternatives may be necessary

• Resective procedures: To reduce or eliminate periodontal sacs and create an acceptable gingival shape that allows proper hygiene.
• Methods for periodontal regeneration: to help recover lost tissues.
• Periodontal plastic surgery for gingival augmentation, correction of recessions or soft tissue defects or other improvements in the oral cavity of aesthetic carácter
• Occlusal therapy: to reduce dental mobility, perform the occlusal adjustment, splints or the installation of devices that reduce occlusal trauma.
• Pre-prosthetic periodontal procedures: access surgery, resective procedures, reconstruction or regeneration procedures, coronary lengthening, etc.
• Selective extraction of teeth, roots or implants: To facilitate periodontal therapy, peri-implant, promote the implant site.
• Replacement of teeth by dental implants
• Procedures to facilitate orthodontic treatments include (not only) dental exposure, frenectomy, “fibrotomy”, gingival augmentation, implant placement.
• Management of systemic and periodontal interrelationships when appropriate.

Expected results may be affected when:

• There is inadequate plate control by the patient
• Lack of patient cooperation
• Systemic diseases without medical control
• Adverse health factors such as smoking, stress or occlusal dysfunction
• Incorrigible or iatrogenic anatomical factors.
• Among others.

Once the patient is discharged, he/she must comply with the PERIODONTAL SUPPORT OR MANAGEMENT THERAPY established by the specialist, since otherwise there is a high possibility that there is a recurrence of the disease.

Periodontal Disease

In the oral cavity live, various microorganisms that constitute the normal microbial flora. It is estimated that more than 500 different species of microorganisms can colonize the mouth. Usually, these microorganisms are in equilibrium due to the regulation given by various internal and external factors. Therefore, in general terms, in a healthy mouth, there is a benign relationship between the microbial flora and its host, since they do not cause damage in the PERIODONTO, which is formed by the structures that support and protect the tooth (alveolar bone, ligament periodontal, gum, root cement)

But when the oral environment provides a suitable condition, there is an imbalance and a group of bacteria change and increase, destroying the periodontium.

So if there are always bacteria in the mouth, why do not all the people have periodontal disease? Because a microorganism is necessary, but it is not enough to cause the disease.

Periodontal disease is considered an infectious – inflammatory disease caused by microorganisms that colonize the tooth surface, forming the BACTERIAL PLAQUE, when the conditions of the mouth are favorable for its growth; and that according to the degree of commitment can lead to tooth loss.

Bacterial plaque:

It is the primary etiologic factor of the periodontal disease. It appears as yellowish-white deposits that adhere to the tooth surface forming a biofilm composed of microorganisms and their bacterial products. It is also known as BIOFILM.

Among the most common diseases produced by the BIOFILM or BACTERIAL PLAQUE that affect the human being are caries and periodontal disease.

DENTAL CALCULUS

It is the bacterial plaque that hardens or calcifies. It appears as a moderate hardness mass of white-yellowish, dark or brown.

If the bacterial plaque is not removed as much as the calculus, the gums become inflamed, and there may be bleeding, pain, swelling, redness of the gums and sometimes suppuration. It indicates that we are facing a problem.

Periodontal diseases such as gingivitis and periodontitis have as the principal causative agent of the BACTERIAL PLAQUE, but its development can be modified by systemic conditions such as diabetes, habits such as smoking, stress and occlusal trauma

GINGIVITIS:

It is the inflammation of the gum without affecting the supporting tissues (periodontal ligament, root cement, alveolar bone). It has different degrees of intensity, and there are signs such as inflammation, bleeding, enlargement, pain and even suppuration of the gums, and there may be dental mobility due to swelling.

If this disease is not treated in time, it can evolve into Periodontitis

PERIODONTITIS

It is the inflammation of the gum and the supporting periodontium, significantly affecting the gingival connective tissue, periodontal ligament, alveolar bone, and root cement. We observed periodontal pocket formation, accompanied by inflammatory signs, loss of insertion tissues and alveolar bone. Additionally, we can see suppuration, mobility, pathological dental migration and pain.

