DrToddWelch: Laser Assisted New Attachment Procedure (LANAP)

DrToddWelch: Laser Assisted New Attachment Procedure (LANAP): "How the LANAP Protocol Works:First, the patient is profoundly anesthetized with local anesthetic. Next, the patient’s pocket depths are prob..."

Laser Assisted New Attachment Procedure (LANAP)

How the LANAP Protocol Works:

First, the patient is profoundly anesthetized with local anesthetic. Next, the patient’s pocket depths are probed down to the level of intra-osseous defects (bone sounding). The thin optic fiber is placed parallel to the root surface.. The first pass with the laser, called laser troughing, is accomplished with the short duration pulse. The free running pulsed Nd:YAG laser is combined with systemic antibiotics to achieve the optimal reduction of microbiotic pathogens (antisepsis) within the periodontal sulcus and surrounding tissues. Perio pathogens and pathologic proteins are selectively destroyed by the laser’s light energy, providing an aseptic surgical environment that allows healing following the laser hemostasis step.

The technique uses selective photothermolysis to remove the diseased, infected and inflamed pocket epithelium while preserving healthy connective tissue, literally separating the tissue layers at the level of the reté pegs and ridges. The practitioner is able to achieve both precise tissue ablation and aseptic hemostasis by varying the laser’s energy density, pulse duration and rate of repetition. The laser assists in the destruction of perio pathogens while preserving the healthy tissue.

The tenacity of the calcified plaque and calculus adherent to the root surface is modified by the laser energy so its removal with an ultrasonic scaler is more easily accomplished.

At this point, a second pass with the laser is taken to finish debriding the pocket and achieve hemostasis with a thermal fibrin clot. Gingival tissue is compressed against the root surface as necessary to close the pocket and aid with formation and stabilization of the fibrin clot. No sutures or surgical glue is needed. Mobile teeth above class II mobility are splinted. Occlusal adjustments are performed to remove interferences, minimize trauma, and provide balance to long axis forces and are considered an essential component of the LANAP protocol.

Finally, post-operative instructions specific to the LANAP protocol, diet guidelines and oral hygiene instructions are explained and their importance is stressed, and continued periodontal maintenance is scheduled. Patients are monitored at one week, 30 days and then every 3 months for periodontal maintenance. No subsequent probing is performed for at least nine months to a year to allow sufficient healing time for the cementum-fiber PDL interface.

For more information please contact Dr. Todd Welch at West Tennessee Periodontics and Dental Implants at 731-215-2347

Eliminate Stress and Save Your Oral Health

Resolve To Eliminate Stress and Save Your Oral Health

The holidays are always stressful. They can be stressful emotionally, physically, and finan- cially. You can probably feel the stress taking its toll on your mind, body, and spirit. What you may not realize is that your everyday stress may be affecting your oral health.

A literature review published in the August issue of the Journal of Periodontology (JOP) saw a strong relationship between stress and periodontal diseases; 57% of the studies included in the review showed a positive relationship between periodontal diseases and psychological factors such as stress, distress, anxiety, depres- sion and loneliness.

While more research is needed to explain the specific role stress plays in gum disease, it is speculated that the hormone cortisol may play a role. When experiencing stress, the body releases increased amounts of cortisol, which can be harmful to the gums and surrounding bone tissue. This damage can eventually cause bone loss which leads tooth loss.

People with high stress levels are also more likely to increase their use of drugs or alcohol which can undermine oral health. Stress can also cause an individual to be less attentive to their oral hygiene. Exercise, a balanced diet and a positive mental attitude are all ways to help reduce stress and ultimately help promote periodontal health.

So this holiday season, don’t let the stress of life take a toll on your oral health. Having a healthy mouth can mean having a healthy body and that is a resolution everyone should make. Dr. Todd Welch. Jackson, TN 731-215-2347

DrToddWelch: Gum Disease Myths

DrToddWelch: Gum Disease Myths: "Bleeding gums are not that big of a deal. Red, swollen and bleeding gums are an important sign of periodontal disease. If you notice bleedin..."

Gum Disease Myths

1. Bleeding gums are not that big of a deal.
   Red, swollen and bleeding gums are an important sign of periodontal disease. If you notice bleeding while brushing or flossing, or when eating certain foods, you should schedule a visit with your dental professional to be evaluated for periodontal disease. Studies have shown that in addition to tooth loss, gum disease may contribute to the progression of other diseases, including heart disease and diabetes, so it is important that you begin treating periodontal disease as soon as possible.



