The “Risk vs. Reward” of Oral Health

Posted on Jun 25, 2024 by William J. Claiborne, DDS MS

Risk versus reward.

This is a phrase that’s often associated with decision-making, such as stock market investments. While certain strategies can increase the potential for “reward,” there is still an element of “risk” in losing part or all of the investment.

As a periodontist in Asheville, I see this in how it relates to decisions in dentistry. This is the case in replacing lost teeth. As a periodontal specialist, I place many dental implants in patients who’ve lost teeth that likely could have been kept had the patient made different decisions.

I also see this is in the decision of patients to have a crown (“cap”) placed on teeth. When a dentist recommends a crown, it is typically to keep the existing tooth structure intact and protected. So, when a tooth that’s been filled and needs yet another filling, the dentist may advise crowning the tooth instead. This preserves the remaining structure by avoiding the “risk” of tooth from breaking off.

Or, when a tooth shows signs of fracture(s), crowning may prevent the tooth from the need for removal. This is because a tooth that eventually breaks below the gum line can no longer be saved. Once removed, tooth replacement brings on an entirely new set of decisions, and costs.

Your general dentist’s goal, like yours, is to help you achieve and maintain a healthy smile. He or she wants you to keep your natural teeth or, if tooth loss does occur, replace them in a way that supports your overall oral health. A periodontist can be a strong team player in this goal.

A periodontist is a dentist who specializes in the prevention, diagnosis, and treatment of periodontal disease and in the placement of dental implants. A periodontist is also a specialist in reshaping gum tissues, for reasons that may include esthetics as well as maintaining oral wellness.

I place many dental implants and am a proponent of them as a superior tooth replacement option. However, as ideal as an implant is, there is nothing as good for your oral health as natural teeth. This is why it’s so important to keep them. This may, for certain teeth, require the placement of a crown.

A periodontist may be involved in certain aspects of treatment to optimize a patient’s results and success level while minimizing discomfort. For instance, a periodontist may work with your general dentist to help save a tooth from removal when a tooth has broken close to the gum line. This is accomplished through crown lengthening procedures where gum tissues are removed to expose more of the tooth. This may be able to make sufficient tooth structure available to support a crown.

Crown lengthening is also beneficial in sealing gum tissues surrounding a tooth at its base. By securing the tissue around the tooth or crown, bacterial entry is avoided and the risk for periodontal (gum) disease decreased. This is especially beneficial in cases where gum tissues have receded, exposing sensitive tooth root sections that are easily affected by oral bacteria.

In some cases, gum tissue height can be corrected by careful removal in a procedure known as a gingivectomy. To enhance the appearance of a smile with an esthetically-pleasing smile line, combined with the placement of crowns, the tooth-to-gum ratio is rebalanced.

This is what is often referred to as a “gummy smile.” Crown lengthening is a common method that teams your general dentist with a periodontist to create a smile that looks natural and is beautifully flattering.

Another look at the risk-reward consideration, the “risk” of not caring properly for oral health can easily upend the “reward” of having a healthy smile. Regular dental check-ups and a thorough at-home oral hygiene regimen can prevent the development of cavities and periodontal disease.

When oral bacteria levels in the mouth are not managed, the teeth and gums pay the price, often through the need for costly treatment that may have been prevented. Periodontal disease is the nation’s leading cause of adult tooth loss.

Research has also found that the inflammatory bacteria of gum disease can enter the bloodstream, triggering or worsening a long list of serious health problems. These include heart disease, stroke, high blood pressure, diabetes, arthritis, memory loss, some cancers, impotency and Alzheimer’s disease.

Although gum disease can exist without obvious signs or symptoms, the most commonly noticed are:

• Red, swollen or tender gums
• Seeing blood in the sink when brushing
• Receded gums
• Loose or separating teeth
• Pus pockets on gum tissues
• Sores in the mouth
• Persistent bad breath

As a periodontist in Asheville, we want everyone to know the benefits of a healthy, confident smile. Maintaining healthy gums and keeping your natural teeth is important to every individual.

If your gum health needs improvement or there are signs of gum disease, we can structure a program that restores healthy gums and helps you maintain your oral health between visits.

For those who have already experienced tooth loss, we are happy to discuss the process to replace them with dental implants. These are the closest thing to the natural teeth you had and will restore stability and dependable biting and chewing. Too, dental implants are designed to last a lifetime, making them an excellent investment.

With proper measures, you can enjoy healthy gums and natural teeth throughout your lifetime. Call 828-274-9440 to schedule a periodontal examination or ask for a consultation to get to know us. A referral to our office is not required.

If dental fear or anxiety has kept you from receiving regular dental care, please ask us about oral or I.V. sedation (“twilight sleep”). Both are administered safely with patient comfort always a priority.