My Blog

Posts for: July, 2021

By Randal Bourjaily, D.D.S. P.C.
July 22, 2021
Category: Oral Health
Tags: gum disease  
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 Randal Bourjaily, D.D.S. P.C.
July 12, 2021
Category: Dental Procedures
Tags: overdenture  
ABetterVersionofaDentureorBridgeWithDentalImplants

A wise sage once said the largest room in the world is the "room for improvement." Indeed, many modern advances would never have happened if someone hadn't first asked, "How can I make this better?"

Dentures and bridges are a case in point. Both of these tooth replacement methods have a long, successful track record in restoring functional, life-like teeth. But a recent development has made them even better: the incorporation of dental implants.

Most people associate implants, metallic posts imbedded in the jawbone, with single tooth replacements. But a few strategically placed implants can connect to and support a full removable denture (or overdenture). We can also use them to permanently affix a full or partial bridge without altering any remaining teeth as with a regular bridge.

There are two great benefits to using implants in this way. The most obvious is that they provide greater support for restorations than the traditional means for securing them in place. But there's also a less obvious benefit: They help sustain and improve bone health.

When you lose teeth, there's a high probability of bone loss. The bone is constantly forming new cells to replace older cells that have dissolved. The forces generated during chewing travel up through the teeth and help stimulate new bone growth. When teeth go missing, though, that stimulus disappears.

As a result, new cell formation can't keep up with the loss of older cells, causing the volume and density of jawbone to diminish over time. And this gradual bone loss continues to occur even with dentures or bridges, which can't replicate the chewing stimulus. Even worse, dentures irritating the bony ridges of the jaw may actually accelerate bone loss.

But the titanium in dental implants attracts bone cells, which readily grow and adhere to the implant surface. They can stop the progression of bone loss, or even help stimulate more growth. That bone growth benefit is also applicable when incorporated with dentures or bridges.

If you're looking at a denture or bridge restoration, consider implant support. It may even be possible to retrofit your existing dentures for implants. It could give you a more secure restoration and healthier bone.

If you would like more information on implant-supported dentures and bridges, 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 “Overdentures & Fixed Dentures.”


By Randal Bourjaily, D.D.S. P.C.
July 02, 2021
Category: Dental Procedures
Tags: oral surgery  
SurgicalCleftCorrectionCandidateforaModernDayMiracle

Once consigned to an extraordinary divine intervention, the term "miracle" is often used today for anything out of the ordinary. But even if the usage has become a little worn, there are things that, though not of supernatural origin, may still deserve the description. In that regard, today's surgical techniques to correct lip or palate clefts and the impact they can have on lives is well-nigh miraculous.

Before the 1950s, though, there was little that could be done to correct these kinds of birth defects. That all changed, though, with a "bolt from the blue" discovery by a military doctor over a half century ago. During Cleft & Craniofacial Awareness & Prevention Month this July, we recognize that doctor's breakthrough insight and the vast progress since then in cleft reconstruction surgery.

Affecting more than 4,000 babies each year, clefts develop during early pregnancy as portions of the face, typically the lips or extending into the palate, don't completely unite with each other. As a result, gaps (clefts) occur where the tissues should be uniform, forming on one side of the face or both.

Clefts can have a harmful effect on a baby's ability to feed or even breathe, and they can interfere with speech development as the child gets older. But what may cause the most emotional pain is the alteration of a person's normal appearance, which may inhibit their ability to socially interact with others.

But a child today with a lip or palate cleft can reclaim a more normal appearance through a series of surgical repairs. The genesis for this began when a U.S. Naval surgeon named Ralph Millard stationed in Korea in 1950 noticed something when studying photographs of his cleft patients. He realized there was no missing tissue with a cleft—all the "parts" were still there and only needed to be "rearranged" surgically.

Today's surgeons do just that, having built modern cleft correction on Dr. Millard's original procedures. And although it involves multiple procedures and often a team of surgeons, dentists and orthodontists, the end result is life-changing.

As amazing as these results may be, cleft correction is a process that can take years, taxing the stamina of both patients and their families. But with ample support, a child with a cleft now has a chance to enter adulthood with a normal smile and appearance. If anything deserves the title "miracle," surely cleft reconstruction surgery does.

If you would like more information about cleft treatment and reconstruction, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Cleft Lip & Cleft Palate.”