Halitosis

Halitosis or bad breath can be described as an offensive and offensive odor emanating from the oral cavity. It affects 50% of the population with different degrees of intensity. It can be a reflection of local or systemic disease.

Generally, the smell of the oral cavity varies with time, age, sex, hours passed since the last intake. Moreover, it is modified by some factors such as the amount of saliva, gram-negative oral flora (bacteria), pH, activity of the oral muscles and the presence of proteins.

Bad breath is a negative factor for interpersonal relationships and may produce alterations in the individual’s behavior such as social isolation and psychological modifications, which affect the person’s work, family and social development.

Therefore halitosis is a problem of personal transcendence that worries many people, and that must be correctly diagnosed, to give the appropriate treatment based on the identification of the etiological agent.

Etiology

Halitosis may be of intra or extraoral origin, with approximately 83% of cases of intraoral type halitosis, while approximately 17% of extraoral origin.

Intraoral halitosis

It is the result of the decomposition produced by bacteria present in the oral cavity, food particles, desquamated cells, blood and some elements present in saliva. These bacteria are responsible for a process called putrefaction, which leads to the production of volatile sulfur compounds (CSV). Other components of breath that can be smelly are putrescine, cadaverine, butyric acid, propionic, etc.

Bad breath in the morning

It is the product of bacterial activity on desquamated epithelial cells and food remains that have remained in the mouth throughout the night, is of intraoral origin

Among the main intraoral causes we list:

1. Deficiency in dental hygiene
2. Saburral tongue (white tongue)
3. Periodontal disease
4. Pericoronitis
5. Alveolitis
6. Dry mouth
7. Mouth sores
8. Caries (carious cavities allow the retention of food remains and subsequent putrefaction)
9. Other elements such as orthodontic appliances (brackets) and prosthetics (plaques), crowns, poor restorations make oral hygiene difficult, contributing to halitosis

Extraoral halitosis

There is a small percentage of patients whose bad breath is related to the presence in the saliva of compounds that result from non-oral processes and bodily functions. Therefore this problem should not be considered in isolation and make a right diagnosis.

For example:

Among the possible extraoral causes of halitosis we can mention:

1. Problems of nasal origin: it is the most common when the problem is not intraoral, issues such as sinusitis, secretions, alterations that impede the normal flow of nasal mucus.
2. Abnormalities such as cleft palate
3. Tuberculosis
4. Pharyngitis
5. Gastrointestinal cause: in cases of a fistula between the stomach and intestine, severe gastric reflux, infection by Helicobacter Pylori.
6. Metabolic reasons: for example
   1. Fish odor syndrome or Trimethylaminuria, which results from the inability of the body to metabolize choline, producing a fishy odor in the breath, urine, and sweat.
   2. People with diabetes, anorexia or dieting may have a breath that smells like acetone.
   3. People with severe kidney problems may manifest a characteristic urine odor due to the presence of uremia.
   4. People with liver and gallbladder problems may have an unpleasant breath with a mousy odor.
7. Drug intake.
8. Pulmonary, bronchial or oropharyngeal carcinoma
9. Hormonal changes during ovulation, menstruation, pregnancy, menopause.
10. Psychic alterations: some healthy individuals complain of having bad breath without it being detected by other people, and once the respective studies are done there are no local or systemic causes, this is known as HALITOSIS ILUSORIA or PSEUDOHALITOSIS
11. Unknown causes

Diagnosis

The diagnosis of halitosis is very simple, and it is established when an unpleasant and offensive odor is perceived that emanates from the mouth of a person at the moment of speaking or when he opens his mouth. The challenge lies in establishing its etiology.

The most used ways to measure halitosis are:

• Organoleptic test: the nose is used, and the intensity of the emanated odor is determined.
• Sulfur monitors: estimate the number of volatile compounds

Treatment

The first step for the treatment is to determine the origin if it is intraoral or extraoral.
Approximately 90% of the cases are of intraoral origin so that the dentist can treat it, and the following procedures that can be performed are:

• Mechanical cleaning procedures of the lingual, dental, interdental spaces, supra, and subgingival extractions, Scraping and Radicular Smoothing performed by a professional.
• Chemical processes: use of mouth rinses with antimicrobial agents
• Change of toothpaste
• Dental hygiene instruction, both oral, interproximal and on the back of the tongue
• Combination of these procedures.

