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Why Do Missing Teeth Even Matter?


We, at Periodontal Specialists in Kansas City, get this question a lot. Especially if the patient is missing a back tooth and they feel that no one can see it or that they are chewing “just fine”. The issue, although, is not just the chewing function for the patient. You see, when a person loses a tooth a lot of unnoticeable changes occur that can lead to other problems.

The thing to realize is that teeth like to touch, or contact, each other. If we lose a bottom tooth, the tooth on the top opposing it will start to grow down into the space. If we lose a tooth on the top, the tooth on the bottom opposing it will grow up in to the space. It is a phenomenon, known as super-eruption of teeth. Also, teeth have a tendency to shift or drift into an empty space, so that if we lose a tooth, the teeth beside the missing tooth will shift into the space. The reason this is important is that if we have teeth that a shifted or drifted, or grown up or down, as we open and close and bite side to side, those teeth will put extra pressure on the teeth that are biting them, and that extra pressure or force can get translated back to our joints and can cause temporomandibular joint paint, or TMJ. So, for out mouth and teeth to be healthy we want a full complement of teeth that bite evenly together.

Another thing that people don’t realize or know is that it’s the roots of our teeth that stimulate the bone around it. When a tooth is taken out, or extracted, the bone that was present will start to shrink, or atrophy. First it starts to shrink width-wise then it starts to shrink height-wise. Once we lose height of bone it becomes very difficult, to impossible, to build that height back in with bone grafting procedures. This can make replacing the tooth very challenging and reduce or options for replacing the tooth.

The question now becomes, “What are my options for replacing one or more teeth?”. Well, most people have three options for replacing teeth. The first is something removable that comes in and out, what we call a Partial Denture. Most patients don’t like this option due to having to take their teeth in and out. Over time the denture becomes loose and may need other procedures done to tighten it, or may need to be replaced. The clasps that help hold the denture in place can also loosen the teeth that they clasp and can endanger the life and health of those teeth.  The second option is something more permanent, that doesn’t come in and out, what we call a Fixed Bridge. This can only be done if there are teeth in front and in back of the missing tooth. It requires cutting down those adjacent teeth, which might not have any problems, and placing crowns with fake teeth attached. Anytime, we as Dentists, cut on a tooth we make tooth more susceptible to problems, like cavities and fractures. Not to mention that the Bridge is completely fused together and makes it very difficult to clean around. Lack of hygiene can lead to gum disease and bone loss around the Bridge and can cause the bridge to fail.

The third option, and best option, for replacing teeth is what we call a Dental Implant. A Dental Implant is a titanium screw that replaces the root of a tooth and a crown can be placed on that implant after an adequate healing time. The Dental Implant does not affect the adjacent teeth and is like you getting your individual tooth back. It can take longer to complete, over the other options, because the Implant must be placed first and must heal for approximately 3-4 months before a permanent crown can be placed. It does have the best success over time, versus the other options, and studies going out 30 years still give Dental Implants a 95% success rate.

So, If you are missing a tooth or multiple teeth, please call your local Kansas City Periodontist, to schedule a consult to talk about your options and what would be best for you!


St. Patrick- The Patron Saint of Gums?


While I think we all know that St. Patrick is not the patron saint of our gums, this is the time when we can all celebrate being Irish and have a drink to celebrate the work of St. Patrick. Most of us celebrate with green attire and green beer, some more than others, and whether we know it or not alcohol can affect our teeth and especially our gums. Alcohol consumption raises our body’s inflammatory response which, in the presence of bacteria around our teeth, can increase destruction of our gums and the bone around our teeth. In a study by Shepherd (2011 Evidence Based Dentistry), evidence was found suggesting that alcohol consumption is a risk indicator for Periodontitis. So, after you celebrate this St. Patrick’s Day make sure to make an appointment with your local Kansas City Periodontist to evaluate the health of your teeth and gums!


February is Heart Month


It’s that time of the year when we cherish the ones we love with flowers and candy. All around us are heart shaped boxes and jewelry enticing us to give gifts in appreciation of how much we feel loved.

