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The Stages of Gum Disease

May 18th, 2023

Taking care of your gums is one of the best ways to protect your smile. But sometimes, we treat our gums like an afterthought when it comes to dental care. It might surprise you to learn just how common gum disease is—and how damaging it can be for your oral health.

Surprising Fact #1:

About half of all adults have suffered or are suffering from some form of gum disease. And about half of all children do, too. As we age, the percentages jump—in fact, some studies estimate that eventually 70% of older adults will be affected by gum disease.

Surprising Fact #2:

The major cause of tooth loss in adults isn’t tooth decay or accidents or aging—it’s gum disease.

Surprising Fact #3:

Gum disease is progressive. The gingivitis that begins with a bit of redness or some minor bleeding when you brush might seem like a temporary annoyance. But when ignored, this early form of gum disease can lead to periodontitis, a serious gum condition which causes receding gums, loose teeth, bone and tissue damage, infections, and tooth loss.

Gingivitis

Gum disease begins quietly and invisibly, and it usually starts with plaque. Plaque along the gum line irritates our gum tissue. The body’s immune system responds and triggers inflammation. Gum tissue becomes swollen and red. The gums might feel tender, or bleed easily when you brush or floss.

If you’ve experienced any of these symptoms, it’s time to call our North Appleton office. Drs. Emily Ruthven and Daniel Cepeda might recommend better brushing and flossing habits, a professional cleaning, and/or an anti-plaque treatment. At this stage, with proper care, gingivitis is reversible.

But left untreated, gingivitis can progress over time until it becomes periodontitis. Periodontitis affects not only gum tissue, but the bone and connective tissue which surround our teeth, supporting them and holding them firmly in place.

Mild Periodontitis

As plaque and tartar continue to irritate gum tissue above and below the gum line, inflammation increases, and the gums begin to pull away from the teeth. This is a problem, because the gums normally surround the tooth roots snugly, protecting them from plaque, bacteria, and other toxins.

When gum tissue pulls away, pockets are created between gums and teeth. These pockets become home to more bacteria, causing more irritation, inflammation, and infection. During this phase, the connective and bone tissue around the tooth’s roots might start to break down.

Moderate Periodontitis

As the disease progresses, pockets become deeper. The structures that hold the teeth in place continue to break down, and the teeth start to loosen. As the gums recede, tooth roots become more vulnerable to decay.

Advanced Periodontitis

When periodontitis has reached the advanced stage, there is significant loss of tissue and bone around the teeth. Teeth become looser and foul breath, pus, and pain when biting or chewing are common. Without prompt treatment, there’s a high risk of tooth loss.

Unlike gingivitis, periodontitis isn’t reversible, and requires professional care. Advanced treatments can do a lot to restore gum health:

  • Topical, time-release, or oral medications treat infection.
  • Scaling and root planing, which are non-surgical deep cleaning procedures, remove plaque and tartar above and below the gum line, and smooth tooth roots to remove bacteria and help the gum tissue reattach to the teeth.
  • Flap surgery treats more advanced gum infection, reducing pocket depth and re-securing the gums snugly around the teeth.
  • Bone grafts, gum grafts, and other regenerative procedures are available that help restore and repair tissue damaged by gum disease.

That’s good news, and there’s even better news: Because gum disease is typically triggered by plaque, it’s very preventable.

  • Brush carefully at least twice each day for at least two minutes. Don’t forget to brush along the gum line!
  • Use floss at least once each day or as directed by Drs. Emily Ruthven and Daniel Cepeda. If you have trouble flossing, ask us for the flossing tools and techniques that will work best for you.
  • See your dentist regularly to catch and treat early gum disease while it is still reversible.

While gum health is essential for dental health, healthy gums might mean more than just healthy teeth. Scientists are studying the potential links between gum disease and its effects on conditions such as heart disease, diabetes, and arthritis. Gum health should never be an afterthought. Taking care of your gums is one of the best things you can do to ensure a lifetime of healthy smiles.

Can You Repair Your Tooth Enamel?

May 11th, 2023

There are lots of ads out there for toothpastes that claim to repair damaged tooth enamel.

Can you treat cavities and tooth decay at home? Well, mostly, no, you can’t.

Can you strengthen your enamel at home? Very possibly—in some circumstances. Let us explain!

Cavities and tooth decay start forming when the enamel on the tooth’s surface breaks down. To discover what causes this breakdown, we need to see how chemistry works with our biology.

Tooth enamel is mainly made from calcium and phosphate ions. These minerals combine to form hydroxyapatite, crystals which make up around 95% of our enamel. Hydroxyapatite crystals are so strong that tooth enamel is the hardest part of our bodies. What can weaken a substance this strong?

