I. Stephen Brown, DDS
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The Perio Group Blog

Oral Conditions Associated with COVID-19

December 30th, 2020 by sbrown

The general public associates COVID-19 with respiratory symptoms, such as difficulty breathing and a dry persistent cough. But the virus has been found in virtually every part of the body, including the mouth.

Recently, new data emerged from clinical practice showing that COVID-19 also has a deleterious effect on the oral cavity, causing a host of clinically significant symptoms. Dentists are noticing that patients with “long COVID-19” are experiencing tooth loss, greying gums, and tooth cracking alongside at a higher rate than usual.

For many, the question is why the disease appears to affect oral tissue so severely. So far, evidence suggests that it relates to the preponderance of ACE-2 receptors in the mouth targeted by the SARS-CoV-2 virus. The salivary glands, tonsils, and tongue carry more of the specific RNA-linked proteins that the coronavirus requires to infect cells, including specific enzymes that make it easier for it to penetrate the cell wall.

As a consequence, dentists are seeing more oral manifestations associated with COVID-19. Here’s a rundown.

Taste And Smell Loss

Loss of taste and smell were among the first identified symptoms of COVID-19. Doctors noticed that case-patients who tested positive would lose these senses early on, especially if their other symptoms were mild. Estimates suggest that the average prevalence of loss of taste among cases is around 38 percent.

The cause of loss of taste and smell in COVID-19 was originally thought to be the viral invasion of facial nerve cells. However, more recent studies cast doubt on that idea because of the absence of ACE-2 receptors in these tissues. Now the theory is that the virus infects susceptible cells surrounding the oral and nasal nervous system and this causes inflammation which then impacts patients’ sense capacities.

Cracked Teeth

Before the virus, the typical dentist might see one cracked tooth every other day. But with the onset of the pandemic, the number of patients with fractured teeth has risen significantly. Two visits per day are now the norm.

Dentists don’t believe that the virus is weakening teeth (although this remains a possibility). Instead, the current theory is that the stress of the pandemic is leading to more teeth grinding which, in turn, is leading to higher-than-usual levels of damage to dentition. COVID-19, looting, rioting, politics, and the general state of the nation has everyone on edge and unconscious bruxing is rising.

Gingival Tissue Breakdown And Oral Ulcerations

Evidence suggests that COVID-19 damages blood vessels across the body, including those that supply the mouth. And this could be leading to an increase in gingival breakdown and oral ulcerations.

The Angiogenesis Foundation – a group that works to uncover the mechanisms of cardiovascular disease – believes that the endothelial cells that line blood vessels are susceptible to SARS-CoV-2 because they carry the ACE-2 receptor. When the virus penetrates them, it damages them, depriving downstream areas of the body of oxygen. In the mouth, this process manifests as ulcerations and dying gum tissue. Generalized COVID-19-induced inflammation compounds the damage, worsening symptoms.

Dry Mouth

Pre-pandemic, dry mouth, or xerostomia, was a condition that dentists saw mainly in the elderly and smokers. Both age and tobacco use damage the salivary glands that keep the oral cavity moist. However, since the advent of the COVID-19 pandemic, more patients than usual are presenting with the condition.

Dry mouth is problematic because it causes bad breath and increases the rate of both cavities and oral infections. Saliva plays a vital role in the mouth, clearing away microbes and providing mild antiseptic action. When it is absent, the rate of oral health issues increases.

COVID-19 may be leading to an epidemic of dry mouth because of frequent mask use. Mouth breathing, evidence suggests, desiccates oral tissues, leading to halitosis and an increase in unhealthy bacteria.

Direct assault by the virus of salivary glands is a secondary mechanism. Data suggest that SARS-CoV-2 can enter salivary cells via the ACE-2 receptor, damage them, and cause them to produce less saliva than usual.

At present, the relationship between xerostomia and COVID-19 is poorly understood. Clinicians require more research to identify the causal mechanisms underlying the correlation. However, the rise in the prevalence of the condition is worrying for some, since in normal practice, dry mouth leads to an increase in both candida infection and caries.

Gingival Inflammation

Gingival inflammation typically occurs when bacteria in the oral cavity damage the gumline. Patients who fail to brush their teeth, for instance, often experience gum bleeding and damage to superficial tissues. And these problems get worse, the longer the oral hygiene hiatus lasts. However, many COVID-19 patients with excellent oral health practices are also experiencing gum problems.

Cytokines and interleukins – inflammatory signaling compounds – direct the immune system to target tissues afflicted by the SARS-CoV-2 virus, leading to redness and swelling. Since inflammation occurs across the whole body, it also adversely affects tissues in the mouth. And this, many researchers believe, is behind the rise of gingival inflammation.

Some patients experience severe inflammatory signaling dysregulation during COVID-19. Here, the body produces an abundance of cytokines and interleukins, inducing a “cytokine storm” as it attempts to direct the immune system to fight infection in multiple tissues. In small doses, inflammatory signaling compounds are helpful and marshal the body’s response to external threats. But in high quantities, they can be very damaging.

Regular periodontal disease causes elevated cytokine levels. Now evidence is emerging that the condition could also be contributing to cases where patients experience a cytokine storm, making the overall course of the disease worse.

Schedule An Appointment

The COVID-19 pandemic has been challenging for everyone. But it is also leading to a new raft of oral health problems.

If you’re concerned about your teeth and gums and would like a consultation, please schedule an appointment with Philadelphia Periodontist Dr. I. Stephen Brown. Solve any problems you may have and get peace of mind today!

Increase of Dry Mouth During COVID-19

November 30th, 2020 by sbrown

The COVID-19 pandemic has presented new challenges in all aspects of our lives, and oral health isn’t any different. The increased presence of dry mouth has become one of the major issues facing patients from all backgrounds. Dr. I. Stephen Brown and The Perio Group team have witnessed a noticeable increase in cases of dry mouth since safely reopening the dental practice.

What causes dry mouth?

Dry mouth is an oral health condition that can be broken into two distinct types: xerostomia relates to a patient’s perception of dry mouth while hyposalivation is a pathological issue defined by reduced saliva flow. In either case, it is a problem that is caused by a lack of saliva production in the salivary glands.

