A few months into wearing braces you may notice your gums are swollen. It's likely you've developed periodontal (gum) disease.
Gum disease is a bacterial infection that usually begins with dental plaque. This thin, accumulated biofilm on teeth is filled with bacteria that cause dental disease. The more of it that remains on your teeth, the higher your risk for a gum infection.
In addition to regular dental cleanings, the best way for a person to reduce their gum disease risk is to remove plaque on a daily basis through brushing and flossing. Unfortunately, wearing braces complicates this: The brackets and wires affixed to your teeth can get in the way of your toothbrush and regular dental floss. As a result, you can easily miss plaque hidden around these bits of hardware.
Aside from gum disease, the braces themselves can irritate your gums. This irritation inflames the gums and may even cause more tissue to grow. Compound this overgrowth with a possible gum infection and it's no wonder your gums are severely swollen.
To lessen the chances of swollen gums with braces, you'll need to beef up your daily hygiene efforts. Simply put, it will typically take more time than normal to thoroughly clean around your braces. A few specialized tools, though, might make it easier.
An interproximal brush with a narrower head than a regular toothbrush is useful for accessing tight places around brackets. And a floss threader or a water flosser (which uses pressurized water to loosen and remove plaque) may help you better maneuver around wires to remove plaque between teeth.
Keeping your teeth clean as possible will certainly help you avoid gum swelling due to disease. But swelling from tissue overgrowth may not be resolved until your braces come off. In severe cases, it may even be necessary to remove the braces to treat the gums before resuming orthodontic treatment.
In any case, be as thorough as possible with your oral hygiene efforts during orthodontics and see your regular dentist for cleanings every six months. When you have completed orthodontic treatment, cleanings every six months are usually recommended. It's the best way to keep your gums healthy while you're wearing braces.
If you would like more information on dental care while wearing braces, 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 Swelling During Orthodontics.”
Parents will do just about anything to relieve their children's discomfort when they're in pain. When a toddler is suffering through a teething episode, it's tempting to turn to a topical numbing ointment to soothe their gums.
But there can be a hidden danger for kids if you use certain over-the-counter products used by adults for gum or teeth pain. Many of these topical ointments contain a pain reliever called benzocaine. While it's relatively safe for adults, benzocaine can be hazardous for infants and young children.
Studies have found that benzocaine contributes to a disease called methemoglobinemia, in which a protein in the blood called methemoglobin increases to abnormal levels. Too much of this protein inhibits the transport of oxygen throughout the body. For young children, this can cause shortness of breath, fatigue and dizziness. In extreme cases, it could lead to seizures, coma or even death.
Parents are urged to avoid using any product containing benzocaine to ease gum or teething pain in children. Instead, the American Academy of Pediatric Dentistry recommends providing a child a chilled (not frozen) teething ring, pacifier or a damp clean cloth to chew on. The chewing action helps relieve gum swelling pressure and the cold will help numb the pain. Massaging the gums with a clean finger may also help.
If the pain persists, parents should consult a doctor or pharmacist about giving their child pain medication. Drugs like ibuprofen or acetaminophen (never aspirin) administered in the proper dosage for a child's age can help ease teething discomfort. Medications should always be given orally—you should never rub substances like aspirin or alcohol directly on the gums, which can further irritate already inflamed tissues.
Teething episodes come and go during a child's early dental development—they are like storms that swell and abate before they finally pass. Except when accompanied by fever or diarrhea, there's no need for concern. Your main goal is to help ease their discomfort as much—and as safely—as possible.
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.
Dorit Kemsley isn't shy. Best known to fans as an outspoken and sometimes outrageous cast member of the reality show Real Housewives of Beverly Hills, Kemsley is never reticent about “mixing it up” with fellow castmates or their significant others. Recently, though, she confessed to something that left her less than confident: her smile.
Kemsley has been self-conscious about her smile because her teeth looked noticeably short, worn down from an unconscious habit of grinding her teeth. Although teeth grinding is more common among children (who normally grow out of it by adolescence), it can persist into adulthood, usually from difficulties managing high stress (a likely component in the fashion designer/reality show star's busy life).
Stress-induced teeth grinding can occur during waking hours or, more likely, during deep sleep. The accumulating, long-term effects from the habit can lead not only to worn teeth but to weakened gum support, a high risk of tooth fracture or jaw pain and dysfunction.
So, how do you know if you grind your teeth, especially if it's only happening at night? Typical signs include sore jaws after awaking from sleep, increased tooth pain or sensitivity or, like Kemsley, a noticeable difference in your tooth length. Your family or sleeping partner may also complain about the “skin-crawling” noise you make during the night.
There are ways to lessen the effects of teeth grinding. The first step is to have us verify the underlying cause for the habit. If it's tension from stress, then you might reduce the habit's occurrences by learning better stress management or relaxation techniques through individual counseling, group support or biofeedback therapy. We can also fit you with a mouth guard to wear at night or through the day that reduces the force generated during teeth grinding.
And if you've already experienced accelerated tooth wear like Kemsley with a resultant “small teeth” smile, you might pursue the same solution as the RHOBH star: dental veneers. These thin, life-like wafers of porcelain are custom-made to mask imperfections like chips, staining, slight tooth gaps and, yes, worn teeth.
Veneers are often less expensive and invasive than other cosmetic techniques, yet they can have a transformative effect, as Kemsley's Instagram followers have seen. In conjunction with other dental treatments needed to repair any underlying damage caused by a grinding habit, veneers are an effective fix for the smile you present to the world.
If you suspect you may have a grinding habit, see us for a complete examination. From there, we'll help you protect your teeth and your smile.
For some, the excitement over their braces coming off gets dampened a bit with the prospect of now having to wear a retainer. But it has to be—newly realigned teeth have a tendency to revert to their previous positions out of a kind of “muscle memory.” A retainer prevents that from happening.
But as essential as it is, the standard retainer is almost as noticeable as braces, a major reason why many patients are less than enthusiastic about wearing them. And, because it's common for them to become lost when out of the mouth, replacing one becomes an added expense.
But there's another option—the bonded retainer. This retainer consists of a metal wire bonded to the back of the teeth to prevent them from moving. Because it's fixed in place, only a dentist can remove it.
The bonded retainer addresses the previous two issues associated with a removable retainer. Because it's behind the teeth rather than in front, it's out of sight to others. And, because it's fixed in place, there's no danger of losing it.
But unlike its removable cousin, which can be taken out for oral hygiene, the bonded retainer can make flossing more difficult. And, by nature, a bonded retainer must be worn all the time; a removable retainer allows for a more flexible schedule later in the treatment of a few hours a day.
So, which retainer option is best for you or another family member? A bonded retainer may be more attractive for appearance's sake, if it must be worn indefinitely, or if there's a high probability of the teeth moving out of alignment. And, it might be the right choice where there's a concern about a patient's ability to keep up with a removable retainer.
If you do decide to go with a bonded retainer, ask your dental hygienist for training on using floss with the fixed appliance—this can help improve oral hygiene. Whatever you choose, bonded or removable, your retainer will help you keep that new, beautiful, straightened smile.
If you would like more information on orthodontic retainers, 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 “Bonded Retainers.”
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