Acids. Acidic foods and drinks, as well as acids created by the bacteria in plaque, strip away calcium and phosphate ions in enamel, weakening the surface of the tooth. This is a process called demineralization, and it’s the first stage of tooth decay. Left alone, weak spots will become bigger and deeper until they form cavities.

And tooth enamel, unlike the rest of your body, isn’t living tissue. It can’t regenerate. Once bacteria and acids have created a deep enough cavity, only Drs. Emily Ruthven and Daniel Cepeda can repair it by removing decay and filling the tooth.

Wait, this sounds a lot more like “No, you can’t repair your enamel” and much less like “It’s possible to strengthen your enamel.” But we’re not through!

Demineralization doesn’t equal cavities—yet. Careful attention to your habits and your diet can make a difference in whether your enamel continues to weaken or becomes stronger.

Our body’s first defense against demineralization is saliva. Calcium and phosphate ions in saliva bathe the teeth throughout the day, restoring the minerals which have been lost. This is called remineralization. Saliva also helps neutralize acids from the foods we eat. But with a diet heavy in acids, or a lot of plaque buildup, saliva just can’t keep up with the damage.

That’s where “enamel-repair” toothpastes come in. Toothpastes are available that contain hydroxyapatite to restore calcium and phosphates to weakened enamel. But for many of the most common enamel-repair toothpastes, the not-so-secret secret to their effectiveness is fluoride.

Dentists recommend fluoride toothpastes for several very good reasons. Fluoride is attracted to the minerals in tooth enamel and bonds with them. Once bonded, fluoride attracts the calcium and phosphate ions in saliva, helping restore lost minerals to the enamel. Even better, when fluoride bonds with the calcium and phosphate in our enamel, fluorapatite is created. This is a crystal even stronger and more acid-resistant than hydroxyapatite.

If you’re concerned about the strength of your enamel, and especially if you notice any signs of acidic erosion, talk to our North Appleton dental team right away. Drs. Emily Ruthven and Daniel Cepeda can:

  • Recommend over-the-counter toothpastes or professional fluoride applications to help reverse early demineralization
  • Provide dental bonding, a crown, or a veneer to protect a tooth with serious erosion
  • Treat a cavity caused by more advanced tooth decay.

Keeping your enamel healthy at home can take many forms. By careful brushing and flossing to remove plaque, by watching the acids in your diet, by making sure you’re properly hydrated, and by using fluoride toothpaste, you can both reduce the risk of demineralization and help restore weak spots in your tooth enamel.

So, can enamel-repair toothpastes effectively repair your teeth? Yes, they can be effective—if demineralization is in its early stages and if you make them a regular part of your daily dental routine.

How to Handle an Unexpected Dental Emergency

May 4th, 2023

Regardless of the type of dental emergency you experience, it is important that you visit North Appleton Dentistry for emergency dental care as soon as possible. A chipped or cracked tooth requires professional attention, as bacteria may gather in these areas, potentially causing infection that could require a root canal. Remember, you may be capable of managing pain, bleeding, and swelling at home, but by visiting our office for immediate treatment, you can fight infections and minimize lasting damage to your mouth, teeth, and gums under the expert care of our emergency dentist.

24/7 Emergency Dental Care

North Appleton Dentistry is proud to offer emergency dental care around the clock, seven days a week. Dental emergencies do not wait for regular business hours, and if you experience a serious dental emergency, you need immediate treatment. Whether you have a broken tooth or if you have bitten through your tongue, do not hesitate to visit us day or night. Until you arrive at our office, however, there are some helpful steps you can take if you encounter a serious dental dilemma.

Managing Your Dental Emergency

If a toothache is causing problems, you can probably keep the discomfort under control until our emergency doctor can treat you. Start by checking the gums that surround the affected tooth for inflammation, bleeding, or foreign objects. There may be food lodged in the gum that could be removed by flossing. You can control pain by placing a cold compress against your mouth, or by using an over-the-counter oral numbing agent.

More serious situations may be extremely time sensitive, and require immediate emergency attention. For example, if a tooth is completely knocked out, carefully clean it with water. Try to place the tooth back into its socket or briefly store it in a cup of milk if it will not fit back into the gum. Never pick up a tooth by the root or force it into the socket. Come straight to our office, as your tooth will need to be replaced within a short amount of time. Similarly, if you have bitten through your lip or tongue, the American Dental Association recommends carefully cleaning the area before coming as quickly as you can to our emergency dental office for treatment.

Remember, there is no reason you should live with discomfort. By visiting our North Appleton office immediately in an emergency, you can take control of your oral health comfortably and safely.