While it is a condition that affects almost everyone from time to time, persistent dry mouth can be immensely damaging to a person’s overall oral health. Given its nature, figures on how many people have ongoing dry mouth range from anywhere between 1% and 65%. The main causes of dry mouth are;

  • Aging,
  • Dehydration,
  • Medication side effects,
  • Cancer treatment,
  • Tobacco,
  • Underlying health issues.

The plethora of underlying health conditions include; Sjögren’s syndrome, Alzheimer’s disease, HIV, diabetes, Parkinson’s disease, Hepatitis C, Lymphoma, hypertension, and various mental health conditions ranging from anxiety to depression.

Dry mouth caused by a lack of saliva production by the salivary glands can impact the oral cavity as well as your general quality of life. It can increase the risk of tooth decay and oral viruses while also making it harder to chew, swallow, and talk. When you have dry mouth, finding a solution is vital.

Due to COVID-19, it’s a challenge that even more people are faced with.

Why is dry mouth more common during COVID-19?

The reasons behind the lack of saliva production can be linked to many issues, but the most common are;

  • Changes in mental wellbeing,
  • Dehydration,
  • Dietary and lifestyle changes.

Changes in mental wellbeing

Anxiety is the most common health issue linked to hypersalivation, impacting the composition and flow of saliva production. This is partly due to the fact that the central nervous system (CNS) is responsible for regulating the salivary reflexes. Meanwhile, depression and other stress-inducing mental health conditions are a huge threat to the activity of the salivary glands.

Right now, our collective mental health is under greater strain than ever before thanks to COVID-19. Experts at The American Psychological Association (APA) have pinpointed the impacts of social detachment and isolation during this time as one of the pandemic’s biggest problems.

Loneliness is further exacerbated by the stress of job insecurity, along with the continued fears of getting the disease. Worse still, it is virtually impossible to trick your body into feeling unstressed. If the situations caused by the pandemic are making you stressed or anxious, saliva production and regulation may undergo noticeable changes, thus leading to xerostomia.

Dehydration

The human body needs regular hydration, and even a minor drop in hydration levels can severely impact your physical and mental wellbeing. Dry mouth is naturally one of the most noticeable changes. The average adult can use the 8×8 rule (eight 8oz glasses per day), although contributing factors such as climate and physical activity can impact this.

COVID-19 makes it significantly harder to stay hydrated throughout the day due to wearing Personal Protective Equipment throughout the day, potentially for several hours at a time. Likewise, you may be hesitant to carry a bottle in public areas as the virus can stay on surfaces all day long.

Even patients that have largely stayed indoors may find that dehydration has increased as a sedentary lifestyle can make it easier to ignore your thirst. When this process is repeated for a few days, the impact on your hydration levels can be vast. Consequently, then, saliva production levels may fall as a result. Moreover, dehydration may harm your immune systems, increasing the threat of COVID-19.

Dietary and lifestyle changes

Boredom, a loss of routine, and restricted possibilities are a common theme at this immensely difficult time. If your lifestyle has changed dramatically since the pandemic, it’s likely that biological impacts will have occurred. Dry mouth is one of the most common, especially if lifestyle alterations have been coupled with modifications to your diet and nutritional habits.

Alcohol is a diuretic, which will lead to dehydration and dry mouth. Alcohol consumption has increased for a lot of people since the start of the pandemic, which has contributed to the growing presence of dry mouth cases. Alcohol consumption is often worsened by the heightened use of tobacco.

Lifestyle changes may also extend to dehydrating yourself by spending more time wrapped up in the warm, especially over the colder months. Meanwhile, most patients are now self-medicating in a wide range of health conditions. The side effects of various medicines can have a telling influence on the activities of your salivary glands and could be a leading cause of your common issues.

Overcoming dry mouth during COVID-19

Beating dry mouth during COVID-19 is largely an assignment that revolves around trying to restore normality to your daily habits, including hydration, lifestyle choices, and oral hygiene. While the pandemic does pose new challenges, maintaining habits that encourage healthy salivary glands will establish the strongest platform for success throughout the coming months.

A conscious effort to avoid falling into bad habits during these times can be supported further by daily routines to reduce stress. Nonetheless, professional dental care remains an important ingredient in the recipe for success. And even the pandemic should not stop you from seeking the right care.

Dr. Brown and his team can provide a safe environment and a comprehensive dental care that includes spotting the clear signs of dehydration. This could include a wide range of symptoms, including but not limited to;

  • Oral thrush,
  • Inflammation,
  • Gum disease,
  • Sialadenitis,
  • Saliva composition,
  • Oral mucosa fissuring.

When dry mouth is diagnosed, Dr. Brown can also investigate the reasons for it surfacing during COVID-19 before devising the best lifestyle changes or course of treatment for dry mouth.

Pathogens Contributing to Oral Cancer

October 30th, 2020 by sbrown


A new study posted in last month’s issue of PLOS Pathogens (1) by Yvonne Kapila of the University of California, San Francisco, has determined that pathogens surrounding the teeth are a leading contributor to a highly aggressive form of Oral Squamous cell Carcinoma (OSCC), commonly known as oral cancer. As a result, regular oral cancer screenings are advised to high-risk patients including tobacco smokers and regular alcohol consumers and should be incorporated as part of a good oral health routine.

Dr. I. Stephen Brown and The Perio Group team offer oral cancer screenings alongside a wide range of dental treatments to identify early signs of oral malignancies and select the right treatment for patients that are found to have the oral disease that can be closely linked to pathogens within the oral cavity.

What is oral cancer?

Oral cancer, also known as mouth cancer, is a term that describes any cancer that develops in the mouth or at the back of the throat. While several forms of oral cancer exist, over 90% of all oral cancers are defined as Oral Squamous Cell carcinoma (OSCC). This occurs when the fish-scale looking squamous cells found on the skin surface tissues are mutated. It can start out as any of the following, before spreading to other parts of the body;

  • Buccal mucosa cancer,
  • Floor of mouth cancer,
  • Gum cancer,
  • Hard palate cancer,
  • Lip cancer,
  • Tongue cancer.

