Soft Tissue Grafting: A Case Study | Chicago Dentist

Although most people concentrate on the teeth for an attractive, healthy smile, the appearance of the gums cannot be ignored. Because your gums are the “frame of your smile”, an ugly frame will destroy the appearance of a beautiful smile. Knowing this, we will often use soft tissue to enhance the appearance of the tissue in conjunction with new restorations. The following case demonstrates one such example:

This case illustrates a 35-year-old physician who was missing two teeth in the front and had a bridge placed many years ago. She did not like the appearance of the bridge and wanted to replace it. The before photos illustrate how an unsightly indentation in the gum tissue compromised the appearance of the bridge. In addition to replacing the bridge, we wanted to improve the appearance of the tissue in order to improve her “picture frame”. Utilizing minimally invasive tunneling procedures, a collagen graft was placed to build out the tissue and create an appearance that a tooth was present, but in actuality, it is missing. The improvement was seen immediately at the time of surgery, and after several weeks in a new temporary bridge, the result is even more apparent. As you can see, we have created the illusion that there are teeth present by simply reconstructing the tissue.

If you find that you have gums that are affecting your smile and self-confidence, soft tissue grafting may just be the solution you’ve been looking for. Not only will it improve the look of your gums but will also give you a discreet way to bring back a reason to smile.

If you would like more information about dental bridges, call Dr. Cabrera in Chicago, IL at 312-994-7939 or visit www.perioimplantchicago.com.

Dr. Peter O. Cabrera proudly serves Chicago and all surrounding areas.

Imbalance in Gum Bacteria Linked to Alzheimer’s Disease Biomarker | Chicago Dentist

Increases in “bad” bacteria and decreases in “good” bacteria in gums associated with amyloid beta

Older adults with more harmful than healthy bacteria in their gums are more likely to have evidence for amyloid beta—a key biomarker for Alzheimer’s disease—in their cerebrospinal fluid (CSF), according to new research from NYU College of Dentistry and Weill Cornell Medicine. However, this imbalance in oral bacteria was not associated with another Alzheimer’s biomarker called tau. 

The study, published in the journal Alzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring, adds to the growing evidence of a connection between periodontal disease (gum disease) and Alzheimer’s. Periodontal disease—which affects 70 percent of adults 65 and older, according to CDC estimates—is characterized by chronic and systemic inflammation, with pockets between the teeth and gums enlarging and harboring bacteria.

“To our knowledge, this is the first study showing an association between the imbalanced bacterial community found under the gumline and a CSF biomarker of Alzheimer’s disease in cognitively normal older adults,” said Angela Kamer, DDS, PhD, associate professor of periodontology and implant dentistry at NYU College of Dentistry and the study’s lead author. “The mouth is home to both harmful bacteria that promote inflammation and healthy, protective bacteria.  We found that having evidence for brain amyloid was associated with increased harmful and decreased beneficial bacteria.”

Alzheimer’s disease is characterized by two hallmark proteins in the brain: amyloid beta, which clumps together to form plaques and is believed to be the first protein deposited in the brain as Alzheimer’s develops, and tau, which builds up in nerve cells and forms tangles. 

“The mechanisms by which levels of brain amyloid accumulate and are associated with Alzheimer’s pathology are complex and only partially understood. The present study adds support to the understanding that proinflammatory diseases disrupt the clearance of amyloid from the brain, as retention of amyloid in the brain can be estimated from CSF levels,” said the study’s senior author Mony J. de Leon, EdD, professor of neuroscience in radiology and director of the Brain Health Imaging Institute at Weill Cornell Medicine. “Amyloid changes are often observed decades before tau pathology or the symptoms of Alzheimer’s disease are detected.”

The researchers studied 48 healthy, cognitively normal adults ages 65 and older. Participants underwent oral examinations to collect bacterial samples from under the gumline, and lumbar puncture was used to obtain CSF in order to determine the levels of amyloid beta and tau. To estimate the brain’s expression of Alzheimer’s proteins, the researchers looked for lower levels of amyloid beta (which translate to higher brain amyloid levels) and higher levels of tau (which reflect higher brain tangle accumulations) in the CSF.

Analyzing the bacterial DNA of the samples taken from beneath the gumline under the guidance of NYU College of Dentistry microbiologist Deepak Saxena, PhD, the researchers quantified bacteria known to be harmful to oral health (e.g. Prevotella, Porphyromonas, Fretibacterium) and pro-oral health bacteria (e.g. Corynebacterium, Actinomyces, Capnocytophaga).

The results showed that individuals with an imbalance in bacteria, with a ratio favoring harmful to healthy bacteria, were more likely to have the Alzheimer’s signature of reduced CSF amyloid levels. The researchers hypothesize that because high levels of healthy bacteria help maintain bacterial balance and decrease inflammation, they may be protective against Alzheimer’s. 