Spring Cleaning

May 4th, 2023

Just like that, it’s almost summertime. As the spring season ends, perhaps these lighter, brighter days are inspiring you to do a bit of last-minute spring cleaning. Or perhaps they’re not. No judgment here!

What we can recommend wholeheartedly is finishing the season with a clean, sparkling smile. And we have some bright ideas for you!

Refresh Your Cleaning Technique

Tooth brushing can become so automatic that we don’t think about the basics anymore. And suddenly, we’ve finished brushing in half the time we used to, and, hey, how long has that floss been sitting on the counter, anyway? We suggest some mindful cleaning for a healthier smile.

  • Spend two minutes brushing, at least twice each day.
  • Make sure you reach all the surfaces of your teeth, inside, outside, and on top of your molars.
  • Use short, gentle brush strokes, covering a tooth or two at a time.
  • Angle your brush to clean along the gum line. Plaque around the gums leads to irritation and inflammation, and is a common cause of gum disease.
  • Use vertical strokes to clean the inside of your front teeth.
  • Floss at least once each day.

Good Cleaning Requires Good Tools

Since we’re tidying up, let’s talk about some helpful cleaning tools. Is your toothbrush looking a bit—long in the tooth?  

After three to four months of brushing, your toothbrush bristles start to break down. Frayed and matted bristles can’t clean as effectively as a toothbrush in top shape. Each change of season is a good time to remind yourself to change brushes.

And, while you’re shopping, remember:

  • Soft bristles are almost always all any brusher needs. Even medium bristles can be abrasive to tooth enamel. And brush gently—scrubbing is also abrasive.
  • If you use an electric toothbrush, those toothbrush heads need to be replaced, too! In fact, because these brushes often have shorter bristles, heads might need to be replaced every two to three months.
  • Use fluoride toothpaste to clean and protect your teeth.
  • Don’t forget the floss!

If you’re not a fan of your current floss, take another look at the dental aisle in your local store. There are lots of new flossing options out there just waiting to be sampled. If manual flossing is difficult, consider a water flosser. Drs. Emily Ruthven and Daniel Cepeda can help you find just the right floss for your one-of-a-kind smile.

And speaking of your dental team . . .

Some Cleaning Jobs Require Professional Help

Dentists typically recommend a professional cleaning at our North Appleton office twice a year to make sure you’re free from built up plaque and tartar. How does your dental team go about getting your teeth cleaner than you can get them at home? With special training and special tools.

  • Plaque and tartar need to be removed from tooth enamel above and below the gum line to prevent cavities and gum disease, and tartar can only be removed by a dental professional. Your hygienist might use an ultrasonic scaler, a hand scaler, or both to gently scrape away sticky plaque and hard tartar.
  • Teeth are polished with a gentle abrasive to remove surface stains. This can be done with a special toothpaste applied with a small rotating cup, or with an air polisher, which removes stains with a stream of fine abrasive powder, water, and pressurized air.
  • An expert flossing will remove any remaining plaque from between the teeth.

Bonus: Your hygienist can point out spots you’ve been missing to help make your home brushing and flossing more effective.

Clean and Bright

Increasing daylight can brighten your mood—and so can a whiter smile! Over time, smiles get dimmer without our even noticing, thanks to tooth-staining foods and drinks, medications, smoking, or thinning enamel as we age. If you’re feeling self-conscious because your smile isn’t its sparkling best, consider a whitening treatment.

  • Whitening Toothpastes

Whitening toothpastes use chemicals and mild abrasives to remove surface stains caused by foods, beverages, and smoking. If you’d like to give a whitening toothpaste a try, ask Drs. Emily Ruthven and Daniel Cepeda for suggestions.

  • Whitening Strips and Gel Trays

Whitening gels can be applied at home with strips or tray kits. These peroxide-based gels are stronger than the formulas used in toothpaste, but can be irritating. Talk to Drs. Emily Ruthven and Daniel Cepeda to learn how to achieve the best and safest outcome with these products.

  • Office Treatment

Whitening treatments at our North Appleton office are generally faster, more effective, and last longer because this process uses a more powerful whitening agent. That’s why it should only be applied by a dental professional, who will examine and prepare your teeth, protect the surrounding gum tissue, and monitor your treatment throughout.

Spring’s coming to an end, but taking care of your dental health is always in season! A clean smile isn’t just a more confident smile, it’s a healthier one. Talk to your dentist for more tips to create your best and brightest smile at any time of year.

Traffic Reminder:

As of April 28, 2025 through late fall 2025 the County E/Ballard Rd. bridge over I-41 will be closed. Please plan ahead to take an alternate route to the office for your appointment.

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