Less common forms of mouth cancer include Oral Verrucous Carcinoma and Oral Melanoma, which can develop in the pigment-producing cells within any part of the oral cavity. When diagnosed early, the five-year survival rate of oral cancer is 84% (2). However, this rate does fall significantly if the cancer is allowed to spread. An oral cancer screening with Dr. Brown and his team will help you stay in control of the situation.

Pathogens causing oral cancer

Pathogens are any organism that can cause a disease. In relation to oral health, this may cover viruses, bacteria, and various other microorganisms. Unfortunately, this issue often goes unnoticed by patients due to a lack of pain while visible changes may be hard to spot due to their location too. This is one of the reasons that, in addition to the 9,750 annual deaths, oral cancer patients are up to 20 times (3) more likely to develop a secondary cancer.

While risk factors do extend to smoking, alcohol consumption, and human papilloma virus infection, Kapila’s study into the impact of periodontal pathogens in the development, progression and metastasis of OSCC tumors has been quite conclusive. It identified three oral pathogens as problematic for cell migration, invasion, and tumor growth. They are;

  • Porphyromonas gingivalis,
  • Treponema denticola,
  • Fusobacterium nucleatum.

The studies conducted on mice analyzed mediation through two pathways, integrin/FAK, and TLR/MyDD88, and determined that processes were inhibited by treatment with the nisin bacteriocin while also indicating its therapeutic potential as an antimicrobial and anticancer agent, which could subsequently inhibit the pathogen-mediated cancer formation.

It is suggested that the findings of Kapila’s study could alter the future of oral cancer treatment, with a greater focus on antimicrobial-based therapies. In turn, it may hold the key to finally unlocking an increased rate of five-year survival after decades of hovering around the 55% mark across patients of all oral cancers and stages. Crucially, an increased understanding of the role that pathogens play can further boost the impact of oral cancer screenings.

Diagnosing mouth cancer with oral screenings

The statistics are pretty clear regarding the importance of finding oral cancer at the earliest stage. It will boost survival rates from the initial cancer while simultaneously reducing the threat of developing secondary cancers. A professional screening with Dr. Brown can look for the presence of pathogens on the tissues surrounding the teeth, as well as other oral cancer symptoms, including lumps and various types of cell degeneration.

Comprehensive oral cancer screenings cover a wide range of factors to test all potential cancer sources.

Extraoral screenings

External examinations will include checking the entire face for a range of issues, such as;

  • Asymmetry,
  • Masses,
  • Swelling,
  • Discoloration,
  • Pigmented skin.

Further steps will include checking the eyes for swelling during movement, analyzing the nasal passages and the neck. The thyroid and lips will additionally undergo screenings.

Intraoral cavity examination

Internal examinations of oral cavities will include visual inspections in which Dr. Brown will use a gloved hand to move the tongue and gain visible access to the tongue, hard and soft palate, tonsils, floor of mouth, and buccal mucosa as well as the tissues surrounding the teeth.

Each part of the examination will look for different signs of oral cancer, which could include;

  • Swelling,
  • Discoloration,
  • Lumps,
  • Lesions,
  • Ulcerations,
  • Other abnormalities.

The examinations will be conducted using various dental appliances that allow for even greater visibility, including a gauze and added light. The examination should only take a few minutes to complete while Dr. Brown ensures a comfortable and safe setting for all patients.

In addition to examining your mouth for signs of cancer, the oral screening can look for additional oral health conditions while also checking your overall oral health. Following the examinations, then, you may be provided helpful advice on how to stay on top of your oral health and reduce the likelihood of getting oral cancer in the future (such as quitting smoking), which makes it a useful procedure even if it is found that no symptoms are present.

Contact Dr. Brown to arrange an oral cancer screening today

Have you noticed changes to your oral health, or wish to gain peace of mind by ruling out the development of oral cancer? If so, contact us to arrange your oral cancer screening today! The Perio Group proudly provides a safe dental practice that has been adapted to meet COVID-19 regulations to keep you protected while still providing the same high standards of dental care throughout every stage of your oral cancer screening. To find out more, including what steps we’ve taken, give us a call today!

Vaping and Periodontal Disease

September 30th, 2020 by sbrown

Vaping has grown in popularity over the last few years. It is seen by many as an alternative to smoking cigarettes, offering a healthier option for smokers. By using e-cigarettes, it’s believed that individuals will avoid many of the health complications associated with traditional tobacco cigarettes. As a result, you’d expect dentists to be over the moon at the prospect of something that reduces the consumption of cigarettes. It’s well known that cigarettes cause a lot of oral health problems – most notably staining and periodontal disease.

However, while vaping might be ‘healthier’ than smoking, it’s certainly not healthy. In fact, research suggests there is a strong link between vaping and periodontal disease. This is down to the chemicals present in e-cigarettes and how they interact with your mouth. Some dentists argue that they might be worse for your oral health than traditional cigarettes.

What is vaping?

Vaping is a term used to describe the act of using e-cigarettes. For all intents and purposes, an e-cigarette is an electronic version of a typical tobacco cigarette. Of course, it is built out of entirely different things and uses technology. The science behind vaping is pretty straightforward: a liquid is heated to generate vapor, which is then inhaled by the user.

A typical e-cigarette will have a few key components:

  • A replaceable inhaler cartridge – this contains the e-liquid that is heated. You can buy many different cartridges of liquids in loads of various flavors. Most e-liquids are made of vegetable glycerin, polyethylene glycol, flavoring, and nicotine/THC.
  • A heating chamber – this is known as the ‘vaporizer’ as it produces the heat that turns the liquid into a gas. It is usually either built into the inhaler cartridge or the main body of the e-cigarette.
  • Rechargeable battery – all vape pens/e-cigarettes will have a rechargeable lithium-ion battery. Obviously, this is required to heat the heating chamber. It is connected to a circuit board that’s often linked to an LED light telling the user when heating is occurring.

