February is Gum Disease Awareness month, a timely reminder that preventing gum disease is one of the best ways to protect our oral health. 

Gum disease is easily treated in its earliest stages. Left untreated, the progressive nature of gum disease makes it one of the leading causes of tooth loss in adults. 

And while we often think of gum disease as an older person’s disease, the fact is that teens and young adults can suffer from gum disease, too. Irregular brushing and flossing habits, hormone fluctuations, family history, and even orthodontic treatment can make people of any age more vulnerable to gum disease.

Let’s take a moment in this shortest month of the year to discuss how understanding, treating, and, above all, preventing gum disease can help us enjoy long-lasting healthy smiles.

How Gum Disease Develops

Gingivitis is the first, mild stage of gum disease. 

• Gingivitis begins with plaque. 
• Plaque irritates gum tissue, causing inflammation, which is the body’s reaction to injury or infection. 
• Typical symptoms include gums which are swollen or red. The gums might feel tender or bleed easily when you brush or floss. You could develop persistent bad breath. 

With proper care, gingivitis is reversible. Because gingivitis symptoms can be very mild, they’re sometimes overlooked. That’s why it’s important to keep up with regular checkups to discover and treat the disease in its earliest stages. 

Periodontitis is a serious gum disease which is destructive to the structures which support our teeth: gums, connective tissue, and bone. 

• Plaque, when it’s not removed, hardens into tartar, which can form on the tooth above and below the gumline. 
• The gums pull away from plaque and tartar deposits, creating a space between the gum tissue and tooth roots. 
• As the gums continue to recede, pockets form between the teeth and gums.
• Infection-causing oral bacteria thrive in these pockets. Gum infections can lead to painful abscesses—but gum disease is not just an infection.
• The body normally responds to bacterial infection with inflammation. With periodontitis, this inflammation becomes destructive chronic inflammation. 
• Over time, chronic inflammation and infection break down the gum tissue, bone, and connective tissue holding teeth in place. Teeth become loose or shift out of alignment.

The tooth’s support structure eventually becomes so compromised that extraction is the only option. That’s why prompt treatment is essential.

Treating Gum Disease

Several options are available to treat gum disease, depending on its severity.

Treatment for gingivitis can be as simple as paying more careful attention to your brushing and flossing and, if necessary, seeing your dentist for a professional cleaning. In some cases, your dentist might recommend an antimicrobial mouthwash or rinse.

Periodontitis requires specialized treatment from your dentist or periodontist, and this treatment will be based on how advanced the condition is:

• Topical, oral, or time-release medications treat infection.
• Non-surgical deep cleaning procedures called scaling and root planing remove plaque and tartar above and below the gumline, allowing gum tissue to reattach to the tooth. 
• Flap surgery treats more advanced gum infection by reducing pocket depth and re-securing the gums snugly around the teeth.
• If needed, bone grafts, gum grafts, and other regenerative procedures are available which help repair and restore damaged tissue.

Preventing Gum Disease

What many people aren’t aware of is just how preventable gum disease is! Because wearing braces can make brushing and flossing more challenging, it’s especially important during these months to stay on top of your dental hygiene and be on the lookout for signs of gingivitis.

• Brush twice a day for two minutes each time, after every meal, or more often if your orthodontist recommends it. 
  • Use proper brushing technique, angling your brush toward the gums to gently clean around and below the gum line. Be sure to brush around your brackets and under your wires. Use a soft-bristled brush to protect both gum tissue and tooth enamel.
• Floss once each day, after every meal, or as directed by Dr. Sung Lee. 
• There are specialized brushes and flossers available to make cleaning around brackets and wires much easier. Electric toothbrushes and water flossers can also be helpful in removing hard-to-reach plaque. Ask Dr. Sung Lee to recommend the flossing tools and techniques which will work best for you.
• See your dentist regularly. Gum disease can be invisible in its beginning stages. Discovered early, treatment is simple and effective. 
• Having your teeth cleaned every six months, or as recommended, will remove tartar buildup which brushing alone can’t handle. 

Your dental hygienist is experienced in cleaning teeth when patients wear braces. And you can get tips for better brushing and flossing techniques from the team at Sung Lee Orthodontics in Puyallup, WA, too!

Even when it seems like there aren’t enough days in the month or hours in the day, it takes just a few minutes daily to care for your gums and teeth. And when you’re aware of just how much those few minutes mean to a healthy smile, it’s time well spent!

