By Dr. Raymond B. van Gennip
July 27, 2021
Category: Oral Health
Tags: gum disease  
SmokersAreMoreSusceptibletoHarmfulGumDiseaseHeresWhy

Along with tooth decay, periodontal (gum) disease is a primary enemy of oral health. If not caught and treated, a gum infection could spread and eventually cause tooth loss.

But although prevalent among the general population, one demographic in particular is highly susceptible to gum disease—smokers and tobacco users in general. It's estimated over 60 percent of all smokers will contend with a gum infection at some point during their lifetimes. Smokers are also twice as likely as non-smokers to develop advanced gum disease that could lead to serious dental damage.

The high rate of gum disease among smokers (and to some extent, all tobacco users) is connected to the effect that tobacco has on oral health in general. Studies show that nicotine constricts blood vessels in the mouth, which in turn reduces their delivery of antibodies to fight disease-causing bacteria. As a result, smokers have more harmful bacteria in their mouths than non-smokers, which increases their risk of dental disease.

Smokers are also less likely than non-smokers to display inflammation or redness, the initial signs of a burgeoning gum infection. This too has to do with the constricted blood vessels in the gums that can't deliver adequate oxygen and nutrients to these tissues. As a result, the gums can appear pink and healthy, yet still be infected. This could delay diagnosis of gum disease, allowing the infection to become more advanced.

Finally, smoking can interfere with the treatment of gum disease. Because of nicotine, a tobacco users' infections and wounds are often slower to heal. Combined with late diagnoses of gum disease, this slower healing creates an environment where smokers are three times more likely than non-smokers to lose teeth from gum disease.

If you do smoke, it's important to let your dentist know how much and for how long you've smoked, which could be relevant to any dental care or treatment. Better yet, quitting the habit could improve your oral health and lower your risk for teeth-destroying gum disease.

If you would like more information on the effects of smoking on oral health, 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 “Smoking and Gum Disease.”

By Dr. Raymond B. van Gennip
July 17, 2021
Category: Oral Health
Tags: oral hygiene  
SeeHowWellYoureRemovingPlaqueWithaDisclosingAgent

You've just finished your daily brushing and flossing. How did you do? Swiping your tongue across your teeth can generally tell you: It's a good sign if it glides smoothly; but if it feels rough and gritty, you better take another run at it.

This "tongue test," however, only gives you a rough idea of how well you're removing plaque, that thin bacterial film on teeth most responsible for dental disease. Plaque, though, can be sneaky, "hiding" in the nooks and crannies on the biting surfaces of teeth, around the gum line and in between teeth.

So, how do you know if you're clearing out any plaque holdouts? An effective way is to use a plaque disclosing agent. This over-the-counter dental product consists of a swab, tablet or solution, which contains a dye that's reactive to plaque.

After brushing and flossing as usual, you apply the solution to your teeth for about 30 seconds. You then take a look in the mirror: Any remaining plaque will be stained a bright color that makes it stand out. There are also agents with two colors of dye, one that stains older plaque and one for newer plaque.

The plaque staining not only helps you see how well you've been brushing and flossing, it can also show you areas in need of improved hygiene. For example, if you notice a scalloped pattern around the gum line, that may mean your brush isn't getting into that area effectively. In this way, you can use a disclosing agent to fine-tune your hygiene.

Repeated use of a disclosing agent is safe, but just remember the dye color can be vivid. It does wear off in a few hours, though, so perhaps schedule it for a day off around the house. You should also avoid swallowing any solution or getting any of it on clothing.

The ultimate test, though, is a thorough dental cleaning with your dentist at least every six months. They can verify whether you've been fairly successful with your brushing and flossing, or if you have room for improvement. If you do use a disclosing agent, you can also discuss that with them in working out better strategies to protect your teeth from tooth decay and gum disease.

If you would like more information on improving your oral hygiene, 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 “Plaque Disclosing Agents.”

By Dr. Raymond B. van Gennip
July 07, 2021
Category: Dental Procedures
Tags: gum disease   root planing  
RootPlaningCleansPlaquefromToothRootsWithoutSurgery

Periodontal (gum) disease is an aggressive bacterial infection caused by built-up plaque on tooth surfaces. Gum disease results in bone loss and causes loss of attachment from the teeth, leading to eventual tooth loss.

The goal of any gum disease treatment is to remove as much plaque and calculus (hardened deposits of plaque) from the gums and teeth as possible. Scaling with special hand instruments or ultrasonic equipment is the basic technique for plaque and calculus removal above and below the gum line. As the infection spreads below the gum line, it can widen the natural gap between teeth and gums to form voids known as periodontal pockets that fill with infection. Accessing and cleaning these pockets, which can occur as deep as the tooth roots, will require more invasive procedures.

Pockets that form at a depth greater than 5 mm below the gum line will most likely require surgical access through the gum tissue. But for pockets not quite that deep there’s an intermediary technique called root planing without surgical intervention. As the name suggests, the roots are physically “planed,” much like shaving a wooden board to remove minute layers of wood.

Using similar instruments as with scaling, root planing removes calculus, bacteria and other infected matter adhering to the root surfaces. It’s best to perform the procedure with local anesthesia to numb the gum tissues, which may be quite sensitive depending on the degree of infection. Working in a pain-free environment also helps us to be as thorough as possible in detecting and removing every bit of plaque and calculus we can find.