“Our results show the importance of the overall oral microbiome—not only of the role of ‘bad’ bacteria, but also ‘good’ bacteria—in modulating amyloid levels,” said Kamer. “These findings suggest that multiple oral bacteria are involved in the expression of amyloid lesions.”

The researchers did not find an association between gum bacteria and tau levels in this study, so it remains unknown whether tau lesions will develop later or if the subjects will develop the symptoms of Alzheimer’s. The researchers plan to conduct a longitudinal study and a clinical trial to test if improving gum health—through “deep cleanings” to remove deposits of plaque and tartar from under the gumline—can modify brain amyloid and prevent Alzheimer’s disease.

Additional study authors include Smruti Pushalkar, Deepthi Gulivindala, and Kumar Raghava Chowdary Annam of NYU College of Dentistry; Tracy Butler, Yi Li, Lidia Glodzik, and Karla V. Ballman of Weill Cornell Medicine; Patricia Corby of the University of Pennsylvania School of Dental Medicine; Kaj Blennow of the University of Gothenburg and Sahlgrenska University; and Henrik Zetterberg of the University of Gothenburg, Sahlgrenska University, and UCL.

 This study was supported by the National Institutes of Health’s National Institute on Aging (AG035137, AG032554, AG12101, AG022374, AG13616, RF1AG057570, R56AG058913), National Institute of Dental and Craniofacial Research (DE023139), and National Center for Advancing Translational Sciences (UL1 TR000038), as well as the Alzheimer’s Association (NIRG-12-173937).

If you would like more information about the link between gum disease and Alzheimer’s Disease, call Dr. Cabrera in Chicago, IL at 312-994-7939 or visit www.perioimplantchicago.com.

Dr. Peter O. Cabrera proudly serves Chicago and all surrounding areas.

Diabetes and Your Dental Health | Chicago Dentist

Over 34 million Americans currently suffer from diabetes – and that’s not counting those that haven’t been diagnosed. Because of this, it is no surprise that many of us are focused on keeping ourselves healthy as much as possible. But did you know that diabetes is directly affected by our oral health, and vice versa? It’s true. Diabetes is a disease focused on sugar levels, and sugar is terrible for our oral health. See, how this can become an issue? Our mouths are the main line of defense to many of our illnesses, so if it becomes compromised, our overall health is affected.

November is National Diabetes Month, so to celebrate, let’s take a look at just how closely diabetes and our oral health is linked. One symptom of diabetes is being excessively thirsty. If you are thirsty, you are not producing saliva, the main defense against bacteria. These bacteria are left to create cavities and other dental issues like gum disease. Bleeding and inflamed gums are common symptoms of gum disease and because diabetes make it harder for wounds to heal, you are more susceptible to more issues if left untreated.

Thankfully, your periodontist will be able to help with this cyclical predicament, but it starts with an appointment. By treating gum disease, you are going to help keep your blood sugar levels in check much easier, as gum disease increases these levels but is rarely taken into account. Proper dental hygiene (including dentures), changing bad habits like smoking and poor diet, and in-office deep cleanings will keep your smiles healthy and diabetes in check.

If you would like more information about diabetes, call Dr. Cabrera in Chicago, IL at 312-994-7939 or visit www.perioimplantchicago.com.

Dr. Peter O. Cabrera proudly serves Chicago and all surrounding areas.

When It’s Time for a Gum Graft | Chicago Dentist

There is little more deflating to your smile than receding gums. Not only does it change the look of your smile, but it can also cause your overall demeanor to change as well. But for many of us, it can’t be helped – gum recession often goes hand-in-hand with the aging process or genetics. It’s really disheartening as we love to show off our smiles. Worry not – the dental industry has addressed this issue and it doesn’t have to be as invasive as it once was.

The goal of correcting gum recession is to rebuild the lost tissues and, where possible, cover the roots. It is important to fix this dental issue before more extreme dental issues develop. One of the earliest treatments published was the connective tissue graft introduced in the early 1990’s and can be seen in an article published by Dr. Cabrera in The Journal of the American Dental Association in 1995.

But what does this treatment option entail? This procedure is essentially plastic surgery in the mouth. A very small opening is created either on the roof of the mouth or behind the last upper teeth. The tissue is then secured to the area of recession with small (slightly bigger than a human hair) sutures (stitches). In most cases, recovery is uneventful, requiring no more than over-the-counter medication.

This approach has been refined over the years. Today, we also employ a number of procedures classified as tunnels, which use very small incisions to accomplish the surgery. So, as you can see, there is no reason to hide your smile from the world because of receding gums – visiting your dental professional can easily repair the look of your smile and the health of your gums.

If you would like more information about gum grafting, call Dr. Cabrera in Chicago, IL at 312-994-7939 or visit www.perioimplantchicago.com.