2. You don’t need to floss every day.
   Routine oral care, which includes brushing after every meal and before bedtime, and flossing at least once a day, is the best way to prevent gum disease. However, a recent survey estimates that only 13.5 percent of Americans floss each day. It is vital that you keep up with your daily oral care, and see a dental professional for a thorough check-up twice a year. If gum disease is diagnosed, a consultation with a periodontist, a dentist who specializes in treating periodontal disease, may be beneficial.



3. A visit to the periodontist will be scary.
   Periodontists are gum disease experts. They have received three or more years of specialized training following dental school centered on the diagnosis, treatment and prevention of periodontal disease. Periodontists are equipped with the latest treatments and technologies, using innovative tools such as digital radiography, ultrasound technology, biomarker measurement and laser therapy to help make your visit more comfortable.



4. A tooth lost to gum disease is a tooth lost forever.
   Gum disease is a major cause of tooth loss in adults. However, in addition to treating gum disease, periodontists are also experts in placing dental implants – a convenient and comfortable way to permanently replace missing teeth. A dental implant is an artificial tooth root that is placed into the jaw to hold a replacement tooth. Studies have shown that dental implants have a 98 percent success rate, and with proper care, allow you to speak, eat and smile with confidence. In fact, a survey conducted by the American Academy of Periodontology found that over70 percent of respondents reported being “pleased” or “extremely satisfied” with the results of their dental implants.



5. Poor oral hygiene is the only way to develop gum disease.
   Forgoing good oral hygiene can certainly contribute to the progression of gum disease, but there are a variety of other factors that can also impact your risk. For instance, tobacco use has been shown to greatly increase your chance of developing gum disease. Stress, poor diet, and even genetics, can also play a role in the health of your gums. If you have any questions please feel free to contact Dr. Todd Welch at West Tennessee Periodontics and Dental Implants in Jackson, TN at 731-215-2347.

DrToddWelch: Your Gums and Your Smile

DrToddWelch: Your Gums and Your Smile: "YOUR GUMS AND YOUR SMILE A smile is one of the most universally recognizable expressions. Smiling can demonstrate a person’s happiness, conf..."

Your Gums and Your Smile

YOUR GUMS AND YOUR SMILE

A smile is one of the most universally recognizable expressions. Smiling can demonstrate a person’s happiness, confidence, attractiveness, sociability, and sincerity. However, the effects of gum disease or other oral tissue disorders cannot only be danger- ous to your health and well-being, but can also have the potential to ruin your smile.

Luckily, periodontists are the ex- perts in treating the tissues around the teeth. They have the know-how to treat the effects of gum disease or other oral tissue disorders and help improve your smile. There are a variety of periodontal cosmetic procedures that can improve and enhance the overall artwork of your smile.

Gum disease is one of the leading causes of tooth loss in adults. In the past, the only options for disguising tooth loss were dentures and bridges. Nowadays, dental implants are a more natural look- ing option because implants look and feel just like real teeth. They also allow the patient to speak and eat with comfort and confi- dence. During this procedure, a dental implant is attached to the root and after a healing period, an artificial tooth is attached. The result is a permanent replacement tooth that blends right in with the rest.

Gum recession as a result of gum disease causes the tooth root to become exposed, which can make teeth look long and can prema- turely age a person. In fact, the phrase “long in the tooth”, used to describe the elderly, is derived from this very reason. A periodontist can fix this problem with a procedure called root coverage. During this procedure, tissue from the mouth’s palate, or other syn- thetic materials, are used to facilitate coverage of the exposed root.

Gummy Smile

Periodontists also have the ability to fix a “gummy smile” when a person’s teeth appear too short. The teeth may actually be the proper length, but they’re covered with too much gum tissue. Your periodontist can correct this by performing a procedure called crown lengthening. During this procedure, excess gum and bone tissue is reshaped to expose more of the natural tooth. Think of it like pushing back the cuticles on a fingernail. The outcome is longer looking teeth and a winning smile. tal, or gum, disease may

the Journal of Periodontology

Your gums are an important part of your smile. They frame the teeth and play an integral role in the overall aesthetics of your eve- ryday appearance. While taking care of them by brushing and flossing daily is the best way to maintain a healthy mouth, talk to your periodontist about the procedures available to maximize the potential of your smile.

DrToddWelch: Laser Periodontal Therapy

DrToddWelch: Laser Periodontal Therapy: "There is a difference in the Laser that is usedL.A.N.A.P. ( laser assisted new attachment procedure ) is used ONLY with one specific laser, ..."

