DENTAL CARE

Q: Why Is That One Tooth Bleeding?

A: The question in the title happened during a routine exam yesterday. I knew the patient in the chair for decades. I treated her and took care of her preventative as well as corrective care over the years. We have a doctor-patient relationship, but as with so many of my patients, we became friends. Her oral health challenge involved gum disease and associated bone loss. Like so many health issues today, a great deal of help and care does not have to come from the medical professional. So much good gets done via self-help and care from the patient. Taking responsibility for health issues can be a challenge, but the result is often much better than what a practitioner can do. Keeping disease under control, which I shall call preventative care, yields a reward that far exceeds the effort.

My patient’s home care is meticulous. She brushes and flosses like a pro. Her visits into the office are quick as there is less to clean. Yet, despite all of this, she had one area that did not look great. Her lower left cuspid, also known as the “eye tooth,” bled when she flossed. When my hygienist went to clean the area, it bled profusely, and the gums in that area show significant inflammation. This whole area is inconsistent with the rest of her mouth. Those were the words of Sarah, my hygienist, when she gave me her report.

When I examined the mouth, I saw the apparent reason for the problem. The lower front teeth are all jammed into each other and crowded. Teeth are rotated and twisted for them to fit into that area of the mouth. Sarah told me that the area in question had a large pocket. We were shocked when I confirmed her findings. Let me define the term pocket for you.

Our teeth sit in bone in our jaws, and a particular type of skin protects them. Like any other body area, skin in the mouth covers the bone and inner muscles, and soft tissue. The scientific name for the skin around the teeth is “gingiva.” We commonly call this tissue “gum.” Each tooth sits in its little sack of skin or gingiva. When the gingiva is healthy, there is a tiny space around the tooth. This gingiva is much like a cuff on a shirt sleeve. In the same way, you can insert your finger under your cuff. I can take a small instrument and place it under the cuff of the gingiva,

When the gingiva is healthy, my small instrument barely finds its way into the space that I just mentioned. However, in the presence of disease, the space grows and gets deeper. Dentistry calls this diseased space a pocket. Once a pocket forms, it is difficult or even impossible to keep the area clean. Now bleeding, gum disease, and bone loss will occur.

Her crowded teeth prevented her from cleaning correctly. Plaque and debris collect in the area, and the result is gum disease. I recommended that we straighten those teeth to fix the problem and arrest the disease process. She was on her way to losing a vital tooth in her mouth. That tooth is right in the front where everyone can see it.

Using clear Aligners, not metal braces, I can move the teeth easily with little disruption to your appearance or daily life in our office. I am evaluating a new product in this field to help save my patients money for the procedure. If you notice crowded and crooked teeth, please call us at 440.951.7856 and let me see if you fit into this new program. We can be reached at 440.951.7856 Jeffrey Gross, DDS, FAGD, is an Ohio licensed general dentist and is a staff member at Case School of Dental Medicine in the Department of Comprehensive Care.

The Healthy Smile

34586 Lakeshore Boulevard (¼ mile west of Route 91 on Lakeshore Blvd) Eastlake, Ohio 44095 440-951-7856 Severance Medical Arts, Suite 603 5 Severance Center Cleveland Heights, Ohio 44118 216-371-2333 www.jeffreygrossdds.com