Our Blog

Biofilm, the protective housing for bacteria, is a hot topic in the medical and dental fields. Routinely taking an antibiotic for a bacterial infection has become more complicated because of biofilm. Bacterial infections may become resistant to antibiotics in part because the biofilm allows for communication among the bacteria, allowing the infection to be sustained.

You’re probably wondering, Drs. Peter Vogel, Vijal Vadecha , what does this have to do with teeth? Since we’re dental professionals, we can tell you why it’s important and what you should know! There is biofilm in your mouth; healthy biofilm and diseased biofilm. Both are made of the same general compounds, but when combined with certain amino acids and cellular chemicals, the diseased biofilm conquers and destroys.

Periodontal disease, otherwise known as gum disease or pyorrhea, is a biofilm disease. If you are undergoing treatment for gum disease and you do not continue with the treatment plan the disease will progress and/or spread due to the biofilm.

There are several ways to treat diseased biofilm. But remember, antibiotics cannot touch the bacterial infection if the biofilm is established.

When your exam is complete, the Ultrasonic or Piezo Scaler should be used. This method of spraying water disturbs the biofilm and provides an opportunity to treat the infection causing bacteria.

Remember, we all need healthy biofilm. Just as your skin protects your body, biofilm housing good bacteria protects your body. The bacteria in the biofilm replicate every twenty minutes. If your body has healthy bacteria, low levels of hydrogen peroxide are produced by the biofilm, preventing harmful bacteria from residing. Harmful bacteria do not like oxygen.

At your exam, we will take measurements around your teeth checking for “pockets”. The higher the number, the deeper the pocket giving more room for harmful bacteria where there is no oxygen. Ask what your numbers are and be involved in restoring your healthy biofilm.

Dental implants are a marvel! They look just like your natural teeth, and, even better, they function just like your natural teeth. So, when you’re planning on a dental implant after an extraction, you want to make sure that your implant has the best chance of success—and we do, too. That’s why we might recommend a socket preservation procedure, where socket grafting takes place immediately after your extraction.

What is a socket graft, and what does it “preserve”? Let’s take a closer look.

Socket Preservation—A Logical Choice After Extraction

You’ve decided on a dental implant for some excellent reasons.

• A missing tooth can change the appearance of your smile.
• Your remaining teeth might shift to fill the empty space, causing alignment and bite problems.
• A lost tooth affects the amount, shape, and health of the bone surrounding your teeth.

No one wants to lose a tooth, but sometimes, due to injury or decay, an extraction is the only choice for your oral health. After your tooth is extracted, if the socket bone holding the tooth is perfectly healthy and the extraction is a simple one, we might be able to place an implant post in the socket right away.

But often, bone needs time to heal before placing an implant post, and you risk losing the bone size and density you need to make a future implant possible. How can you lose bone? That’s an unfortunate consequence of losing teeth. Teeth are important not just because they let us eat comfortably—they also help maintain bone health.

Without the stimulation of biting and chewing, the bone beneath the teeth begins a process called resorption. As older cells are absorbed back into the body, new bone cells aren’t produced as quickly to replace them. The alveolar bone, the thick ridge of the jaw which holds our sockets, shrinks in size. As the bone gets smaller, gum tissue shrinks around it, causing a sunken spot where your tooth used to be.

For a dental implant to anchor successfully in the jawbone, you need healthy bone that is high enough, wide enough, and dense enough to hold the implant post securely as it fuses with the bone.

A socket graft at the time of extraction provides two important benefits: grafting material fills the empty socket immediately, preserving the bone and gum area around it, and the graft material acts as scaffolding for new bone growth, creating a firm, dense foundation for your implant.

Grafting materials are gradually and safely absorbed as your new, healthy bone tissue replaces them. The result, after several months of healing, is an alveolar ridge with normal height and width and with the density needed to anchor an implant successfully.

The Grafting Procedure

Grafting material comes in different forms, including allografts (made from donor bone), synthetic grafts (made from synthetic materials which function like bone tissue), and autografts (bone taken from your own body). Growth factors may also be included in the grafting material to encourage new cell growth. Drs. Peter Vogel, Vijal Vadecha will recommend the type of graft which will work best for you.

A socket preservation procedure will frequently involve the following steps:

• Local anesthesia to numb the area before your extraction. You might choose sedation options as well, which we’re happy to discuss with you in advance.
• Careful cleaning of the site after the tooth is extracted.
• Filling the empty socket with bone grafting material.
• Placing a barrier or membrane over the graft to protect it as it heals.
• Suturing the surrounding gum tissue.

Aftercare Treatment

Aftercare treatment for a socket graft is a lot like the treatment for a tooth extraction. You’ll need to be careful around the graft area for several days as it heals, and we’ll give you specific instructions for your recovery. Normally, these may include:

• Don’t disturb or touch the area. Even pulling on lips or mouth to look at the site can put stress on your sutures.
• Immediately after the procedure, we can give you suggestions for reducing swelling and managing any pain you might be feeling.
• We’ll let you know when and how to rinse your mouth clean and when you can return to brushing. And no spitting!
• Eat carefully. We might recommend a liquid diet for a few days before transitioning to bland and cool soft foods. We’ll let you know the best diet for the period after your surgery. Don’t use a straw for your liquid diet, because suction can interfere with the wound.
• Treat yourself carefully for a few days by avoiding strenuous activities, including workouts.
• Don’t smoke. Smoking interferes with the healing process, and the suction involved does your graft no favors either.
• Visit our Anthem office for follow up appointments as recommended. We’ll monitor your healing, and give you a timeline for your future implant.

