Smile Files

Periodontal Disease vs. Gingivitis

Thu, 19 Mar 2026 19:45:00 GMT

Bleeding gums are never “normal” regardless of how often or how much blood is present. Just as is the case with bleeding, for instance, as the result of a cut on a finger, nosebleed or even a bleeding stomach ulcer: bleeding indicates injury or damaged tissue. In cases other than the mouth the obvious course of action is to stop the bleeding with whatever is the appropriate course of action. So within the mouth, specifically the gums, the scenario is exactly the same in that an abnormal situation must be corrected to stop the bleeding.

In the case of bleeding gums the reasons can range from mild, local inflammation (like a stuck popcorn kernel) to chronic soft tissue damage to active infection and eventually bone loss of the jaws leading to loosening and loss of teeth.

Periodontitis: A “silent” disease

Very frequently I hear disbelief when I find signs and symptoms of periodontal disease with the common response of “…but doctor I never have any pain in my mouth, how can I have periodontal disease.” And the answer is “Exactly!” It’s not until late stages that pain symptoms are felt as a result of loose teeth, but at that point usually over 50% of supporting bone has already been lost. Periodontal disease is a slowly progressing process of soft and hard tissue destruction without pain. In most cases the slow progression of nerve deterioration does not present with any pain. The good news is that (in most cases) this process is preventable with inexpensive and easy dental hygiene, namely daily brushing AND flossing to remove plaque!

Bleeding gums and plaque: What’s the connection?

Plaque is a sticky, pasty substance composed of dead epithelial cells, retained food particles, salivary minerals and lots of bacteria. The bacteria live and thrive on the yummy food particles left behind between and on the teeth. Like every other living being on earth, these bacteria produce acidic waste as a product of their digesting leftover food. This acidic waste is what activates the body’s defense systems which produce inflammation. This chronic inflammation process lies at the root of periodontal disease and is similar in several ways to chronic infection. The body, in essence, self destructs in it’s attempt to fight and destroy the bacterial waste products.

Gingivitis to Periodontal Disease

Although a direct cause-effect relationship between gingivitis and periodontal disease is not well established, both processes share similar symptoms and many consider gingivitis as a precursor to periodontal disease. With the gum swelling and plaque buildup that occurs in gingivitis “pockets” form at the gum-tooth junction. These pockets form shelters for bacteria to thrive and progress in depth over time. They eventually reach depths which one cannot reach with flossing and brushing. These pockets are the very foundation of periodontal disease present in almost every case.

A plan to fight this disease.

Yes, periodontitis is a real disease. It affects many people and is the leading cause of adult tooth loss worldwide. The most effective weapons at your disposal to fight this problem are toothbrush, floss and regular dental checkups. Inexpensive and highly effective but only if done regularly and diligently. Treatment for periodontal disease is expensive, possibly extensive and in many cases does not stop the disease but only slows it down. So the best thing to do is prevent it from even starting.

Beware the Drifter

Mon, 02 Mar 2026 20:37:16 GMT

Beware the Drifter

Drifter: a wanderer without a permanent home. One who doesn’t stay in one place for very long. One who moves about aimlessly. A hobo or a bum. One who moves from place to place w/out a purpose or plan.

While the definition given above may be considered derogatory, in dentistry, the drifting teeth are our enemy. Mainly because of the ill effects they have on neighborin g teeth, oral health and ultimately in TMJ function.

Mesial drift (the term we use to assign direction of movement) is the natural, gradual tendency for teeth to slowly shift forward, towards the front of the mouth (the midline), a common phenomenon that can cause crowding, especially in the lower front teeth, as people age.

Causes of Mesial Drift

Tooth Loss : When a tooth is extracted, surrounding teeth drift into the gap to fill it.
Gum Disease : (Periodontal Disease): Bone and gum recession weaken tooth support, leading to mobility and shifting.
Aging : Periodontal ligaments weaken, and jawbone density decreases over time, allowing teeth to move more easily.
Genetics : Heredity can play a role in how teeth shift.
Lack of Retainer Wear : Teeth can drift back to their original positions after orthodontic treatment if retainers aren't worn.

Consequences

Crowding & Overlapping: Teeth push forward, leading to a crowded or crooked smile.
Open Contacts : Spaces can form between teeth, potentially requiring new crowns or fillings.
TMJ Issues : Shifting can alter bite alignment, potentially causing jaw pain or clicking (temporomandibular joint dysfunction).

Solutions to the drifting problem:

Whenever teeth are lost, serious consideration should be made to for replacement(s). This the best way to restore chewing function and esthetics, as well as to prevent more serious and costly future consequences. Implants, bridges, and removable partial dentures are several options available to maintain the teeth function as a healthy unit.

This model of a person’s teeth shows what can happen when severe drift of a tooth has occurred. The upper molar tooth has drifted downward into the vacant space where a tooth was never replaced. If replacement had been done sooner, the upper molar would have been unaffected. But in this case, the only treatment option is the extraction of the upper drifted tooth. Now the patient will be left without upper and lower teeth to chew with on the right side of their mouth.

Introducing Twinkles: For our discerning patients, new and existing!

Thu, 18 Dec 2025 21:30:00 GMT

New offering for all North Branch Dental Works patients!

Genuine, Swiss-made tooth jewelry manufactured with quality materials. Many different designs, 18K and 24K white and yellow gold, diamonds and gemstones, and Swarovski crystal! Not cheap, costume grade, but real jewelry applied professionally in our office! Enhance your beautiful smile with a little bling with the assurance that you’ll be getting excellent care, durable dental-grade materials, and adhesive in our office.

