What causes gum disease? Gum disease starts when harmful bacteria lodged in plaque and tartar deposits multiply, releasing toxins that cause the gum tissue to shrink and pull away from the surfaces of your teeth. As the gums shrink, they create pockets and spaces that make it easier for the bacteria to migrate down the tooth surface. Over time, the gums recede substantially, exposing the lower portions of the teeth and causing the teeth to weaken and fall out. Poor oral hygiene, eating a lot of sugary or carbohydrate-rich foods, smoking, and some chronic diseases like diabetes can all increase the likelihood you’ll develop gum disease, which is the leading cause of tooth loss among adults in the United States. What kinds of symptoms does gum disease cause? Gum disease occurs in “stages.” The first stage is gingivitis, when symptoms first begin to appear. The last stage is periodontitis, when bacteria have moved far down the tooth surface and threaten the health of the tooth. In the very early stages of the disease, very few symptoms appear. As the disease continues without treatment, you may have symptoms such as: Bleeding gums Swollen, red, or tender gums Chronic bad breath A persistent or recurring sour taste in your mouth Tooth soreness, especially when pressure is applied to the tooth Loose teeth Tooth loss Because gum disease causes very few symptoms in the very early stages, having routine dental checkups and cleanings every six months is very important for “catching” the disease early so it can be treated and tooth damage can be prevented. How is gum disease treated? Mild to moderate gum disease may be treated with frequent teeth cleanings and improvements in your brushing and flossing habits between office visits. When gum disease is more severe, Dr. Sodergren or Dr. Gur-Arie may recommend deeper cleaning treatments called root planing and scaling. In these procedures, special instruments are used to reach below the gumline and around the tooth
Many types of tooth damage - even damage in the central portion of the tooth - can be corrected without extractions. But sometimes, a tooth is so badly damaged that extraction is the best option. For instance, teeth that have broken off below the gumline as a result of extensive decay may be too badly damaged to be repaired. Likewise, teeth that are impacted (“stuck” under neighboring teeth) or causing problems such as overcrowding also may need to be extracted. Before any tooth is extracted, Dr. Sodergren or Dr. Gur-Arie will perform a careful evaluation to ensure that extraction is the best option for your needs.
That depends on why the tooth is being pulled, the location of the tooth, and other factors. For simple extractions, special instruments are used to gently lift the tooth from the socket. More complex extractions, including extraction of wisdom teeth and for teeth that are broken off below the gums, require incisions into the gums to ensure the entire tooth is removed. In some cases, a small amount of bone may need to be removed to access the tooth.
It’s almost always a good idea to have your wisdom teeth pulled. Why? There are a couple of reasons. First, wisdom teeth are the last teeth to emerge, which means your mouth is already pretty full of teeth by the time the wisdom teeth come in. Often, wisdom teeth come in sideways or become impacted under neighboring teeth, or they may push other teeth out of alignment. Removing your wisdom teeth can prevent crowding and similar problems that can lead to significant oral health problems. Even if your wisdom teeth come in without issues, their location makes them very difficult to clean, which means they’re more likely to become decayed or become harbors for disease-causing bacteria. Having them pulled eliminates these risks for better long-term oral health.
If a tooth is pulled because of crowding issues, you won’t need to replace it. But if a tooth is extracted because of decay, disease, or trauma and crowding is not an issue, you should definitely have a restoration like a bridge, denture, or implant to prevent bite balance problems and to avoid future tooth loss.