The following aspects of a nutritional nature must also be taken into account:

• The diet that does not contain a high content of sugars and fats
• Avoid foods that cause a terrible mouth odor like garlic and onions
• Drink 2 liters of water per day.

And for the remaining 10%, an interconsultation should be made with the otolaryngologist.
In ORALCORP we offer you preventive and specialized treatments that allow you to maintain good oral health. But it is essential that you go to the dentist periodically.

Dental Hypersensitivity

Dental hypersensitivity is a problem that affects several people; it can be defined as the painful sensation caused when eating cold, hot, sweet or acidic foods or drinks. You may also feel pain when vacuuming cold air.

In a tooth under normal conditions, the dentine (the layer that directly surrounds the nerve) is covered by the enamel (visible tooth layer), and together they form the dental crown, and the gum that surrounds the tooth.

For some reasons, the tooth enamel that is the hard surface layer of the tooth can become thinner. So, it wears out, providing less protection.

The gums can also be retracted for different reasons, exposing tooth root.

The dentin contains a large number of pores or ducts that run from the outside of the tooth to the nerve (dental pulp) in the center. When the dentine is exposed, the liquid contained in these ducts can be stimulated by changes in temperature or certain foods.

What causes it?

Dental hypersensitivity can come or go, but can not be ignored, here are some causes of this problem:

• Brush your teeth inadequately and energetically with a hard bristle brush as it may cause retraction or loss of gums
• The consumption of carbonated beverages, foods or beverages with a high content of acids, which cause the erosion of the enamel and the exposure of the dentine
• Diet rich in sugars, as they contribute to the formation of caries that can cause sensitivity.
• Tighten or grind the teeth, as it causes the tooth enamel to wear, causing sensitivity in most, or all, of the teeth.
• Brush with a very abrasive toothpaste.
• Gum disease, which can cause gum retraction and radicular exposure.
• A fractured or cracked tooth can expose dentin

Also, some dental treatments can cause sensitivity, some of them are teeth whitening, professional dental cleanings, etc. In general, it disappears shortly after finishing the treatment. If you have any questions, contact us at ORALCORP, we are happy to help you.

What can I do about it?

The first step is to discover the cause, through a thorough examination by a dental health professional. If the sensitivity is due to the exposed dentin, there are several steps that you and your dentist can take to reduce sensitivity. These may include:

• Use a very soft bristle toothbrush
• Brushing correctly to help prevent abrasion of the enamel and gum retraction, in addition to proper dental and interproximal cleaning and three times daily to avoid any gum disease
• Use a specially formulated toothpaste to help reduce sensitivity
• Avoid carbonated foods or drinks or those with high acid content.

Your dentist can:

• Apply a fluoride varnish or desensitizers to sensitive areas to help strengthen the tooth
• Recipe toothpaste with high fluoride concentration to use every day
• Place a dental restoration in the indicated regions.

The most important step is to visit a dental health professional to determine the cause of your dental sensitivity, come and visit us at ORALCORP, we will help you find a solution that works!

Peri-implant disease

Periodontal diseases (around natural teeth) can be classified into different forms of gingivitis and periodontitis. The term gingivitis refers to an inflammation of the gums without loss of supporting tissues (gum, periodontal ligament, and bone), during periodontitis. In addition to gingival inflammation, is characterized by the loss of bone.

Peri-implant diseases (around dental implants) include two entities: peri-implant mucositis, which corresponds to gingivitis and peri-implantitis, which corresponds to periodontitis.

This disease is caused by bacterial infections (more common) and occlusal overload, or a combination of both, and can be influenced by environmental and anatomical factors.