Many people choose to vape as it is seen as the best way to stop smoking. The nicotine concentration is far lower – and some e-liquids are completely nicotine-free. The feeling of having an e-cigarette in your hand makes your body associate it with the feeling of smoking, so it’s easier to adapt and slowly decrease your nicotine consumption. However, some of the ingredients in these devices are bad for your oral health.

How does vaping damage your oral health?

Primarily, the concerns stem from the three main ingredients in e-liquids:

  • Propylene glycol (PG)
  • Vegetable glycerin (VG) & flavorings
  • Nicotine

The sole purpose of PG is to act as a carrier for the e-liquid. You can’t taste it, it doesn’t smell, and it is used in many different products throughout the food industry. The problem is that it is directly ingested through the mouth when vaping. As this happens, PG will break down into propionaldehyde, lactic acid, and acetic acid. These things all have a direct impact on your oral health! Specifically, they’re shown to break down enamel and soft tissues in the mouth. Thus, PG can cause gum issues and potentially pave the way for cavity formation. It’s also found that it can cause dry mouth, which is a very bad condition as it makes it easier for cavities to form.

VG isn’t that dangerous when used on its own. While it is a sugary liquid, it will not cause cavities. The issue is that VG is used alongside other flavorings to make the vape liquid taste better. Here, the combination of VG and flavorings leads to a massive increase in both microbial adhesions to enamel and biofilm formation. This was discovered by a study in 2018, and it also found that enamel hardness decreased by 27%. In essence, this combination leads to more bacteria in the mouth, weaker enamel, and the perfect breeding ground for cavities.

Lastly, you have nicotine – a product that’s also found in traditional cigarettes. The effects of nicotine on oral health are known by many. Essentially, it can stem the flow of blood to the gum tissue, which can cause gum disease. Excessive nicotine use has been linked to tooth loss due to severe periodontitis. Granted, the concentration of nicotine is far less in e-cigarettes, but there’s still enough to cause problems.

To summarize, the ingredients in e-liquids will increase the likelihood of tooth decay forming, causing cavities in the mouth. There are also very strong links that suggest periodontal disease is more likely with regular vaping. Nicotine is still a prime culprit, but the VG and PG are also at fault. Ultimately, using these chemicals in your mouth is not a good idea as it can cause gums to recede and bleed, which causes teeth to fall out.

Additional concerns about vaping

As well as the ingredients, vaping devices present another serious threat. The lithium-ion battery has been known to explode when being used. Seeing as this product is used in your mouth, the likelihood of oral health complications is very high. While this doesn’t have a direct impact on periodontal disease, it’s still worth thinking about.

The dangers of periodontal disease

Clearly, all oral health issues are serious. However, periodontal disease is one of the biggest challenges as it often goes untreated. The main danger is that your gums will slowly start to fade away. They recede further and further until they expose the roots of your teeth. This weakens the supporting structures of your teeth and makes you more prone to tooth loss.

Thankfully, periodontal disease can be treated, and the effects can be reversed. It’s a simple case of cutting out bad habits and following a strict oral hygiene routine. You will also benefit from some periodontal disease treatment by a qualified periodontist.

If you’re in need of periodontal treatment, don’t hesitate to contact us today. Schedule an appointment with Dr. I. Stephen Brown for a full consultation. This will identify your main problems and allow Dr. Brown to formulate the perfect treatment plan to repair your gums.

Cracked Teeth Due to Grinding During COVID-19

September 15th, 2020 by sbrown

History will remember 2020 for its many stress-inducing challenges. The world has undergone drastic changes, increasing the tension that most people feel. As a result, Dr. I. Stephen Brown and his team have seen more patients with cracked teeth than ever before. This problem seems to stem from excessive grinding due to mass amounts of stress. It led to Dr. Brown dubbing this problem the ‘COVID-clench.’

The good news is that the technology exists to treat this problem. Dr. Brown can craft custom appliances that fit in your mouth, preventing excessive grinding at night. If you suffer from the COVID-clench, this could be the perfect treatment to make your night easier.

How does grinding cause cracked teeth?

Teeth grinding – or bruxism – is a condition that affects millions of patients across the US. It’s a relatively serious condition in that it can lead to severe tooth damage. To make matters worse, most people with bruxism don’t realize they have it. Teeth grinding is a subconscious act that manifests itself due to stress or other conditions. It happens without thinking about it, usually when you’re in bed at night.

Naturally, your teeth are very hard – after all, they’re designed to break through food and chew things for years on end. In fact, one study revealed that tooth enamel is harder than steel, but breaks much easier. Therefore, teeth grinding presents a serious problem as you have two hard surfaces moving against one another. When this happens day after day, your teeth wear down, and the enamel starts to chip away.

As you may already know, enamel’s primary purpose is to protect your teeth. It’s essentially a protective layer that stops the rest of the tooth from being damaged. When it begins to wear down, what do you think will happen? A lack of enamel means the tooth is exposed, making it more prone to severe issues. As the grinding continues, your unprotected teeth move against one another, causing cracks to form.

What is COVID-clench?

COVID-clench is a term coined by Dr. Brown that relates to a common issue seen by dentists across the country. While the world entered lockdown, dental practices were busier than ever. Dentists saw more patients with cracked teeth than ever before – was this a coincidence? Or is it directly linked to the effects of COVID-19.

The exact causes of teeth grinding are hard to pinpoint as anyone can fall into this bad habit. Nevertheless, studies point to a link between emotional stability and bruxism. To summarize, individuals with high levels of stress are found to grind their teeth more often. Therefore, Dr. Brown believes that the stress of COVID-19 is causing more people to grind their teeth. You may stay up late every night worrying about your job, health, or financial future. All of these things are significant concerns during a pandemic. As a result, you could start grinding your teeth as an impulsive reaction to this stress. Hence, the COVID-clench is born. It is simply no coincidence that there has been an increase in cracked and fractured teeth alongside an ongoing pandemic.

What happens when cracked teeth are left untreated?

Some patients will have cracked teeth that can be left alone. These are surface cracks that provide no pain and present no further issues. There’s no need to have them treated, but you can if you want.