Dr. Peter O. Cabrera proudly serves Chicago and all surrounding areas.

Stop Receding Gums with a Tissue Graft | Chicago Dentist

There is little more deflating to your smile than receding gums. Not only does it change the look of your smile, but it can also cause your overall demeanor to change as well. We all want a great smile to show off. Unfortunately, it is a fact of life as we age. Worry not – there is a solution.

The goal of correcting gum recession is to rebuild the lost tissues, and where possible, cover the roots. It is important to fix this dental issue before more extreme issues, like infection or gum disease, arise. One of the earliest treatments published was the connective tissue graft introduced in the early 1990’s and can be seen in an article published by Dr. Cabrera in The Journal of the American Dental Association in 1995 titled The Connective Tissue Graft, and later reprinted in The Canadian Dental Journal.

But what does this treatment option entail? This procedure is essentially plastic surgery in the mouth. A very small opening is created either on the roof of the mouth or behind the last upper teeth. The tissue is then secured to the area of recession with small (slightly bigger than a human hair) sutures (stitches). In most cases, recovery is uneventful, requiring no more than over-the-counter medication.

This approach has been refined over the years. Today, we also employ a number of procedures classified as tunnels, which use very small incisions to accomplish the surgery. So, as you can see, there is no reason to hide your smile with receding gums – just need to consult with your dentist.

If you would like more information about connective tissue graft, call Dr. Cabrera in Chicago, IL at 312-994-7939 or visit www.perioimplantchicago.com.

Dr. Peter O. Cabrera proudly serves Chicago and all surrounding areas.

What You Need to Know About Diabetes and Your Smile | Chicago Dentist

Let’s face it – diabetes is a disease that runs rampant through our great country. So much so, over 29 million Americans suffer from diabetes – and that’s just counting those that have been diagnosed. Who knows the extent of those who haven’t been? But did you know that diabetes is directly affected by our oral health, and vice versa? It’s true. Diabetes is a disease focused on sugar levels, and sugar is terrible for our oral health. Our mouths are the main line of defense to many of our illnesses, so if it becomes compromised, our overall health is affected.

November is National Diabetes Month, so to celebrate, let’s take a look at just how closely diabetes and our oral health is linked. One symptom of diabetes is being excessively thirsty. If you are thirsty, you are not producing saliva, the main defense against bacteria. These bacteria are left to create cavities and other dental issues like gum disease. Bleeding and inflamed gums are common symptoms of gum disease and because diabetes make it harder for wounds to heal, you are more susceptible to more issues if left untreated.

Thankfully, your periodontist will be able to help with this cyclical predicament, but it starts with an appointment. By treating gum disease, you are going to help keep your blood sugar levels in check much easier, as gum disease increases these levels but is rarely taken into account. Proper dental hygiene (including dentures), changing bad habits like smoking and poor diet, and in-office deep cleanings will keep your smiles healthy and diabetes in check.

If you would like more information about diabetes and your dental health, call Dr. Peter O. Cabrera in Chicago, IL at 312-994-7939 or visit www.perioimplantchicago.com.

Dr. Cabrera proudly serves Chicago and all surrounding areas.

Reasons You May Have Gum Disease | Chicago Dentist

Gum disease is an infection of the tissues that surround your teeth. It is a major cause of tooth loss in adults. Because gum disease is typically painless, you may not even know you have it. But what causes gum disease? Plaque is the primary cause of gum disease. However, other factors can contribute to periodontal disease, including:

  • Hormonal changes, such as those occurring during pregnancy, puberty, menopause, and monthly menstruation, make gums more sensitive, which makes it easier for gingivitis to develop.
  • Various illnesses may affect the condition of your gums. This includes diseases such as cancer or HIV, because they interfere with the immune system. Diabetes’ effects on the body’s ability to use blood sugar makes patients with this disease at a higher risk of developing infections, including periodontal disease and cavities.
  • Medications can affect oral health, because some lessen the flow of saliva, which has a protective effect on teeth and gums.
  • Bad habits such as smoking make it harder for gum tissue to repair itself.
  • Poor oral hygiene habits such as not brushing and flossing on a daily basis, make it easier for gingivitis to develop.
  • Family history of dental disease can be a contributing factor for the development of gingivitis.

Gum disease may progress without producing obvious signs, even in the late stages of the disease. Although the symptoms of periodontal disease can often be subtle, it can present some warning signs. But even if you don’t notice any symptoms, you may still have some degree of gum disease. In some people, gum disease may affect only certain teeth, such as the molars. Only a dentist or a periodontist can recognize and determine the progression of gum disease.

If you would like more information about gum disease, call Dr. Peter O. Cabrera in Chicago, IL at 312-994-7939 or visit www.perioimplantchicago.com.

Dr. Cabrera proudly serves Chicago and all surrounding areas.