This infection begins with the formation of bacterial plaque around the surface of the implant and its colonization by pathogenic bacteria, this causes an inflammation of the surrounding tissues, establishing a Peri-implant disease that according to its progress can be:

1. PERIIMPLANTARY MUCOSITIS:

It is a reversible inflammation of the soft tissues that surround the dental implant and osseointegrated and in function, without signs of loss of supporting bone. (1st stage)

2. PERIIMPLANTITIS:

It is the inflammation of the soft tissues that surround the dental implant and osseointegrated and in function, which involves the loss of bone around a dental implant. (2nd stage)
Most studies report that peri-implant mucositis occurs in about 80% of patients with osseointegrated implants and that the prevalence of peri-implantitis varies between 28% and 56% of patients.
Therefore, due to the high number of implants that are currently being placed, and the higher number of years depending on those already set, these figures increase exponentially. It is, therefore, a very current problem.

In the peri-implantitis can be seen the presence of bacterial plaque, a probe depth greater than 4mm, bleeding on probing, radiographic bone loss and in more advanced cases we can also find suppuration and even mobility of the implant.

RISK FACTORS:

Factors with clear evidence that associates them with peri-implant diseases

• Previous periodontal disease
• Tobacco
• Poor oral hygiene

Elements with limited evidence that associates them with peri-implant diseases

• Uncontrolled diabetes
• Consumption of alcohol

Factors with limited and conflicting evidence that associates them with peri-implant diseases

• Genetic influence
• Implant surface

TREATMENT

To avoid these diseases, first of all, the patient who is going to receive the implants must be prepared, or the risk factors must be controlled both before placing the implants and when the biological complications have already appeared.

In many cases we need to sanitize the suprastructures since, in the interest of greater aesthetics or a lack of knowledge of the biology of the peri-implant tissues, they are performed in such a way that they prevent adequate access to cleaning, causing the retention of bacterial plaque with the consequent mucositis and periimplantitis.

There are therapies for the treatment of this disease, both non-surgical and surgical; the choice will depend on the degree of progress of the disease. But no procedure is considered of choice for peri-implantitis, and that shows a clear superiority with the rest.

The non-surgical ones are effective in the treatment of peri-implant mucositis but ineffective for peri-implantitis. The surgical ones are more effective for both than the non-surgical ones.

These treatments must be accompanied by an improvement in oral hygiene, recommending the patient to quit smoking if he is a smoker and a periodontal support therapy establishment.

Oral hygiene

How to brush

To brush the outer surfaces of the teeth, place the brush at a 45-degree angle, where the gums and teeth meet. Gently move the brush in a circular motion several times. Use a little pressure so that the bristles of the brush enter between the teeth, but without the pressure causing discomfort. When you have finished cleaning the outer surfaces of all your teeth, proceed to clean the inside of the posterior teeth following the same indications indicated above.

To clean the internal surfaces of the upper and lower anterior teeth, hold the brush vertically, move the brush back and forth gently on each tooth. Do not forget to brush the tissue of the surrounding gum gently.

Next, you should clean the chewing surfaces of the teeth. To do this, use short, smooth movements from back to front. Change the brush position as often as necessary to reach and clean all surfaces.

It is advisable to clean your teeth when looking at yourself in a mirror to make sure you clean every dental and mucosal surface. Once you have finished brushing your teeth, wash the back of your tongue. To do this, stick out your tongue and with sweeping movements from back to front placing the brush vertically clean the back of the tongue. This can also be done with a tongue cleaner. Then, rinse vigorously to remove plaque that may have loosened during brushing.

Finally, floss to clean between the teeth and complete your oral hygiene. Repeat these steps 3 times a day, after each meal and before going to sleep, every day.
If you have pain during brushing or have any questions about how to brush correctly, please contact us at ORALCORP, we will be happy to address your concerns.

How to floss

Periodontal disease usually appears between the teeth, where the brush can not clean. Flossing is a handy tool to remove plaque from the interdental surfaces. However, it is essential that the technique is adequate. The following instructions will help you, but remember that it takes time and practice.

Begin by cutting a piece of dental floss that is 30 cm long. Gently wrap most of the floss around the middle finger of one hand. Wrap the rest of the floss around the middle finger of the other hand.