However, deeper cracks need to be treated as soon as possible. When they’re not, they will gradually get worse. Consider what a crack does on the surface of a rock. It weakens the entire structure, making the rock more prone to breaking apart. The same happens with your teeth; if cracks are deep enough to cause pain, they will eventually lead to fractures or chips of your teeth coming out.

Ultimately, this can leave you with a very painful tooth that needs to be extracted. Or, the entire tooth falls out of its own accord. Either way, it’s recommended that you consult with a dentist if you notice any pain or cracks in your teeth.

How are cracked teeth and bruxism treated?

Cracked teeth can be treated in numerous ways depending on the severity of the crack. Some cracks are dealt with using composite bonding to fill in space. This restores the look and function of the teeth. For more severe cracks, a crown may need to be placed on the tooth, protecting it from further damage. It’s not uncommon for the deepest cracks to require root canal treatment if the pulp is exposed. Extractions are also common if the tooth is damaged beyond repair, paving the way for tooth-replacement treatments.

Moreover, all of these treatments are pointless if the cause isn’t addressed. You can restore your teeth, but the cracks will come back if the grinding persists. This is why you must treat bruxism alongside the cracks. Dr. Brown and his team can provide you with the best treatment for this problem. His office contains the best scanning technology to craft custom-made oral appliances that fit in your mouth. This will protect your teeth from grinding and can be worn at night to prevent the COVID-clench from doing its damage.

Naturally, you should also work on dealing with the issues that cause you to grind your teeth. During a pandemic, it’s hard to reduce stress and feel less tense. So, some protective oral appliances work best to ensure your teeth don’t suffer from excessive grinding. Over time, your grinding may subside, so you can stop wearing your mouthpiece to bed.

Contact Dr. Brown for a Zoom consultation

Do you suffer from cracked teeth due to excessive grinding? If so, contact us to schedule a consultation. Appointments are available in the office, but you can begin with a virtual consultation on Zoom. This ensures that your problem is assessed and treatment is deemed necessary. The consultation is entirely free, and you can schedule your in-office appointment at the same time. Here, you will undergo a thorough exam and assessment before being scanned for your custom-made oral appliance.

Can I Afford Dental Implants?

August 30th, 2020 by sbrown

It might be hard to believe, but the oral health situation in this country still isn’t where it needs to be. So many people struggle with their oral health, which leads to things like tooth decay, cavities, and oral diseases.

There are plenty of theories as to why people don’t visit the dentist as often as they should, from an underlying fear to having a bad experience as a child. But, not regularly getting your teeth looked at by a professional and having an oral examination can lead to unfortunate consequences.

As a dental practice, we believe that every patient should keep as many of their original teeth as possible. Unfortunately, things don’t always work that way. Whether you have lost teeth to decay, or you have teeth that are broken and need to be extracted, losing your teeth isn’t exactly a pleasant thing to life with.

But, dental implants can help.

What Are Dental Implants?

Dental implants are often the best option for patients with missing teeth. They are specifically meant to work with the existing bone tissue in your mouth to form a strong and sturdy “root”. This base acts as a platform for a dental crown, which will make your teeth look flawless.

Because dental implants are available in different sizes and even different configurations, they are extremely customizable and meant to fit almost anyone.

What Treatment Options Are Available Using Dental Implants?

Because dental implants can be used in a variety of ways, there are different types of implants, as well as different techniques to consider. Some of the most common include:

  • Implant-Supported Dentures: This is a fairly straightforward process in which traditional dentures are either supported by or attached to dental implants that are in the jaw bone. The dentures sit on top of the implants to give you the look of real teeth.
  • All On 4: This is an alternative solution for a full arch. Instead, four implants are placed within your own available bone. After following a modified diet for about six months so the gum tissue has a chance to heal and grow around the implants, permanent replacement teeth will be added, and you can resume your normal activities. This particular procedure eliminates the need for bone grafting.
  • Teeth in a Day: This process essentially streamlines implant-supported dentures. Rather than placing implants in the mouth, patients are fitted with either a fully-removable denture. It’s likely that the dentures will need to be adjusted a few times as you wait for a permanent denture, but this option makes it possible to have “teeth” right away without having to wait months.

If you’re not sure which of these options is right for you or you have questions about how they work, talking to Dr. I Stephen Brown or a team member at The Perio Group can help you to get the answers you need.

What is the Cost of Dental Implants?

There is no concrete number when it comes to the cost of dental implants. They are a very specific and customizable process for everyone, and the overall cost is impacted by everything from the number of implants you might require, to any additional procedures that may be necessary along the way.

With that being said, it’s important to look at dental implants as an investment, rather than something you’re paying for as a “quick fix” for your teeth. They are a long-term solution that will impact and improve your smile and oral health for years to come. Unlike options like crowns and bridges, dental implants can last forever.

So, it is important to compare the cost with other methods to determine the right option for you. Caps, crowns, and bridges will need to be replaced every 5-7 years, while implants are typically meant to last a lifetime. Dental implants also are less likely to cause any future dental problems, while other methods can sometimes increase your risk of decay or gum problems.

You will only be able to determine your actual cost of dental implants by sitting down for a consultation. At our practice, Dr. Brown is always happy to talk with patients about the benefits of dental implants and whether they are the best option for replacing your teeth. Again, keep in mind that all dentists want patients to keep as many of their own teeth as possible. But, if your current teeth are in bad shape or you’re missing some, short-term solutions like caps and crowns may not be your best solution.

So, you have to be the one to decide if you’re ready to invest in yourself and your oral health.

Making An Investment in Your Oral Health

What does that mean, exactly? Essentially, it means determining what you think your smile is worth. It means weighing out the benefits of dental implants and understanding how they will impact your life on a long-term basis.

Some of those important benefits include:

  • They feel, look, and fit like natural teeth, so there is no discomfort or irritation
  • They are made to last a lifetime
  • You can regain your confidence if you’ve been struggling with your smile for a long time
  • They can prevent bone loss and actually stimulate new bone growth

So, to answer the major question; can you afford dental implants? The answer should be a resounding ‘yes’. Though implants are an investment and may have a high price tag upfront, comparing them to the overall cost of other options makes it easy to realize that they are often the best solution. You won’t have to have extra work done on them or have them replaced every few years. So, a one-time investment can allow you years of a brilliant, beautiful smile.

