Family Dentistry

Pediatric Services | Women’s Oral Health »

………………………………………………………………………………………………………………………

Gingival Enlargement

orthodontic treatment with braces may necessitate gingivectomy or frenectomy with a laserWhile your child is wearing braces and undergoing orthodontic treatment, the teeth slowly shift. Sometimes, the trauma from this movement is enough to cause the gums to become compressed, resulting in swollen gums.

Left untreated, the swollen gums typically revert back to normal only when the braces are removed. Swollen gums prevent proper oral hygiene and can cause discomfort during brushing. Poor oral hygiene can increase the risk of cavities and detrimentally effect the outcome of orthodontic therapy.

The orthodontist may recommend a procedure called a gingivectomy, where the gums are sculpted to restore oral health and allow for proper oral hygiene to resume.

A conventional gingivectomy is performed with a scalpel or electrocautery and requires anesthetic. The procedure can cause pain for several days and often leads to post-operative bleeding.

A gingivectomy performed with our Waterlase YSGG laser is painless and an anesthetic injection is often not required for treatment. The recovery is very quick and uneventful. The patient can also resume normal daily activities immediately. This laser treatment is safe for children of any age.

 

Frenectomy

A frenectomy or gingivectomy performed by a dental laser specialist, such as Dr. Diamond or Dr. Schlesinger in Manhattan, means your child can go right back to school and resume normal activitites with minimal discomfort.A frenum is a muscle attachment found under the tongue and beneath the center of the upper and/ or lower lips. A frenectomy is the surgical removal of a frenum.

A lingual frenectomy is the removal of the lingual frenum under the tongue. If the frenum is attached too closely to the tip of the tongue, it can interfere with speech development and tooth alignment. The frenectomy is a common procedure performed on children who are “tongue-tied”.

A labial frenectomy is the removal of the frenum attached to the center of the upper or lower lip. A frenum attached too close to the teeth can cause gum recession or gaps to form between the affected teeth. An orthodontist or pediatric dentist may recommend this procedure to prevent harm to the teeth.

Frenectomy with our Waterlase YSGG laser is minimally invasive, requires very little anesthetic, and rarely requires sutures. Recovery is very quick and uneventful. The patient can also resume normal daily activities immediately. The procedure is safe for children at any age.

…………………………………………………………………………………………………..

Women’s Oral Health Issues

Female health needs are unique, and oral health is no different.   Hormonal fluctuations can have a marked impact on oral health, especially on the gums.

Puberty

During puberty, increased hormone levels render the gums more prone to irritation from food and bacterial plaque.  Irritated gums can become red, swollen and tender.  Good home care and periodic dental cleanings are typically adequate to keep this condition under control and prevent harm.  Occasionally, more advanced periodontal therapy may be recommended if the dentist feels that there is a risk for damage to the tissues.  The gums tend to revert back to normal after puberty ends.

Menstruation

Menstruation gingivitis is a term that describes red, swollen and bleeding gums that occur right before a woman’s period begins.  It is generally harmless, and goes away once her period has started.

Pregnancy

Every woman who is thinking of becoming pregnant should have a periodontal examination.During pregnancy some women may notice their gums may be swollen, tender, red or bleed easily.  This is called pregnancy gingivitis.  It usually begins in the 2nd or 3rd month of pregnancy, and can progressively worsen until the 8th month.

In some cases, the gums in pregnancy gingivitis can form painless red, lumpy growths in response to irritants such as certain foods and plaque.  This is commonly referred to as a pregnancy tumor, but it is not cancerous.

Pregnancy gingivitis and pregnancy tumors for the most part are harmless.  The best treatment is often good oral hygiene.  If either of these conditions worsens, they can safely receive necessary periodontal treatment.

Some studies show that the presence of untreated periodontal disease and periodontal infections in pregnant women may have a negative impact on the growing baby.   Evidence points to a relationship between periodontal disease and pre-term, low birth weight babies.   However, the role of periodontal treatment and its ability to reduce these risks remains unclear.   The American Academy of Periodontology continues to recommend that a periodontal examination should be an important part of prenatal care.

Contraceptives

Women taking oral contraceptives may experience the same signs and symptoms that affect pregnant women.  It is also important to understand that taking an antibiotic may lessen the contraceptive’s effect.

Menopause / Post-Menopause

Menopausal and post-menopausal women may experience a negative oral health impact.  Discomfort may be due to dry mouth or result from pain and burning sensations in the gums, palate and tongue.  Altered taste sensations are also not uncommon.

Treatment for these conditions is not simple since there are many factors involved.  Sometimes the symptoms are temporary.  Sometimes a pain specialist is needed to help tailor a drug regimen to fit the specific needs.  Sometimes other drugs cause side-effects and collaboration with a physician can help reduce some symptoms.  Estrogen supplements may also be beneficial.

Hormone Replacement Therapy (HRT) has been shown to protect oral health as well as the rest of the body from osteoporosis.  There are some studies that link periodontal disease with osteoporosis, but no definitive conclusions are ready to be made yet.

Bisphosphonates

Bisphosphonates are bone-sparing drugs used in the treatment of osteoporosis and cancers that have spread to the bone.  Recently, the FDA has set precautions for intravenous bisphosphonate therapy.  These IV drugs, Aredia and Zometa for example, are given to cancer patients.  Those cancer patients are at high risk for developing a dangerous condition called osteonecrosis of the jaw following surgical dental procedures such as extractions or dental implants.  Osteonecrosis is a painful and irreversible destruction of the jawbone.

Oral bisphosphonates, such as Fosamax (alendronate), were not the subject of those same precautions.  Currently, oral bisphosphonates do not represent a contraindication to surgical dental procedures including extractions, dental implants or periodontal surgery.

Treatment of Women’s Oral Health Issues

The decision about when and whether or not oral health issues require treatment must be made in the best judgment of the dentist.  In light of the link between periodontal disease and pregnancy, it is important that mothers-to-be are diagnosed properly and are fully informed of their oral health and the treatment options.  The doctors of The Diamond Schlesinger Group routinely treat prenatal and pregnant women, and we always discuss treatment with your OB/GYN to ensure the safety and well-being of the mother and baby.

In addition, we are able to avoid certain invasive procedures, and reduce trauma to the body, by utilizing our Waterlase YSGG laser to perform all aspects of periodontal therapy.  Laser therapy is safe and gentle.  Use of the laser to assist in therapy often times makes the decision about whether or not treatment should be postponed much easier.

NYLI

The Waterlase YSGG advanced laser system represents such a significant breakthrough in the practice of periodontics, esthetic and implant dentistry, that we have devoted an entire website to this cutting edge method of treatment.