DrToddWelch: Targeting Tobacco Use

DrToddWelch: Targeting Tobacco Use: "You are probably aware of the devastating effects that smoking and tobacco use can have on your heart, lungs, and other organs. However, y..."

Targeting Tobacco Use

You are probably aware of the devastating effects that smoking and tobacco use can have on your heart, lungs, and other organs. However, you might not be familiar with the whole other “mouthful” of problems caused by tobacco use. For example, tobacco use is a significant risk factor in the development and progression of periodontal disease, which is a major cause of tooth loss in adults. The sooner you take aim at your tobacco use and quit, the closer you will be to healthy teeth and gums!

Tobacco users are more likely to have calculus, dental plaque that hardens on your teeth and can only be removed during professional cleanings. If this calculus is not removed and it remains below the gum line, the bacteria in the calculus will infect the gums causing redness and swelling, otherwise known as inflammation. This inflammation damages the tissues that support the teeth, including the bone. When this happens, the gums can separate from the teeth, forming pockets. Tobacco users often have deeper pockets than people who do not use tobacco. These pockets can then fill with more bacteria, which leads to more inflammation. If the infected pockets are left untreated, the gums may shrink away from the teeth, making teeth appear longer and possibly causing them to become loose and fall out.

The detection of periodontal disease is often more difficult in tobacco users. This is because the nicotine and other chemicals found in tobacco products can hide the symptoms commonly associated with periodontal disease, such as bleeding

gums. Since the detection of periodontal disease in tobacco users can be difficult, necessary treatment is sometimes delayed.

Treating periodontal disease in tobacco users can be a difficult task, but not an impossible one. Smoking and tobacco use reduces the delivery of oxygen and nutrients to the gingival tissues, weakening the body’s defense mechanisms. This can slow down the healing process and make periodontal treatment results less predictable. For example, dental implants that are placed in a tobacco user’s mouth fail more often than they would in a patient who does not use tobacco. Additionally, the actual treatment of periodontal disease can vary widely depending on how far the disease has progressed. If caught in the early stages, simple non- surgical periodontal therapy may be used.

Because the treatment of periodontal diseases can be more difficult in tobacco users, your periodontist will urge you to quit your tobacco use. Quitting seems to gradually erase the harmful effects of tobacco use on periodontal health. One study showed that 11 years after quitting, a former smoker’s likelihood of developing periodontal diseases was not much different from one who had never smoked. And with the increasing amount of research indicating that periodontal health may be related to overall health, reducing your risk of periodontal disease is more important than ever. Start taking aim at quitting your tobacco use today and move one step closer to a lifetime of periodontal health and happy smiles! Please contact Dr. Todd Welch at West Tennessee Periodontics and Dental Implants at 731-215-2347 for more information.

DrToddWelch: Laser Periodontal Therapy

DrToddWelch: Laser Periodontal Therapy: "There is a difference in the Laser that is usedL.A.N.A.P. ( laser assisted new attachment procedure ) is used ONLY with one specific laser, ..."

DrToddWelch: Gum disease and cardiovascular disease

DrToddWelch: Gum disease and cardiovascular disease: "Gum disease and cardiovascular disease are both major public health issues that impact a large number of Americans every day. While these tw..."

DrToddWelch: Brush and Floss Properly

DrToddWelch: Brush and Floss Properly: "One of the easiest ways to help prevent gum disease is to brush and floss every day, so therefore it is very important to know the correct w..."

Brush and Floss Properly

One of the easiest ways to help prevent gum disease is to brush and floss every day, so therefore it is very important to know the correct way to take care of your teeth and gums. It does not matter if you brush first or floss first, as long as you do both (twice a day!).

Equipment

The most commonly used toothbrush is the manual toothbrush. Another option is the electric toothbrush, which uses electrical power to move the brush head. The resulting vibrations that are created gently clean the teeth. It is important to always choose a soft brush head when using either a manual or electric toothbrush, and to replace the toothbrush when the bristles begin to bend (or every two to three months).

According to a recent study in the Journal of Periodontology1, all dental flosses are equally effective. This means that it does not matter which type of floss you choose to use. There are many different varieties of floss, including waxed, unwaxed, flavored, and shred-resistant, so there is a type of floss out there for everyone!