To clean the upper teeth, hold the thread firmly between the thumb and index finger of each hand. Gently insert the floss between the teeth with an upward and backward movement. Do not force the floss to try to adjust it in place. Bring the thread to the line of the gums and then to the contact between the teeth. Slide it into the space between the gum and the tooth until you feel a slight resistance. Move the floss up and down on the side of a tooth. And then repeat the movement on the other tooth. Remember that there are two surfaces of the teeth that need to be cleaned in each space. Floss each site of all upper teeth. Be careful not to cut the gum tissue between the teeth. As the thread becomes dirty, turn from one finger to another to obtain a new section.
To clean between the lower teeth, guide the floss using the index finger of both hands and repeat the indications given for the upper teeth.

Do not forget the back of the last tooth on both sides, top, and bottom.

When finished, rinse vigorously with water to remove plaque and food particles. Do not be alarmed if your gums bleed or feel a little pain during the first week of flossing. If the gums hurt while flossing, you might be doing the cleaning too hard. As you floss daily and remove dental plaque, the gums heal, and the bleeding stops.

Cleaning the lingual back

The cleaning of the back of the tongue can be done using a regular toothbrush, better if it is of pediatric size, used exclusively for the tongue. There are lingual brushes or special lingual cleansers for this purpose. The cleaning should start at the most posterior part possible, avoiding producing the gag reflex and soft tissue damage; only the practice will lead to each person finding by himself the most appropriate way to clean the tongue. When the patient has a saburral tongue, he should receive the pertinent indications so that the daily scraping of his tongue that leads to the recovery of the normal whitish pink color that this organ has.

Interdental or interproximal cleaning

To clean interdental spaces, flossing or interdental brushes can be used, being mechanical means of oral hygiene that remove food particles and microorganisms responsible for putrefaction.

 

Braces Brushing

How to choose suitable products for oral higiene

There are so many products on the market that choosing the right one can be difficult. ORALCORP recommends some tips for the selection of oral care products that will work for most patients:

• Always buy toothbrushes with soft bristles, small head and ergonomic handle for you and your family’s hygiene.
• Electric toothbrushes are safe and effective for people with motor and mental disabilities or older adults.
• There are small brushes (interproximal brushes) that are used to clean between the teeth, but if they are misused they could injure the gums, so be sure to ask how to use these brushes to your dentist correctly.
• Start using waxed dental floss since its use will be easier and more comfortable.
• Fluoride toothpaste and mouthwashes can reduce tooth decay by up to 40% but REMEMBER that they are not recommended for children under six years of age.
• Always choose a bottle of mouthwash without alcohol and do not use it for a long time.

SOFT TISSUE GRAFTING

When a gum recession occurs, the body loses a natural defense against both bacterial penetration and trauma. When gum recession is a problem, reconstruction of the gums using grafting techniques is an option.

When there is only a slight recession, in some the healthy gum is often maintained and protected teeth, so it is necessary to change the practices of home care. However, when the recession reaches the mucosa, the first line of defense against bacterial penetration is lost.

Besides, gum recession often results in the sensitivity of the root to hot and cold foods, as well as an unsightly appearance of the gum and tooth. When significant, gum recession may predispose to worsening recession and expose the root surface, which is softer than enamel, which leads to root decay and root wears.

A gingival graft is designed to solve these problems. A thin piece of tissue is taken from the roof of the mouth and gently moves over the adjacent areas to provide a stable band of gum inserted around the tooth. The gingival graft can be placed in such a way as to cover the exposed part of the root.

The gingival graft procedure is highly predictable and results in a stable and healthy band of tissue adhered around the tooth.

Recession or Gingival Retraction

Gingival recession is the migration of the gum margin from its normal position at the boundary between the crown and root to places below this limit. This leads to exposure of the tooth root surface.