If you’re interested in dental implants or any other options for tooth repair or replacement, feel free to contact us for more information. Our team will be happy to answer your questions or set up a consultation for you.

Tips for Managing Gum Inflammation

August 23rd, 2020 by sbrown

If your gums are tender or swollen, you may have gum inflammation. Gum inflammation is caused when plaque builds up along your gums and even under them. If you have blood on your toothbrush or appear when you eat hard foods like apples, you might have gingivitis. Gingivitis is an early-stage gum disease that causes inflammation and may lead to periodontal disease, a more advanced gum disease. Periodontal disease begins with inflamed gums but can cause bad breath, gaps between teeth and gums, and even loose or missing teeth. Here’s how to prevent gum inflammation and keep your mouth healthy.

Brush Your Teeth Twice A Day

Brushing your teeth after breakfast in the morning and when going to bed at night will help remove plaque and reduce gum inflammation. Brushing keeps the bacteria in plaque from attacking your gums, which is why brushing after eating is recommended for eliminating both residual plaque and any food debris. You should brush for 2 minutes for each session, using a soft-bristled brush. Avoid brushing your teeth too harshly, as this can make your gums sore.

If you are using an electric toothbrush, make sure you change the head every three-four months and replace regular toothbrushes after the same amount of time. When brushing your teeth, remember to brush behind your front and back teeth, without scrubbing too harshly along the gum line. Brush the top, front, and rear of your teeth, as well as your gums and tongue, in a circular motion to cover all areas of the mouth.

Make Sure You Floss

Dental floss is the best way to get between your teeth and remove the build-up of plaque that could cause bacteria to gather and lead to inflamed gums. Flossing once a day will help keep your gums healthy. Flossing after brushing will help clear up anything that your regular brushing might have missed.

If you’ve got bridges or existing dental work that makes flossing uncomfortable, try using water flossers. Water flossers send bursts of water out that can wash out plaque from between your teeth. Dental picks are suitable for hard to reach areas. However, plaque or dental scraping should always be done by a trained Periodontist like Dr. I. Stephen Brown to avoid damaging your gums.

Visit Your Periodontist

Visiting The Perio Group for regular check-ups, dental scrapings, or advice on gum disease is the best way to prevent gum inflammation. Over time, plaque can build-up into a hard coating on your teeth called tartar, which can only be removed by a dental scraping from your periodontist. Tartar can accumulate below the gums and cause irritation, inflammation, and, eventually, periodontal disease.

For more advanced gum disease treatments, Dr. Brown is considered a pioneer in treating with non-surgical techniques. Using laser gum treatment, The Perio Group can safely target the plaque or tartar, removing them from along and underneath the gum line to restore your gums to a healthy and uninflamed state. The procedure is known as Laser Assisted New Attachment Procedure (LANAP) and is the perfect way to treat advanced gum disease without more invasive techniques or a scalpel.

Eat More Vitamin C, D, And Calcium

Vitamin C helps fight periodontal disease by boosting the immune system and enhancing its ability to fight infection. Consuming either vitamin C supplements or taking it from fruit like oranges or lemons will have the same effect of reducing bleeding gums and keeping them in a healthy state.

Recent studies suggest that vitamin D plays a massive role in periodontal care, from maintaining healthy gums and reducing inflammation to helping the mouth heal after periodontal treatments. There is also 2020 research showing that vitamin D reduces the number of oral bacteria that directly cause gum disease. Vitamin D is found in mushrooms, fish like tuna or anchovies, and other seafood like shrimp or oysters. Spending time in sunlight will also boost your vitamin D levels.

Calcium not only boosts the health of your teeth and gums, with studies supporting reduced gum disease for those regularly consuming calcium. Calcium is found in milk, cheese, and other dairy products, leafy greens like kale or spinach, and bread.

Make Healthier Lifestyle Choices

Quitting smoking and cutting back on alcohol and excess sugar can help reduce the impact of gum inflammation. Smoking weakens your immune system, making it harder for your body to fight gum disease and more difficult for your gums to recover from gingivitis or damage. According to the CDC, smoking doubles the risk of gum disease.

Alcohol dehydrates the mouth, leading to an increased risk of gum disease. Alcohol also increases the concentration of harmful bacteria in the mouth, leading to gum inflammation. Non Drinkers have a better mix of bacteria (and more ‘good’ bacteria), which is considered healthier for your gums.

High blood sugar levels can cause the blood vessels to constrict and become damaged, reducing blood flow to different parts of the body. This can affect your gums in the same way, limiting the amount of oxygen and nutrients that meet the gums and making them more prone to gum disease and other infections. That’s why individuals with diabetes have an increased risk of gum disease.

Other Treatments For Advanced Gum Disease

Dr. Brown offers many treatments to combat periodontal disease. We’ve already spoken about LANAP and laser treatments, but The Perio Group also offers gum regeneration treatment, promoting the body to produce healthy tissue. We will safely remove any bacteria causing the disease, then use tissue-promoting proteins or bone grafts to encourage your gums’ healthy regeneration. This will reduce the depth of the pockets between your gums and teeth, reducing the recurrence of bacteria alongside an excellent oral hygiene regime.

Dr. Brown and The Perio Group are on hand for advice on the right oral hygiene procedures to reduce gum inflammation and advancement into periodontal disease. If you have a more advanced condition, we can still treat these with a range of surgical and non-surgical treatments to restore your gums’ health. Contact us today to find out how Dr. Brown and The Perio Group can keep your gums healthy.

Tips for Finding The Best Periodontist

July 30th, 2020 by sbrown

Periodontal disease is a serious condition that needs to be diagnosed by a specialist. Many patients reach out to a periodontist at different stages of gum disease discomfort. We have worked with patients who periodically experience several symptoms associated with periodontal disease, such as swollen gums, bleeding gums when brushing, receding gums, bad breath, deep pockets between the gums and the teeth, loss of jawbone and gums support for the teeth, etc.