Pricing

Our first priority is maintaining optimal dental health, so Twinkles are done in conjunction with a dental examination, x-rays ,and a general dental cleaning (if diagnosed with periodontal disease, deep scaling is a separate cost). Self-pay patients without dental insurance can receive a gem at no extra cost. For PPO discounted plans, one gem can be applied for $80 in conjunction with exam, x-rays, and routine cleaning. Twinkles are not eligible for insurance coverage. Note: Where tooth decay is present/oral conditions are poor, eligibility of this offer is at our dentist’s discretion. In the best health interests of our patients , decay and periodontal disease must be treated before cosmetic services arerendered. Additional Twinkles priced at $100/each.

Water Fluoridation

Thu, 20 Nov 2025 16:15:00 GMT

Fact vs Fiction

With misinformation dissemination on the rise from those finding themselves in previously unfamiliar positions of authority, it is important to rely on accurate, proven information, especially in matters of health. Water fluoridation has long been the subject of conspiracy theory and other scare tactic infiltration with interjections and statements designed to forward a political agenda. That being said, if this has become a concern for you and your loved ones in recent times, I’d like to help by mythbusting and calming mass hysteria in an effort to help with health decisions of importance.

Information obtained in this edition of the Smile Files can be credited to Dr. Scott Tomar, associate professor of prevention and public health services and epidemiologist of the CDC. Fact: Fluoride in drinking water is a cheap and easy preventative measure for preventing tooth decay which saves thousands if not millions of dollars nationwide. Fluoride is a naturally occurring element in drinking water found to be highly effective in strengthening tooth enamel originally confirmed in studies of Native American populations. There exist areas in our country where fluoride content in natural water is low or non-existent. The addition of fluoride merely supplements existing levels to 1 part per million to replicate nature. Additionally, following an 80-year-old study and implementation of fluoridated water in Grand Rapids, MI, Evanston, IL, New York City, and Ontario, Canada, many other cities saw the positive result of a dramatic decrease in dental decay and followed suit with fluoridation.

The misinformation about the assumed effects of fluoride had started years before the addition to drinking water. No causal relationship has been shown to exist between fluoride and AIDS, immunity, bone cancer, autism, retardation, dementia, skin disorder (not even communist plots nor nuclear waste relation!). There has simply never been any real world evidence established to support this.

Unfortunately, in a post-COVID world, many are more receptive to conspiracy theories regarding vaccinations and healthcare. Politically speaking, there is no real interest in becoming educated from scientific research. Fluoride is in fact all around us—in the soil, rocks, seawater, and naturally occurring in foods. The freedom of choice argument is moot when one considers the implementation of seatbelt laws, iodized salt, and the addition of vitamin D to milk. The only motivations and aspirations in these examples are to protect the population from disease and injury, save US taxpayers and medical insurance utilizers millions of dollars with no adverse effects.

As dental providers with families, our primary concern is to prevent disease and public harm…so why would we advocate for a harmful substance to be given to the public? The American Academy of Pediatrics, American Dental Association, American Medical Association, UK, and Australian health organizations and National Toxicology Reports all support fluoridation in water, as there are no proven adverse effects. While bottled water may seem like a healthy alternative, tap water is far more regulated for safety and contains fluoride, an important element for maintaining healthy teeth.

New Smile Design Program at North Branch Dental Works!

Fri, 07 Nov 2025 01:00:02 GMT

Have you ever wondered...

Have you ever wondered or thought about improving your smile but hesitated because of the cost, uncertainty about the final outcome or leeriness of a high-pressure sales pitch?

No need to worry with us; we use a newly acquired dental software program that quickly and painlessly shows what can be achieved at our office with before-and-after photos of your face following esthetic dentistry services at NB Dental. Best of all, a consult using this advanced tool is very quick, costs you nothing, and you are under no pressure whatsoever to accept treatment. Just take a look at some sample before-and-after photos for examples.

So, Ouzo and Phoebe wanted to help, so here we go - it even works on dogs!

The Dreaded Black Triangles

Thu, 23 Oct 2025 20:32:49 GMT

And how to make them go away!

“You’re looking long in the tooth” is used to describe the appearance of teeth that often occurs as we age. While the appearance is that of an elongation of teeth, the cause is quite the opposite. This condition happens as a result of gingival (gum) recession, which is caused by several different factors, all adding up to some level of periodontal disease. Genetics, inadequate oral hygiene in brushing and flossing, untreated early periodontal disease, etc., can all contribute to a chronic progression of supporting bone and gum loss. The result is the appearance of longer teeth due to a lowered or receding gum line.

The gum tissue between the teeth is also ultimately affected, resulting in what is referred to as “black triangles” between the teeth. The gold standard of care for periodontal disease is scaling of deposits on teeth, possible periodontal surgery, frequent follow-up periodontal maintenance, and thorough daily oral hygiene with brushing AND flossing.

The goal of periodontal treatment is to address bone loss that has occurred and to take measures to stop the progression of the disease and preserve the amount of supporting bone that is left. Unfortunately, this treatment does not address the esthetic consequences of periodontal bone/gum loss — dark spacing between the teeth.

Enter esthetic calcium hydroxylapatite or Type I and Type III collagen and biostimulator a.k.a. FDA cleared injectable filler for oral and maxillofacial defects which has been in use since 2003. As the name might imply, this treatment is simply a “filler” that only expands the gums. Studies have shown that collagen and elastin biostimulation could be taking place as well. While bone regeneration is unlikely in moderate and advanced cases of periodontitis, injectable periodontal filler can both provide dramatic esthetic results as well as improve gum health.

We offer this procedure at North Branch Dental Works as a ½ to 1 hour minimally invasive, non-surgical procedure that gives immediate esthetic improvement to eliminate those dreaded dark triangles. Reserve a consultation appointment today instead of hiding your smile to conceal dark triangles.