Many patients underestimate the importance of wearing their retainers after their braces come off, but it is one of the most critical post care practices to keep your teeth in alignment. Why spend all that time, energy, and money to straighten your teeth when you don't plan to keep them straightened after treatment?

What is a retainer?

As the name implies, a retainer keeps teeth from moving back to the positions in which they started before treatment was administered; they "retain" your smile and bite. There are many different types of retainers—some are removable and some are permanent. Some retainers are made of plastic and metal (known as Hawley retainers) and others are all plastic or all metal. Some retainers can even be bonded to the back of your teeth!

How long do I need to wear it?

If you've been given a removable retainer by Dr. Sung Lee, you may be wondering how long you need to wear it. It takes time for the tissues and bones around your teeth to reorganize and set into place after braces treatment.

The amount of time you’ll need to wear your retainer depends on your unique situation, but typically, retainers should be worn at least as long as the time you spent in braces. You might need to wear them full-time for a while, and then transition to wearing them only at night. Dr. Sung Lee will have a treatment plan especially for you, and if you stick to it, you'll always have a straight smile.

Nothing is forever (at least without retainers!)

Research has shown that there is no “permanent” position for your teeth to remain in. In fact, some studies say upward of 70% of patients will see a change to their bite and tooth alignment as they get older. This applies to people who have had orthodontic treatment and those who have not. Of course, some people's teeth never seem to shift—you can consider them the lucky ones, as most people's teeth do.

And this is precisely where retainers come in. The only way to ensure your teeth stay in alignment long-term is by wearing your retainers. If you have any questions about retainers or your treatment plan, please ask any member of our Puyallup, WA staff.

The purpose of braces and other forms of orthodontic treatment at Sung Lee Orthodontics is to correct malocclusion, also known as crooked or crowded teeth, or “bad bites.” Past orthodontic practice dictated that wisdom teeth be removed, especially in cases of crowding.

The wisdom teeth are the last teeth to come in, and are officially known as the third molars. The teeth typically erupt, or break the surface of the skin, in young people between the ages of 13 and 20.

Sometimes, wisdom teeth are impacted. That means they cannot break through the gum tissue. This typically happens when the mouth or jaw is too small to accommodate the teeth. Impacted wisdom teeth can become infected, and some dentists and orthodontists may want to remove them as prophylaxis to prevent possible future infection.

Justification for removing wisdom teeth

Dr. Sung Lee will tell you that in some cases, wisdom teeth attempt to come in the wrong way, either tilting in the jaw, or sideways. If the mouth is too small to accommodate these additional teeth, they inevitably become impacted. Swelling or infection of the gum flap above an impacted wisdom tooth may cause pain. The greatest danger is pericoronitis, a potentially dangerous infection that can occur in the gum area around an impacted wisdom tooth, or around a wisdom tooth that has erupted.

Orthodontists base their decision to remove wisdom teeth on each patient's individual circumstances. To learn more about the impact wisdom teeth have on orthodontic treatment, or to schedule a visit with Dr. Sung Lee, please give us a call at our convenient Puyallup, WA office!

You've made an investment on spending money on getting braces, so why not keep your teeth in good health while undergoing orthodontic treatment?  Dr. Sung Lee and our team at Sung Lee Orthodontics will tell you it is just as important to develop a regular hygiene routine while you're wearing braces as you did before proceeding with treatment.

Flossing is essential to the health of your teeth and gums when you're wearing braces. Because braces may hold food, sugars and liquids upon eating, it is very important to keep on top of your brushing and flossing, as well as visiting our office for regular adjustments.

While we know it's tough enough to get kids to floss daily without braces, that battle becomes even tougher when braces are involved. Remember that by not flossing, you will become more prone to cavities and gum disease during your treatment.

When flossing, remember to gently massage your gums in between the teeth. You will find that flossing with braces takes extra time, as you will have to weave the floss through each bracket. When flossing, there should be no signs of blood. If you see blood, you are not flossing enough or properly.

Using an electric toothbrush is also a good idea to massage your gums before or after flossing as electric toothbrushes can help remove any harmful bacteria that are lingering in your mouth. And don't forget to add a mouthwash to your routine to break up any bacteria that has formed. A good mouthwash will help keep your teeth and gums in good shape during your treatment.

If you have any questions about flossing or your orthodontic treatment at Sung Lee Orthodontics please don't hesitate to give us a call or during your next adjustment appointment!