James A. Vito D.M.D.
523 East Lancaster Avenue
Wayne, Pennsylvania 19087
Ph: 610-971-2590
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Contact us for more information about periodontics in the greater Philadelphia area, including Bryn Mawr, Villanova, Radnor, Wayne, Berwyn, Devon, Malvern, Paoli, and Valley Forge, Pennsylvania.
Dr Vito is a periodontist who is a specialist trained in the diagnosis, treatment and management of gum disease and bone loss.
Periodontics: Treatment for Gum and Periodontal Disease
| PROBLEM: | HALITOSIS, SWOLLEN GUMS, BLEEDING GUMS & LOOSE TEETH |
| SOLUTION: | PERIODONTAL EVALUATION, TREATMENT & MAINTENANCE |
The root of most dental problems is plaque. Plaque is a combination of food, bacteria
and dead skin that lines the mouth. This combination forms an acidic, slimy film that readily
adheres to the teeth. This plaque then hardens over time to form a barnacle like substance called
calculus (tartar). This acidic film results in two destructive dental processes. The first process is dental decay, a destructive bacterial
process that destroys tooth structure. The second process, periodontal disease, is a destructive
inflammatory progressive disease that begins initially in the gums and progresses to the surrounding
bone, resulting in irreversible bone loss. This inflammatory process can only be resolved by the
removal of the plaque, corrective periodontal surgery and/or bone regenerative techniques. Regular
hygiene maintenance appointments are key to maintaining periodontal health and minimizing additional problems,
which may necessitate further periodontics treatment.
Symptoms of periodontal disease include inflamed gum tissues, bleeding gums, migration and movement of teeth, dental decay, dental abscesses, root canal, halitosis, metallic taste, irreversible bone loss and ultimately tooth loss.
Recently, periodontal disease and the bacteria associated with it has been linked to an increased likelihood of heart attacks in people with a history of heart disease, complications with pregnancy resulting in premature low birth weight infants, increased periodontal problems in the elderly who live in a community setting and increased infection complications with patients undergoing cancer therapy. With these consequences, the field of periodontics can help you maintain, not only the health of your teeth, but also your overall health.
As a multi-specialty dental office, our job, in addition to treating dental disease, is to educate our patients about gum disease and stress the importance of the complex interaction between the host (patient) and the pathogenic bacteria that resides in the mouth. It is important to resolve the problem early and make sure periodontal patients understand the importance of keeping their regularly scheduled hygiene maintenance appointments, determined by their specific needs. This is key to preventing and/or minimizing future problems of either a restorative or a periodontal nature.
Periodontal disease can be broken down into four categories:
Gingivitis : Is characterized by irritation of the surrounding gum tissue and swollen bleeding gum tissue. There is no bone loss associated with this process.
Mild Periodontal Disease : Gingivitis with radiographic evidence of bone loss, up to 10% of the total volume of bone.
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Moderate Periodontal Disease : Gingivitis with radiographic evidence of bone loss, up to 50% of the total volume of bone. Additional symptoms include tooth mobility, shifting of teeth, halitosis, metallic taste and spontaneous bleeding of the gums upon probing.
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Advanced Periodontal Disease : Gingivitis with radiographic evidence of bone loss greater than 50% of the total volume of bone. This stage is marked by extremely visible mobile teeth, shifting and spacing of teeth under normal function, persistent halitosis and metallic taste. Tooth loss is probable.
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There is no cure for periodontal disease or dental decay. However, the appropriate periodontal treatment can control and limit the progression of both these disease processes by minimizing the bacterial buildup in one's mouth. The bacteria responsible for dental decay and periodontal disease inhabit the mouth twenty-four hours a day. Only through the proper diagnosis and treatment of the specific periodontal problem and adherence to a strict hygiene maintenance schedule based on one's disease activity can the severity of periodontal disease or tooth decay be minimized. There must be a partnership between the dentist and periodontal patient. The dentist educates and treats while the patient must understand their dental condition, be an active and cooperative participant in their treatment, and exhibit good oral hygiene on a daily basis. Through this partnership a patient can expect to have not only a smile that is healthy, functional and aesthetic, but also one that should last a lifetime!
Aesthetic Periodontal Gum Treatment
| PROBLEM: | GUMMY SMILE, UNEVEN GUM LINE, EXPOSED ROOT SURFACE |
| SOLUTION: | AESTHETIC PERIODONTIC SURGICAL TECHNIQUES |
The art and science of aesthetic periodontal surgical techniques can be performed to enhance and improve not only the gingival health but also the aesthetics of your smile. By performing simple surgical procedures, results can be achieved and maximized that may not be realized through restorative dentistry alone.
The art and science of aesthetic dentistry is to create a picture utilizing the color, shape, position, symmetry and luminescence of the teeth, which is then framed by healthy gum tissue to achieve a smile that is healthy, youthful and natural. For more information, contact Dr. Vito's periodontics practice in Wayne.
Bruxism or Grinding
| PROBLEM: | EXTENSIVE LOSS OF TOOTH STRUCTURE DUE TO GRINDING |
| SOLUTION: | BITE GUARD APPLIANCE OR COMBINATION TREATMENT |
Bruxism, or grinding of the teeth, results in a progressive loss of tooth height and structure. This is due to unintentionally bringing the teeth together under pressure and rubbing them together. This will cause the tips of the teeth to take on a flattened, roughened look. This situation can continue to the point where the enamel is rubbed off, exposing the inside of the tooth, called the dentin. When exposed, dentin may become sensitive. Bruxers may also experience pain in their TMJ (Tempro Mandibular Joint), which may manifest itself as popping and clicking.
Bruxism is seen in people under stress or with certain personality types. Anger, pain and frustration can trigger bruxism. People who are aggressive, competitive and hurried are also a a greater risk for bruxism.
It is interesting to note that most patients that clench or grind their teeth are not aware that they have this very unique, destructive dental habit.
The attrition of the teeth occurs in three stages over time. The initial or physiologic stage, is the wearing away of the enamel, resulting in the flattening of the teeth and the exposure of the next tooth lawyer, the dentin. In the second or transitory stage, the dentin layer is more visibly exposed. The tooth is noticeably shorter, jagged or rough edges become more pronounced, and the tooth may become sensitive to chemical and thermal stimulation. In the final or senile stage, there is continued reduction of tooth height, and the continued wear through the dentin layer is to the point where the nerve is exposed or nearly exposed, resulting in increased tooth sensitivity.
Treatment, if the problem is recognized early, is accomplished with a hard acrylic bite guard appliance. This appliance is designed to fit on the biting surface of the upper teeth. This will not prevent the grinding habit, but it will absorb the force of the grinding and protect the teeth. The patient will create wear patterns, holes or even destroy the acrylic appliance, which is much softer than the opposing lower teeth, and leave the teeth intact. The bite appliance is more economical to repair or replace than the teeth themselves. Thus, when worn on a daily basis, the bite guard will prevent or greatly reduce the attrition process.
If this grinding pattern is not recognized or treated in a preventative fashion, then it requires a multidisciplinary approach to repair: root canal therapy has to be performed due to the exposed nerve or the close proximity of the nerve to the tooth surface; periodontal surgery removes some of the supporting bone so that the teeth can be made longer for the restorative phase where the teeth are then crowned. A bite guard appliance is then made to protect the newly restored teeth.