But, periodontal care is only one of the reasons you may want to schedule an appointment with a periodontist. A periodontist can also provide permanent solutions for tooth replacement, as their extensive knowledge of gum and jawbone health can be associated with dental implant services. A gum specialist can also offer cosmetic procedures focused on the gum area.

These are some of the reasons why you would be looking for a periodontist. However, finding the best periodontist in Philadelphia for your needs can be tricky. If you are unfamiliar with periodontics, these are the factors you need to consider to find a periodontist you can trust in Philadelphia.

A periodontist is a specialized dentist

Periodontists are dentists who have specialized in the prevention, diagnosis, and treatment of gum diseases and the secured placement of dental implants. Therefore, the first thing you want to consider when looking for the best periodontist is their education.

Periodontists graduate from an accredited dental school with a DDS, Doctor of Dental Surgery, or a DMD, Doctor of Medical Dentistry, degree. After their degree, they pursue their education with specialist periodontal training in an ADA-accredited (American Dental Association) periodontology residency program. The training period can last between 3 and 7 years, after which they pass the relevant written and oral examinations to receive their national board certification by the American Board of Periodontology (ABP). Periodontists need to demonstrate updated knowledge and competence in their area of expertise and pursue further education and activities in periodontistry to be regularly recertified by the ABP. Therefore, the first check you may want to perform to find a periodontist in your area is to review their certification on the ABP website. Certified periodontists become Diplomates of the ABP.

At The Perio Group, we are proud to say that Dr. I. Stephen Brown has a DDS degree and is a Diplomate of the ABP. He is also a respected Fellow of the American and International Colleges of Dentist, the Academy of Osseointegration, and a Fellow and Diplomate of the Internal Congress of Oral Implantologists. Dr. Brown was the first doctor in the country to add adult orthodontics training to his periodontist specialization.

Different types of periodontal procedures

Depending on your mouth health, medical history, and periodontal requirements, you may find that periodontists can provide a variety of gum-related procedures.

Periodontists provide non-surgical gum treatment, such as deep cleanings, tartar and plaque removal, bacterial toxins removal, etc. Non-surgical treatments are sometimes referred to as scaling and root planing. In the early stages of periodontal disease, gum treatments can be followed by medicated therapy to manage periodontal health.

If your periodontal disease is more advanced, you will be looking for a specialist who has a history of performing effective gum surgery procedures, such as removing infected gum tissue and encouraging the body’s natural ability to regenerate gum tissue and bone.

Periodontists can also provide services that protect or restore your teeth, including reshaping excess gum and bone tissues and osseointegration – the process of binding an artificial tooth root into the jaw. Dental implants are associated with osseointegration.

Pain and healing management

No procedure is likely to be entirely pain-free. Nevertheless, if your pain threshold is low or prevents you from seeking treatment, you want to look for a periodontist committed to reducing patients’ discomfort and stress. We are proud to offer minimally invasive procedures that speed up recovery time. Dr. Brown can perform Laser Assisted New Attachment Procedure (LANAP) to eliminate infection and regenerate lost tissue. The Perio Group was also the first periodontics office to offer non-invasive gum-receding treatment in Philadelphia, with the Pinhole Surgical Technique.

We also appreciate that some of our patients may be nervous about periodontal procedures. We offer sedation dentistry to ensure our patients can feel as comfortable as possible during treatments.

A respected periodontist in their field

Finding a periodontist you trust takes time. But once you’ve considered their credentials and the types of treatment they offer, you can already get a better sense of their competences. A business that has been operated for several years is a sign that they are experienced, which can be an essential trust factor for patients who are worried about complex procedures. Reading online reviews about the business can provide sufficient insights into the quality of the treatments they offer and the level of satisfaction of other patients. Third-party reviews, such as Google Ratings, are an objective description of a periodontal business. We recommend that patients focus their attention on businesses that have 4 or more stars. Our periodontist, Dr. Brown, has been elected Top Dentist for the 11th time in Philadelphia Magazine 2020.

Additionally, you can also check the website for testimonials. If you prefer to judge the competence of a periodontist via visual clues, video or photo testimonials are the best source of information to find someone you trust.

Ease of making an appointment

You can’t afford to delay seeing a periodontist as it could aggravate your gum health issues. Therefore, it’s essential to consider an accessible location with suitable business hours.

At The Perio Group, we are dedicated to making appointment scheduling as stress-free and straightforward as possible. You can obtain an appointment via your doctor referral or directly get in touch with our team, (267) 828-1656. Alternatively, you can use the contact form on the website to schedule an appointment with Dr. Brown. We are committed to our patients’ health, which is why we also provide virtual consultations whenever possible during Covid-19.

Who Should Treat My Periodontal Disease?

June 30th, 2020 by sbrown

Your gum health is crucial to maintaining your mouth structure. As such, any health issue related to your gum needs to be treated in priority. Gum disease, or periodontal disease, refers to the bacterial infection of the gum. While it is a health condition typically diagnosed by your dentist, or directly by a periodontist, there are tell-tale signs that you can’t miss. The Perio Group has extensive experience dealing with gum disease, which is why we are adamant that you should seek treatment from us for any of the following conditions:

  • Bleeding gums
  • Bad breath
  • Deep pockets between your teeth and your gums
  • Receding gums
  • Swollen gums

While there may be more than one reason why you would experience the above-mentioned symptoms, combined, they could be the sign of gum disease. You need a specialist to provide the appropriate periodontal disease treatment, such as Dr. I. Stephen Brown, who uses laser and non-surgical alternatives to treat the condition.

Periodontal disease could turn into a recurring condition

It’s important to understand that your gums require the same maintenance and check up routine as your teeth to manage their health. While a dentist can perform essential routines, they are not specialized in gum health. Without appropriate treatment, gum discomfort could become a recurring health condition, which is how periodontal disease develops. Most patients are not aware that a periodontist can provide in-depth cleaning and maintenance to keep periodontal disease at bay. If you are at risk for gum disease, it is essential to schedule regular checkup appointments with Dr. Brown to:

  • Deep clean the area and keep your gums free of infection
  • Check plaque and tartar development
  • Provide gum health maintenance and prevent further risks

If your dentist suspects you may be developing periodontal disease, you are likely to be referred to a periodontist who will assess your dental and gum health. Alternatively, you can also reach out to a specialist and book your first appointment with a periodontist without any medical referral if you are worried about your gum health.