Preserving your socket now instead of repairing it later has many advantages. Immediate placement of a graft protects bone size and density, eliminates the need for a potential bone grafting procedure in the future, and makes it possible for you to enjoy the natural look and feel of a dental implant as soon as possible. If you have an extraction scheduled, let’s discuss why socket preservation might be your best path to an efficient, timely, and successful dental implant.

Our teeth are a lot more complicated than they look. Beneath that shiny white surface is an entire system of different cell tissues working together to keep each tooth vital and healthy.

• Enamel, the protective exterior of the crown (the visible part of the tooth), is the strongest substance in the body and the first line of defense against damage to our teeth.
• Dentin, the hard tissue under the enamel and cementum, has microscopic tubules that connect to the pulp.
• Pulp, the tissue at the center of the tooth, contains the nerves, blood vessels, and connective tissue that keep the tooth alive.
• Cementum, composed of connective tissue which forms the protective exterior of the root, also attaches to fibers in the periodontal ligaments which hold the teeth securely in the jaw.

Because cementum is below the gum line, it’s generally safe from the cavity-causing conditions that our enamel is exposed to every day. But there are still potential hazards that we should be aware of.

• Cementum Erosion

With a name like “cementum,” it’s logical to assume that this is the hardest tissue in the body. Actually, however, that distinction goes to our enamel. And if even our enamel can be damaged by bacteria and plaque, cementum doesn’t stand a chance!

How does cementum come in contact with cavity-causing bacteria? Gums often recede as a natural part of the aging process, leaving part of the root exposed. Gum disease, failure to brush and floss regularly, and heavy-handed brushing can lead to early gum recession. The newly exposed cementum is now exposed to the same conditions, which cause cavities in our enamel. But a root cavity can be trickier to treat and, because the cementum is not as strong as enamel, can progress more quickly. And if a cavity reaches the pulp, a root canal could be necessary.

But the erosion of cementum doesn’t have to result in a cavity to cause discomfort. When cementum is removed, the dentin beneath is exposed. Dentin, you’ll recall, contains tiny tubes that connect to the pulp of the tooth. The result? Conditions such as heat, cold, even an intake of air can cause tooth sensitivity as they stimulate the nerves in the pulp. If your hot coffee or ice cream cone is suddenly causing you pain, let us know. There are treatments, which can reduce tooth sensitivity.

• Gum Disease (Periodontitis)

In more severe cases of gum disease, the gums pull away from the teeth leaving pockets, which harbor plaque and bacteria. Left untreated, these pockets can become home to infections, which attack and destroy bone structure and connective tissue. Caught early, a treatment called tooth scaling and planing can help. In this type of deep cleaning, your dentist or endodontist will remove plaque and tartar and then smooth the root surface to make it harder for bacteria and plaque to stick. If the gums have receded too far, a gum graft might be necessary to protect the exposed roots.

• Trauma

The same traumas that can damage teeth above the gum line can result in injuries below it. Chewing on hard objects (ice, hard candies, wooden pencils), bruxism (tooth grinding), and sports injuries or accidents can cause cracks in the cementum. If your root is split or fractured, it might be possible to save your tooth, but sometimes extraction is the best option.

So how do you protect your cementum, hidden as it is under your gum line? The same way you protect the more visible parts of your teeth!

• Keep to a healthy daily routine of brushing and flossing. This will help prevent gum disease and keep gum recession at bay. Using a soft brush and brushing firmly but gently will remove plaque while protecting both enamel and cementum. If you notice tooth sensitivity, give us a call!
• Come in to our Anthem office for regular dental exams. The best treatment for gum disease is prevention. When you come in for regular checkups, we are able to discover early signs of gum disease before it becomes a serious problem. If you are suffering from more advanced periodontitis, there are treatments available.
• Safety first when it comes to your smile. If you chew on hard objects, talk to Drs. Peter Vogel, Vijal Vadecha about how to break the habit. If you grind your teeth, see us for solutions. If you play sports, let us know—often a mouthguard can help protect your teeth from injuries that could otherwise lead to more complex procedures or even tooth loss.

Maintaining your healthy dental habits is a lot like cementum—the foundation of a beautiful smile. Nothing complicated about that!

Children’s oral health differs from that of adults in a variety of ways. Drs. Peter Vogel, Vijal Vadecha and our team want you to understand how you can provide the best care for your son or daughter’s teeth. It’s essential to understand what your child will need from you when it comes to his or her oral health in those first few years.

In-home dental care begins when your baby starts to show signs of developing the first tooth. We recommend that you bring your child to our Anthem office between the ages of one and two. Drs. Peter Vogel, Vijal Vadecha will take a look at your child’s tooth development and gums during this first scheduled appointment.

The initial appointment with your little one is designed to get him or her accustomed to our office. We recommend allowing your child to be in the exam room alone with us during the first visit in order to become comfortable with our staff at an early age.

We will go over several general matters during your child’s first visit:

• Look for signs of decay or other tooth or gum problems
• Make sure your youngster doesn’t have gum disease or cavities
• Examine your child’s bite, and check for misalignment that could lead to problems in the future
• Clean the teeth, and apply fluoride if your son or daughter is old enough
• Talk to you about proper oral health care for your
• Give you some tips for brushing and flossing your child’s teeth
• Answer any questions you may have about caring for your little one’s teeth

Once your child is old enough for his or her first visit to the dentist, you should begin to schedule regular cleanings every six months. If any problems arise before a scheduled appointment, call our Anthem location and we will be happy to answer any questions you may have.

Remember, creating healthy oral health habits with your child early on is crucial. We’re here to guide you through this process and make sure your child is healthy and happy.