But don’t you think that our loved ones would want us to make sure we take care of ourselves so that we will be around to love?

Month by month, more and more studies come out linking periodontal disease to cardiovascular, or heart, disease. The mechanisms that create this relationship are becoming more understood in that we know that patients with periodontal disease are at more risk for heart attacks and stroke. Heart attacks are caused by plaques that develop along artery, or blood vessel, walls making it harder for blood to flow to the heart. If those plaques were removed and cultured to find out what was in them, you would find the same bacteria living in those plaques that live in the month and cause periodontal disease. If you have been told that you have “gum disease”, “periodontal disease”, or “pockets” around your teeth it is important that you see a Periodontist for a consult to determine what can be done to control the disease so that we can reduce your risk factors for diseases such as cardiovascular disease.

This month, the best gift you can give your loved ones is a healthy you, a healthy heart, and a healthy mouth! Let Periodontal Specialists help keep you healthy this Valentine’s Day!


New Year New Teeth


As the New Year begins, we are strapped with bills and the hunger that this year will be better than the last. We make resolutions and set goals for ourselves, some that we meet and some that are all too soon forgotten or given up on. We, at Periodontal Specialists, would encourage you to make a commitment to your health and the health of your teeth and gums. Month by month, more and more studies and research are coming out linking the health of the mouth to many other diseases of the body including, Cardiovascular disease, stroke, Alzheimer’s disease, and some forms of cancer. It is of upmost importance that you take care of your health before you can take care of the health of your loved ones. Do yourself a favor and in this season of new beginnings, make an appointment with your Kansas City Periodontal office to evaluate your oral health and get you the smile to beam you into the New Year!


Feeling a little Stressed lately?


Every day stresses, like driving to work, dealing with the boss, the screaming kids, and even getting out of bed in the morning can just be enough to push someone off the edge. If you compound that with the stress of the holidays, and shopping for presents, and for the holiday meals can make things even worse. We tend to ignore our health in these times to the hustle and bustle of the day and not realize the toll that stress can take on our bodies and even our teeth.

Studies have shown (Genco et al, 1999) that stress, especially financial stress, can increase the risk of developing periodontal disease, which is a disease of our gums and bone that can lead to loss of teeth. Stress can reduce the response of our immune system to bacteria that live between our teeth and gums, which causes inflammation, and leads to bone loss around the teeth. If you have been feeling stressed lately it is time to focus on your health. It would be wise to seek out an appointment and an evaluation from your local Kansas City Periodontist, to evaluate your periodontal health!


Are you worried about that extra holiday weight?


We all love to indulge over the holiday season, and why not? It’s the one time of year we can have multiple Thanksgiving feasts, office parties, and all the yuletide has to offer. But did you know that packing on that extra holiday weight can actually affect your teeth. I’m not talking about just cavities but obesity, specifically, can increase your risk for developing periodontal disease, where the bone and gums around your teeth are eroded and loss of teeth can occur.

In periodontal disease, our gums become infected by bacteria and our body tries to fight the bacteria by increasing blood flow to the area and a state of inflammation occurs in our gums and bone. Adipose tissue, or fat, produces cytokines, which can lead to a hyperinflamed state. Studies have found (Gorman et al, 2012), that overall obesity is associated with an increased hazard of periodontal disease progression in men.

This chronic inflammation causes increased destruction of bone and gums around teeth and can accelerate the disease process and loss of teeth faster. Due to obesity being a true Risk Factor for periodontal disease, it is important that if you have trouble controlling your weight, or have put on a few pounds recently, that you consult with your Kansas City Periodontist so they can evaluate the health of your teeth and gums!


Thank You For Not Smoking


Everyday more commercials and information come out warning the public on the dangers of smoking. I’m sure that every time you have a physical and tell your physician that you smoke they give you talk on quitting. So, at this point we should all know that smoking can cause emphysema, cardiopulmonary disease (COPD), and the most scary, lung cancer. But most of us don’t realize that smoking can affect our teeth. Ok, we do know that it will probably stain our teeth, but it can also lead to the loss of our teeth.

