In this video, Dr. Lina Palomo, a periodontist, discusses various issues related to dental health. She emphasizes the importance of replacing missing teeth to prevent neighboring teeth from shifting and to maintain overall oral health and quality of life. Dr. Palomo explains different options for tooth replacement, including removable options like retainers and partial dentures, as well as dental implants. She also discusses the types and causes of abscesses in the gums, highlighting the need for proper diagnosis and treatment to prevent further complications. Throughout the video, Dr. Palomo provides valuable insights and advice for maintaining healthy gums.
Key Insights:
- There are different options available for replacing a missing tooth, including removable options, bridge options, and dental implant options.
- If a tooth is not replaced, the surrounding teeth may shift and move into that area.
- If a crown is not placed on top of an implant, neighboring teeth might still erupt into the space, causing further complications.
- Research shows that not replacing a tooth can negatively impact a person’s quality of life, including things like chewing force, nutrition, and social interactions.
- Other removable non-implant options for replacing a missing tooth include Essex retainers, flippers, and removable partial dentures.
- Veneers can be used to enhance the appearance of a tooth, but there are different ways to do veneers, depending on the specific needs and materials used.
- Abscesses can occur in the gum area due to periodontal or endodontic issues, and they can cause swelling, pus, pain, and fever.
- Periodontal abscesses can be treated with antibiotics, while endodontic abscesses may require root canal treatment.
- If left untreated, abscesses can spread and affect other structures in the body.
- It’s important to see a periodontist or dentist for proper diagnosis and treatment of dental issues.
Transcript
All right everybody, we are talking everything you need to know when it comes to the mouth. This is periodontist Dr. Lina Palomo. Hello, girl, and she knows a thing or two about keeping your gums healthy. I mean, all this in general but definitely the gums.
Dr. Palomo is a periodontist based in New York City. Where did you go to school, Dr. Paloma?
I went to college and dental school and advanced training in periodontology at Case Western Reserve. But now I’m a professor and chair of the Ashman Department of Periodontology and Implant Dentistry at NYU. That is a mouthful, it sounds all important, and I am proud of you.
Now, also hear that your husband is also in dentistry. He is an orthodontist and a program director at Case Western Reserve. Oh, well, excuse me. I’m sure you’re the boss though.
So, this question comes from someone on TikTok. They want to know what you can do if you’re missing a tooth. There are removable options, there are bridge options which are prosthetics fixed to natural teeth, and then there’s the dental implant option. There’s a screw called a dental implant which fits into the bone like an artificial joint. The difference between an implant and a natural tooth is that there’s no ligament, so it fits right into the bone. And then on top of that screw, same as you put a screw into drywall and hang a picture off of it, instead of a picture frame, we put a crown of a tooth.
So if someone is missing a tooth and doesn’t replace it, what can happen? And if someone started an implant and left just the healing abutment and never got the crown, what can happen?
So if we’re missing a tooth and we don’t replace it, the teeth in the area can shift and move into that area. Unfortunately, if you don’t put the crown on top of an implant, the adjacent tooth or the opposing tooth might still erupt into their space and complicate further treatment. Additionally, there’s research that shows if a tooth isn’t replaced, the quality of life of that patient, and I’m not just talking about chewing force and nutrition, I’m also talking about going out on a date or applying for a job. There is a quality of life measurable difference in not replacing that tooth.
So I’ve heard of removable, non-implant options. Can you explain some other options that might be available?
So an Essex is one, almost like a retainer with a little area for the missing tooth filled in with white plastic material. So that’s an Essex. Another option is a flipper, which is almost like a retainer if you recall being a kid and wearing a retainer, except it has a little prosthetic tooth where the tooth is missing. We also have removable partial dentures, which again, you have to take all these removable options out to go to sleep at night and also when it’s time to eat. So they solve some of the problems of a missing tooth, but not all of them.
Is this different than something called a veneer?
So a veneer is a facing on the visible part of a tooth, almost like an acrylic fingernail is the facing on a nail. I’ve seen some veneers that were where the tooth was shaved down and something was put on it like a crown, and then I’ve seen the glued veneers. What’s the difference?
There are many ways to do veneers. There are different materials that are used for veneers. There are partial and full veneers, and then there are full coverage crowns as well. So depending on the specific needs, a veneer of one material or another, a crown or a dental implant, it’s just specifically for your needs in that area. Wow, isn’t that special? If you’re missing a tooth, go get it fixed. Go find a tooth and find a way to put something in that space.
Okay, let’s take a look at this video. As you can see, they have what looks like a bump on this person’s gum. Dr. Palomo, can you break this down for us?
There are two types of abscesses, well, there are several types. There is a periodontal abscess, meaning one which originates in the periodontal supporting structures of the tooth, and there’s a periapical abscess, which has more to do with the pulp and the root and the root canal. The first steps are to determine with an x-ray and a clinical exam, which of these two diagnoses it is. If it turns out to be a periodontal abscess, sometimes we use antibiotics as the first line of defense and then move into more significant therapies. If it’s an endodontic abscess, meaning one originating in the pulp and the root canal area of the tooth, then it would be seen by an endodontist, which is a special kind of dentist to do root canals and endodontic therapies.
What might cause these kinds of things, these bumps on the gum?
So basically, these are infections, and when the bacteria settles in and does its business, what it’s actually doing is settling into the bony potholes that are supposed to be high around the necks of the teeth but now have like potholes in them. The body says this doesn’t belong here, and the body’s way of attacking that through our immune system is to create swelling and to create pus and to make this area in general miserable and painful and sore. And sometimes we also have a fever. If this is allowed to progress, sometimes our lymph nodes might show some signs of infection. We use our antibiotics, and we also use our mechanical therapies and then treat it so that it can’t return back into those spaces.
So you said something about a dental pulp. What exactly is that?
Way inside a tooth, there’s a hollow area called a pulp, and there’s blood supply in there. There’s a nerve through the root canal going into that pulp chamber, and that keeps the tooth vital over the course of the tooth’s life. If that ever becomes infected, as with an endodontic abscess, then we have a root canal to treat that. But you know if you ever hit your thumb with a hammer, it swells up and it hurts. But at least there’s space for it to swell up. In the case of an endodontic abscess, when that pulp chamber wants to swell up and it’s got hard enamel and dentin around it, there’s no place for it to swell, and that’s what causes the pain, right?
So, I mean, outside of the pain, if you don’t get it treated, what else can happen?
So eventually, whether it’s an endodontic abscess or a periodontal abscess, it will swell and you’ll see, immediately, something’s wrong. And then, you know, the old golf ball-looking appearance, something’s wrong. And if you still don’t treat it, it could spread. It can impinge on other structures. Sometimes your eye can swell shut. And the last thing we want to see is that bacteria spread all over the body.
All right, comment below with your pressing health questions, and of course, hit subscribe here to the health channel to get more answers from medical experts on the questions you want to know. Dr. Palomo, thank you so much for joining us and answering all of our periodontal dental questions. Remember to see your periodontist for any medical advice, right, Dr. Palomo?
Also, now listen about that implant. Okay, now what if I never put… I’m gonna put it on there. Okay, don’t get me… Don’t give me, do not. You’re looking at me like you don’t believe.