Before recommending the most appropriate periodontal disease treatment, periodontists need to review your dental and medical history. They will also ensure they understand your lifestyle and are aware of habits that could aggravate gum disease, such as smoking, for instance. Additionally, some medications can interfere with periodontal treatment. Oral contraceptives, for example, can affect the treatment.

Patients can expect a periodontist to perform a full examination of the teeth and gums, but also the whole mouth, the throat, head, neck, and jaw joints, along with X-rays of the mouth. These are important steps for recommending periodontal disease treatment options for your unique situation.

A periodontist is specifically trained

A periodontist is a specialist in the prevention, diagnosis, and treatment of periodontal disease. Your general dentist has extensive knowledge of your unique dental and medical history, which can help recognize early signs of gum disease. But when it comes to treating periodontal disease, your dentist will most likely refer you to a professional who is specially trained in gum health management. At The Perio Group, we recommend that our patients maintain a close relationship with their dentist and periodontist to protect their full mouth health.

Your dentist can provide some level of care for periodontal needs, such as cleaning your gums or treating mild gum conditions. However, a periodontist is better suited to provide periodontal disease treatment for patients with severe gum disease or complex medical history.

When can a dentist treat periodontal disease?

Your general dentist can provide maintenance and preventive care for both your teeth and gums. If you don’t experience any severe gum health issues, your dentist can safely perform essential cleaning and diagnosis.

However, your general dentist is not trained to handle gum disease treatment for patients who have aggravating medical conditions and medical history, such as:

  • Immune problems
  • Smoking
  • History of diabetes
  • Senior patients

Additionally, a periodontist is the best contact for periodontal disease treatment if you experience the following gum health issues:

  • Deep pockets of 6mm or over
  • Loose teeth
  • Bone loss between the roots of the teeth
  • Exposed roots of teeth through receding gum
  • No firm gum tissue around the teeth
  • Recessing risk factor

If your dentist can’t treat your periodontal disease safely, you will be referred to a gums specialist.

What difference does a periodontist make?

A periodontist makes the same difference as any specialist doctor makes compared to a generalist physician. A periodontist’s extensive training includes advanced knowledge and techniques to provide the most suitable periodontal disease treatment for each unique patient, including patients who may require more complex treatment options. Additionally, a periodontist is also trained in cosmetic gum-related procedures to achieve the best possible outcome.

At The Perio Group, Dr. Brown is committed to the comfort of his patients. Therefore, he is a pioneer in using less invasive and more precise laser technology, LANAP, for gum surgery. LANAP can play a significant role in the recovery process, especially for patients whose medical history makes them ineligible for surgery. The laser gum treatment offers an alternative to periodontal surgery that can gently and safely remove infected gum tissue.

We are proud to say that Dr. Brown is the first periodontist in Philadelphia to use the non-invasive pinhole surgical technique for receding gums. The pinhole surgical technique presents an alternative to the gum grafting surgery procedure that can lead to increased discomfort and prolonged recovery time for patients.

Should you go to a periodontist without a referral?

Periodontists are specialists in gum health, including periodontal disease treatment. However, if you have concerns about your gum health, we recommend reaching out to your general dentist to discuss your worries. Indeed, your dentist can help confirm a gum disease diagnosis or find another cause for your symptoms.

If your dentist confirms the periodontal symptoms or you are already familiar with periodontal disease, our team at The Perio Group will be happy to help. You do not need a medical referral. You can seek support from our own periodontist, Dr. Brown, by scheduling your appointment online. We also provide virtual consultations to keep on top of your gum health during Covid-19. Contact us to schedule an appointment today!

Bad Breath and Your Overall Health

May 30th, 2020 by sbrown

When it comes to bad breath, a lot of people assume that it’s merely an embarrassing problem, and not linked to your general health in any way. However, a lack of oral hygiene doesn’t simply cause bad breath. There are a wide number of health-related issues that can impact your health.

The fact is that at one point or another, almost everyone will experience bad breath. For some people, bad breath is a daily problem; for others, it happens every so often and isn’t a significant cause for concern. Around 30% of the population has experienced bad breath at one point or another – it’s a fairly common health complaint and usually a benign one.

Commonly, bad breath occurs after waking up in the morning or after eating food containing high amounts of garlic or onion. Coffee and smoking can also cause bad breath, as can being on a calorie-reduced diet. A lot of people don’t notice that they have bad breath and learn about it from a friend, family member, or co-worker who mentions it to them, causing upset and embarrassment.

What causes bad breath, and how is it linked to your general health?

Internal and external factors: Bad breath can originate both inside and outside of your mouth. Often, bad breath is caused by bacteria that collect on the teeth and tongue and cause foul-smelling breath. Often, poor oral hygiene can lead to bad breath, as can dental problems such as cavities, mouth abscesses, and gum disease.

Infections: Infections and illnesses, such as tonsillitis, respiratory infections, sinusitis, and bronchitis, as well as gastrointestinal disease, can cause bad breath.

Disease: Certain diseases in their advanced stages, such as liver and kidney diseases, can also cause bad breath to occur. Uncontrolled diabetes can also cause bad breath to occur. However, it’s important to note that in these cases, a person will almost always have other symptoms alongside their bad breath.

How to manage bad breath?

When it comes to managing bad breath, the most crucial factor is to have the underlying cause diagnosed. If you are taking care of your teeth and gums, and your oral hygiene is up to scratch, then the chances are that it is not an oral hygiene problem causing your breath issues.

In the first instance, you should make an appointment to see your doctor and advise you about the steps you should take to manage your bad breath. They may be able to suggest a treatment route or refer you to an ear, nose, and throat specialist for further testing and support.

If you are concerned that it is a dental issue, then seeking support from Dr. I. Stephen Brown should be the first step. He will be able to check your teeth and gums and determine whether there is an oral problem causing your bad breath, or whether there is another underlying cause that needs to be investigated. Contact us to schedule an appointment today!