Smoking is a risk factor for Periodontal disease. A risk factor is a characteristic that places an individual at increased risk of contracting a disease. Periodontal disease is the loss of the supporting bone around the teeth that causes the teeth to become loose and the teeth will eventually come out. According to a study by Grossi (2000), smokers are 2.7 times more likely to have periodontal disease than non-smokers. Smokers, also, have 18 times more periodontal pathogens, or bacteria, compared with non-smokers.

Prevalence studies, or studies of how common something is, have shown that 90% of smokers have some form of Periodontal disease.

It is the bacteria in the mouth that hide between our teeth and gums which cause the body to initiate its immune response and the result of the interaction between the body and bacteria is bone loss. The cells responsible for our immune response are known as white blood cells and they live in our red blood and our blood vessels. When bacteria are present, we see an increase in blood flow to the area causing inflammation, and around our gums a sign of that inflammation is bleeding. An ingredient in tobacco is nicotine. Nicotine causes vasoconstrictor in our skin and gums. So, like a boa constrictor nicotine actually closes off and makes smaller the blood vessels in our skin and gums, making it harder for our body to let out the cells to kill bacteria. Nicotine, also, masks the amount of inflammation present in a smoker’s gums so that they don’t see as much bleeding in their gums and can’t identify the early signs of Periodontal disease.

Ok, so I’m sure know you’re thinking, “I get that cigarettes are bad, but what about other forms of tobacco use like cigars, pipes, or even smokeless tobacco like vaping”. In a study of 690 men, Krall et al (1999) found an increased risk for tooth loss in men who smoked cigars or pipes and for bone loss in cigar smokers similar to that observed in cigarette smokers. Smokeless tobacco products also contain nicotine so the harmful immune effects and bone loss around teeth will still be seen.


We, at Periodontal Specialists, would love to sit down and talk to you about your periodontal status. We want to make sure you get the best information and even if quitting smoking is something that you don’t want to do at this time, still go over your treatment options to deal with your specific situation. If quitting is something you have been thinking about we can develop a plan to help you quit and arrange for follow-up visits to keep you on track. So, for the benefit of your teeth and gums and not only the rest of your body please think seriously about quitting and see a Periodontist for a consult.




So, your dentist told you that you have periodontal disease and pocket formation, what should you do now? Well, your first step should be contacting a Periodontist. They are the most knowledgeable about periodontal disease and can give you the best treatment options.

Periodontal disease results from bacteria in the mouth that colonize the area between your teeth and gums. Once certain bacteria are present in your gums they cause inflammation, or redness and swelling, which if not controlled by regular dental cleanings and checkups, can result in actual bone loss around your teeth. Periodontal disease is a progressive disease, meaning that if it is not controlled with treatment then the bone loss continues around your teeth until they get loose and fall out. Think of it like a splinter in your skin. Eventually, if you don’t remove the splinter the body will push it out. With periodontal disease, your teeth and the roots of teeth are being coated with plaque and bacteria which the body doesn’t recognize and views as foreign, so the body forces your tooth or teeth out, in a sense, just like the splinter.

The sad thing about periodontal disease is that it does not hurt and most patients don’t know that they have the disease until a dentist checks their pocket depths and they are already deeper than they should be. There is no cure for periodontal disease, either. It is a disease that has to be controlled, and more specifically, it is the level and population of bacteria in the mouth that has to be controlled. Like patients with high blood pressure that have to control their disease with medication, diet and exercise because they will always be susceptible to having high blood pressure numbers that can lead to heart attack and death. High blood is known as the silent killer of the body, and periodontal disease is known as the silent killer of the teeth!

There is a bright side, however! Not all patients with periodontal disease will lose their teeth and most don’t have to lose any teeth! Treatment is available and is very successful. A partnership will develop

between you and your Periodontist to gain control of the disease with daily brushing and flossing and treatments recommended by your Periodontist.