What Are Gums Anyway? | Chicago Dentist

We all know our smile is basically composed of lips, teeth and gums. A set of bright white teeth and a pouty lip, and you’ve got yourself a great smile. But what are our gums? Today we will discuss the basics of what our gums do and how we can keep them nice and healthy our entire lives.

Gum tissue serves two main purposes: it provides a seal around teeth, keeping bacteria away from the tooth root, and it provides physical support for the tooth, helping keep the tooth firmly in its socket. One of the most significant risks of periodontal disease is loss of gum tissue – as bacteria from plaque and tartar spreads beneath the gums, it damages bone and gum tissue, leading to a number of problems.

Dentists and periodontists will advise patients to have professional cleanings to help minimize the likelihood of developing periodontal disease. If they determine that periodontal disease is becoming a problem, they’ll likely advise corrective action such as scaling and root planning, where plaque and tartar is physically removed from the roots of the teeth beneath the gum-line, removing the damaging bacteria and giving the gums an opportunity to heal. In some cases, however, the gum tissue will recede, exposing the roots of the teeth. In these cases, periodontists will recommend a procedure to replace gum tissue over the tooth root (such as gum grafting) to help restore the barrier around the tooth root and protecting the tooth’s long-term health.

If you’re experiencing bleeding, sore, inflamed gums, be sure to speak to a dentist or periodontist soon, so that you can minimize the risk of damage to gum tissue.

If you would like more information about gum recession, call Dr. Peter O. Cabrera in Chicago, IL at 312-994-7939 or visit www.perioimplantchicago.com.

Dr. Cabrera proudly serves Chicago and all surrounding areas.

Quit Ruining Your Smile with Smoking | Chicago Dentist

Many people do not know but today is World No Tobacco Day, and as dental periodontist, it is a good day. Not only because smoking will end up causing various problems to your health, from lung cancer to heart conditions, but the damage it does to your mouth. Believe it or not, but the mouth is the first line of defense when it comes to your overall health, so taking care of it is extremely important. When you smoke cigarettes, you are breaking down your immune system, or the parts of your body that prevent infection. Not only does it break down your immune system, but it also kills the good bacteria in your mouth, allowing the disease-causing bacteria to invade, take hold and flourish.

Tobacco products damage your gums by affecting the way your teeth are attached to the bone and soft tissue. When this happens, your gums will begin to recede, giving bacteria access to the tooth’s roots. If left untreated, you will begin to lose your teeth.

Gum disease will affect most adults at some point in their lives. If you’re a smoker, you are raising those doubling those stakes than that of a non-smoker. And because smoking causes your blood vessels to shrink, it will also be more difficult to heal the gum disease you have developed over time.

We know it is difficult, but smoking is one habit that has so many adverse effects, it is important that you make an effort to quit. Not only will you improve your overall health, your smile will thank you for it. Keeping up with your oral health is necessary, so make sure you practice proper dental hygiene and visit your dentist regularly.

If you would like more information about quitting smoking, call Dr. Peter O. Cabrera in Chicago, IL at 312-994-7939 or visit www.perioimplantchicago.com.

Dr. Cabrera proudly serves Chicago and all surrounding areas.

What Is Gum Disease? | Chicago Dentist

We all want a healthy smile, but for many of us, this is not the case. And gum disease is the main culprit in the realm of dental issues. Gum disease is an infection of the tissues that surround your teeth and is a major cause of tooth loss in adults. Because gum disease is typically painless, you may not even know you have it. But what causes gum disease? Plaque is the primary cause of gum disease. However, other factors can contribute to periodontal disease, including:

  • Hormonal changes, such as those occurring during pregnancy, puberty, menopause, and monthly menstruation make gums more sensitive.
  • Various illnesses, such as cancer or HIV, because they interfere with the immune system. Diabetes’ effects on the body’s ability to use blood sugar makes patients with this disease at a higher risk of developing infections.
  • Medications can affect oral health, because some lessen the flow of saliva, which has a protective effect on teeth and gums.
  • Bad habits such as smoking
  • Poor oral hygiene habits
  • Family history

Gum disease may progress without producing obvious signs, even in the late stages of the disease. Although the symptoms of periodontal disease can often be subtle, it can present some warning signs. Certain symptoms may point to some form of the disease. The symptoms of gum disease include:

  • Gums that bleed during and after tooth brushing
  • Red, swollen, or tender gums
  • Persistent bad breath or bad taste in the mouth
  • Receding gums
  • Formation of deep pockets between teeth and gums
  • Loose or shifting teeth
  • Changes in the way teeth fit together upon biting down, or in the fit of partial dentures

If you would like more information about gum disease, call Dr. Peter O. Cabrera in Chicago, IL at 312-994-7939 or visit www.perioimplantchicago.com.

Dr. Cabrera proudly serves Chicago and all surrounding areas.