• It is more frequent that the recession is present through the vestibular tooth
• Affect children and adults
• Its prevalence increases with the years
• Adults over 50 have the highest degree of affection
• This condition is often treatable

It is associated with undesirable aesthetics, tooth sensitivity, and cervical caries

Causes:

Predisposing factors: They are morphological-anatomical conditioners that determine the position of the margin of the gum:

• Bone and gingival biotype
• Marginal insertions of muscles and braces
• Dental malposition
• Fenestration and dehiscence of the alveolar bone

Determining factors:: They are those that directly affect the formation of gingival recession:

• Traumatic:
  • Traumatic Dental Brushing or Bruxism (Parafunctional Habits)
  • Occlusion Trauma
• Inflammatory: Periodontal Disease
• Orthodontic treatment
• Cervical restorations (shims in the neck of the tooth) aggravate the recession.

Gingival recession is an entity of multifactorial etiology, which has not been fully clarified. The review of the literature on the most important factors related to the pathogenesis of gingival recession leads us to the following conclusions:

The lack of adherent gingiva does not predispose the appearance of gingival recession if good plaque control is achieved and this is done by an atraumatic brushing technique and with a soft bristle brush.

The braces can favor the development of gingival recession mainly in two cases: when the brace has a papillary insertion and when the frenulum is inserted into gingival tissue, and there is a lack of adherent gingiva.

The outwardly inclined teeth usually have a gum band attached thinner to vestibular than the teeth located correctly in the arch. When the teeth emerge in a malposition, they can present dehiscences of the alveolar bone. If a tooth has dehiscence, but there is an adequate gum band attached, it is unlikely that a recession will occur. On the other hand, if there is an insufficient adherent gum band, the minor traumatism can cause a recession.

Erroneous and traumatizing tooth brushing is the most important precipitating factor in the etiology of gingival recession. The tooth brushing can influence many factors so that it becomes incorrect and traumatizing: the material of the bristles of the brush, the shape of the endings of the bristles, the pressure exerted with the brush, the frequency of brushing, the technique of brushing, etc. Each of these factors must be controlled in hygiene instruction and plaque control visits to prevent a gingival recession.

Periodontal disease usually causes loss of insertion through the formation of periodontal pockets, but it can also cause insertion loss in the form of a recession in teeth where the gingival tissue and alveolar bone have a reduced thickness. Finally, the gingival recession may be a process of compensatory remodeling of the gum architecture, due to the loss of periodontal support between the teeth.

Experimental studies in animals show that orthodontic movements can produce a gingival recession, whereas epidemiological studies are comparing populations of treated and untreated orthodontists, but it hardly indicates differences in the prevalence of gingival recession.

Treatment

The treatment is surgical type before the elimination or correction of the factor that causes the recession. Within the alternatives, we have surgical procedures that include flaps, grafts, regenerative techniques or combination of methods. The choice of the process will depend on the condition and degree of the recession.

What is regeneration using the PRF system?

Platelet-rich fibrin (PRF, platelet rich fibrin), corresponds to an autologous fibrin matrix rich in growth factors, which promotes and accelerates the repair of soft and hard tissues.

The PRF is obtained by centrifugation of a patient’s blood sample and has a characteristic yellow color. This technique of centrifugation is not taking advantage, until recently, the reparative potential of fibrin in the first cycle of centrifugation.

Main advantages

• Promotes the regeneration of soft (gum) and hard (bone) tissues
• Shorten healing times.
• There is no possibility of rejection due to being a patient of one’s own.
• Decrease the risk of infection and postoperative pain

And this works?

Without a doubt, yes. There are many studies that support the use of this technique.
Professional athletes have benefited especially with this treatment, due to the propensity to be injured and the need or desire to return to activity in the shortest time possible (muscle injuries, knee injuries, ankle, etc.).

Treatment with PRF shortens the recovery and rehabilitation period and reduces the chances of recovery.

Sticky Bone

It is a new concept in the product of platelet concentrates rich in growth factors that are obtained from the mixture of a fibrin matrix rich in platelets and cytokines (PRF) with the addition of bone graft material.

Advantage:

Provide stabilization of the bone graft in the defect, thus accelerating the healing of the tissue and minimizing the loss of mass during the healing period.

Main uses:

• Bone regeneration around the osseointegrated implants, filling the defect immediately after having the implants.
• In block bone grafts, to fill the donor area, compacting the border areas of the graft, thus avoiding the bony steps.
• Reconstruction of large bone defects after oncological surgery.