In advanced cases, it may be necessary to perform this procedure during multiple visits. As plaque and calculus are removed the inflammation in affected tissues will begin to subside, revealing more deposits of plaque and calculus. It’s also important to begin and maintain a daily habit of effective brushing and flossing to lessen the chances of a recurring infection.

Treating gum disease is an ongoing effort that requires constant monitoring and sustained efforts to remove plaque and calculus, including root planing. Saving your teeth, however, is well worth the effort.

If you would like more information on treating periodontal 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 “Root Planing.”

By Dr. Raymond B. van Gennip
June 27, 2021
Category: Oral Health
PrettyLittleLiarsLucyHaleCrushesonSmiles

Is a “teeth crush” a thing? According to a recent confession by Lucy Hale, it is. Hale, who has played Aria Montgomery for seven seasons on the hit TV show Pretty Little Liars, admitted her fascination with other people's smiles to Kelly Clarkson during a recent episode of the latter's talk show (Clarkson seems to share her obsession).

Among Hale's favorite “grills”: rappers Cardi B and Post Malone, Julia Roberts, Drake and Madonna. Although some of their smiles aren't picture-perfect, Hale admires how the person makes it work for them: “I love when you embrace what makes you quirky.”

So, how can you make your smile more attractive, but uniquely you? Here are a few ways to gain a smile that other people just might “crush” over.

Keep it clean. Actually, one of the best things you can do to maintain an attractive smile is to brush and floss daily to remove bacterial plaque. Consistent oral hygiene offers a “twofer”: It removes the plaque that can dull your teeth, and it lowers your risk of dental disease that could also foul up your smile. In addition to your daily oral hygiene routine at home, professional teeth cleanings are necessary to get at those hard-to-reach spots you miss with your toothbrush and floss and to remove tartar (calculus) that requires the use of special tools.

Brighten things up. Even with dedicated hygiene, teeth may still yellow from staining and aging. But teeth-whitening techniques can put the dazzle back in your smile. In just one visit to the dental office, it's possible to lighten teeth by up to ten shades for a difference you can see right away. It's also possible to do teeth whitening at home over several weeks using custom-made trays that fit over your teeth and safe whitening solutions that we provide.

Hide tooth flaws. Chipped, stained or slightly gapped teeth can detract from your smile. But bonding or dental veneers, thin layers of porcelain custom-made for your teeth, mask those unsightly blemishes. Minimally invasive, these techniques can turn a lackluster smile into one that gets noticed.

Straighten out your smile. Although the main goal for orthodontically straightening teeth is to improve dental health and function, it can also give you a more attractive smile. And even if you're well past your teen years, it's not too late: As long as you're reasonably healthy, you can straighten a crooked smile with braces or clear aligners at any age.

Sometimes a simple technique or procedure can work wonders, but perhaps your smile could benefit more from a full makeover. If this is your situation, talk to us about a more comprehensive smile renovation.  Treatments like dental implants for missing teeth combined with various tooth replacement options, crown lengthening for gummy smiles or tooth extractions to help orthodontics can be combined to completely transform your smile.

There's no need to put up with a smile that's less than you want it to be. Whether a simple cosmetic procedure or a multi-specialty makeover, you can have a smile that puts the “crush” in “teeth crush.”

If you would like more information about cosmetic measures for enhancing your smile, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Teeth Whitening” and “Porcelain Veneers.”

By Dr. Raymond B. van Gennip
June 17, 2021
Category: Oral Health
Tags: oral health  
5ThingsYouCanDoToKeepYourTeethandGumsHealthy

While your dentist plays an important role in keeping things inside your mouth healthy, what you do every day often makes the biggest difference. Here are 5 routine things you can do for better oral health.

Brush and floss every day. The most important thing you can do for your teeth and gums is adhere to a daily schedule of brushing and flossing. These twin tasks remove the daily buildup of plaque, a thin bacterial biofilm most responsible for tooth decay and gum disease.

Check your hygiene. There's brushing and flossing—and then there's brushing and flossing effectively. To make sure you're getting the job done, run the tip of your tongue along your teeth after you brush and floss. If it feels smooth, mission accomplished! If it feels rough and gritty, though, try again. You can also use plaque disclosure products occasionally to highlight any missed plaque still on your teeth.

Say no to sugar. Chances are you love sugar—and so do the disease-causing bacteria in your mouth. As they feed on sugar, they multiply and produce acid, which in high levels can erode tooth enamel and lead to tooth decay. Limiting sugar in your diet reduces oral bacteria and the acid they produce, and thus lowers your risk for disease.

Drink plenty of water. Saliva plays an important role in oral health: It helps fight off bacteria, neutralizes acid and re-mineralizes tooth enamel. But it can't do those things if there's not enough of it. So, if your mouth consistently feels dry, drink more water to give your body what it needs to make saliva. Drinking water also washes away food particles that could become plaque and lowers your mouth's acidity.

Maintain your dental appliances. You can extend the life of dentures, retainers or other types of dental appliances by cleaning and maintaining them. You should clean your appliance regularly using regular hand soap or a designated cleaner (not toothpaste, which can be too abrasive). Unless otherwise directed by your dentist, take them out at night and be sure to store them where kids or pets can't get to them.

If you would like more information on best dental care practices, 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 “10 Tips for Daily Oral Care at Home.”





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Dr. Raymond B. van Gennip

(301) 565-8030
8630 Fenton Street, Suite 212 Silver Spring, MD 20910