How to Brush

Position the toothbrush at a 45 degree angle where your gums and teeth meet. While applying slight pressure, gently move the brush in a circular motion using

short strokes. Use this method to clean the front of your teeth, then move to the back of your teeth, then the biting surfaces, and then your tongue, using the same gentle movements. Be sure you are constantly moving the brush head to avoid damaging your gums!

How to Floss

Using about 18 inches of floss, wrap the floss around your middle finger. Wrap the rest around your other middle finger, leaving 2-3 inches of floss between your fingers. While tightly holding the floss between your thumbs, insert it between two teeth. Curve the floss into a “C” shape against the tooth, and gently slide it up and down. Then, with the floss still in between the two teeth, switch the “C” shape against the adjacent tooth, and repeat the sliding motion. Move to the next tooth over, and repeat the process, unwrapping fresh floss from your middle finger as you go.

For more information on brushing and flossing techniques, to learn other ways to prevent gum disease, or to find a periodontist in Jackson, TN visit www.wtnperio.com or call Dr. Todd Welch at 731-215-2347.

Laser Periodontal Therapy

There is a difference in the Laser that is used

L.A.N.A.P. ( laser assisted new attachment procedure ) is used ONLY with one specific laser, the Periolase MVP-7. Most people think a laser is a laser. This is not the case. The difference between lasers is the certain wavelength it emits, this is why LASIK is not done with a hair removal laser. Lasers at different wavelengths are absorbed by different tissues/materials. The Periolase MVP-7 used in L.A.N.A.P. is a Nd:YAG laser which emits at 1064 nm. Other lasers used in the Medical/Dental field are CO2, YAG, Argon, Er:YAG, Ho:YAG, Diode, ErCr:YSSG, Nd:YAP, HeNe. All of these lasers are absorbed by different tissues and have different effects and treatment modalities.

The Periolase MVP-7 used in LANAP was developed specifically for the use in periodontal or gum disease. The laser is absorbed by darker pigmented tissues, which includes the bacteria that cause periodontal disease, and also the lining of the periodontal pocket, called epithelium. By removing these tissues from the periodontal pockets it leaves behing healthy connective tissue which can reattach to the tooth. Other lasers used in the dental field do not selectively remove these tissues without altering the connective tissue (which is required for regeneration). For example, the Biolase Waterlase, which is ErCr:YSSG laser, is absorbed highly by water, so any tissue that contains water would be detroyed. Diode lasers, which emit at 980nm, are essentially just a "hot tip" which removes tissue by heating. The diode would kill the bacteria but also destroy the healthy connective tissue we want when doing LANAP.

My point of this post is that if considering Laser Gum Therapy (LANAP) be sure that laser that is being used is the Periolase MVP-7. It is the only laser used in LANAP, which is an FDA cleared procedure.

Gum disease and cardiovascular disease

Gum disease and cardiovascular disease are both major public health issues that impact a large number of Americans every day. While these two diseases impact separate areas of the body, research indicates that periodontal disease and cardiovascular disease are connected; having one disease may actually increase your risk of developing the other.

Inflammation’s Role

Periodontal disease and cardiovascular disease are both considered chronic inflammatory conditions. Inflammation is the body’s instinctive reaction to fight off infection. Inflammation is initially good for your body because it helps in the healing process. However, chronic and prolonged inflammation can lead to severe health complications. Researchers believe that inflammation provides the basis for the connection between gum disease and heart disease1. And now, periodontists and those who treat cardiovascular disease are working together to provide the best care to patients.

The Perio-Cardio Connection

In July 2009, a consensus paper2 was published in both the Journal of Periodontology and The American Journal of Cardiology. The paper was jointly developed by periodontists and cardiologists. Periodontists are dentists with advanced training in the treatment

and prevention of periodontal disease, and cardiologists are doctors who specialize in treating diseases of the heart. The paper summarizes the evidence that links periodontal disease and cardiovascular disease, and provides clinical recommendations for periodontists and cardiologists to use in managing their patients living with, or at risk for, either disease.

What does this Mean for You?

You might be surprised when your periodontist now asks even more questions about your medical history, especially questions about your family history of heart disease and any behaviors that may affect your heart health such as smoking. Your cardiologist may start to ask you about your dental history and might even look in your mouth to evaluate your teeth and gums! These new recommendations are intended to help periodontists and cardiologists better manage your risk factors for future disease progression, and ensure your well- being. Hopefully by working together with your periodontist to ensure healthy teeth and gums, you will also ensure a healthy heart throughout your entire life. If you have any questions about this please contact Dr. Todd Welch at 731-215-2347 at his Jackson, TN office or visit www.wtnperio.com