The first treatment that is usually initiated is what most patients call a “deep cleaning” and is professionally known as scaling and root planing. It typically involves numbing of the right half of the mouth one day and the left half within a couple days, or within a week. A follow-up is scheduled in about 1 month, when healing will be checked and a comparison of pocket depths would be reviewed. If pocketing is still deep, further treatment may be required to reduce the pocketing and possible grafting of bone around the teeth to reverse the damage that the periodontal disease has caused. The most important treatment and way to control periodontal disease is with a more frequent cleaning schedule. Studies and research show that it takes 3 months for bacteria, in the mouth, to get to levels and populations that will cause inflammation, infection, and disease. Patients with periodontal disease are recommended to come in every 3 months for cleanings, or periodontal maintenance, to control the population of bacteria and keep them below disease thresholds.

So, if you have been told you have periodontal disease, please see a Periodontist for a consult today!




Have you ever brushed your teeth and found blood in the sink or have tasted it in your mouth? Are your gums sore, red, or sometimes throb for no reason? These can all be signs of inflammation around your teeth called gingivitis, or a more serious condition known as periodontitis. If you experience these symptoms the best place to go is to a Periodontist. They are dental specialists that have expertise in dealing with the supporting structures of the teeth, including gums and bone.

Bleeding gums is the number one sign that DISEASE is occurring around your teeth. We just don’t share our mouth with the food that we eat. We also have different kinds of bacteria living there, also. Bacteria like our mouths because it is dark, warm, wet, and food is always there. Some bacteria hide in the cracks and crevices of our teeth and cause decay or cavities. Other bacteria, though, hide in the spaces between our teeth and gums. Healthy space is referred to as a sulcus and can be managed, typically, with just regular 6 month dental cleanings, but if there is bleeding present and the area between the teeth and gums is larger than it should be, that space is now referred to as a pocket. If your dentist tells you that you have pockets you should ask them if a referral to a Periodontist is a good idea. Most would say, yes!

Periodontists are the best at dealing with bleeding gums and pockets around teeth. They will be able to explain the disease process and give you the best tools to manage the inflammation and infection affecting your gums and teeth. They will help rid you of your bleeding and sore gums and give you the healthy smile you deserve.


Teeth Grinding


Do you frequently wake up in the morning with a sore jaw and a headache? If so, you might grind your teeth at night.  In fact, most of us grind and clench our teeth without even knowing it. A condition known as bruxism, teeth grinding affects children and adults of all ages, and it damages your teeth.

Here’s a basic overview on why people grind their teeth and how you can treat bruxism symptoms.

Reasons for Teeth Grinding People grind their teeth at any time of day or night for a variety of reasons:

Not sure why you grind your teeth? Talk to a sleep expert. He or she can analyze your current lifestyle and sleeping habits to pinpoint the problem.

Common Symptoms

Several symptoms hint that you might grind your teeth. These symptoms include the following:

Others may also complain that you make biting or chomping sounds in your sleep.

These symptoms can be painful and bothersome, but they aren’t the only side effects of the habit. Severe teeth grinding causes multiple complications that may require medical or periodontal help.

Complications from Teeth Grinding

When you grind your teeth, the enamel erodes near the gum line. Teeth grinding also damages underlying bone and can lead to gum recession, which enables bacteria to penetrate the root surface and cause decay.

Other complications include:

Because this condition usually occurs when you’re unaware of it, you may also feel helpless. After all, how can you break a habit you do in your sleep?

Fortunately, simple changes at home can minimize teeth grinding. And if your mouth hassuffered damage from grinding, you can seek help from a periodontal specialist.

What You Can Do

You can lessen the effects of teeth grinding and prevent further damage by changing your current lifestyle.

You might also consider wearing a mouthguard at night. Mouthguards provide an extra layer of protection between your top and bottom teeth, minimizing wear and tear.

What Your Periodontal Specialist Can Do

If you suffer from severe teeth grinding, seek help from a periodontal specialist. These doctors will repair damage to gum tissue and bones, as well as treat symptoms of gum disease that you may also face. If you have chipped or missing teeth, your periodontal specialist can also provide implants and other cosmetic procedures to improve the look and feel of your smile.

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