Biofilm, the protective housing for bacteria, is a hot topic in the medical and dental fields. Routinely taking an antibiotic for a bacterial infection has become more complicated because of biofilm. Bacterial infections may become resistant to antibiotics in part because the biofilm allows for communication among the bacteria, allowing the infection to be sustained.

You’re probably wondering, Drs. Darrin and Greg Gremban , what does this have to do with teeth? Since we’re dental professionals, we can tell you why it’s important and what you should know! There is biofilm in your mouth; healthy biofilm and diseased biofilm. Both are made of the same general compounds, but when combined with certain amino acids and cellular chemicals, the diseased biofilm conquers and destroys.

Periodontal disease, otherwise known as gum disease or pyorrhea, is a biofilm disease. If you are undergoing treatment for gum disease and you do not continue with the treatment plan the disease will progress and/or spread due to the biofilm.

There are several ways to treat diseased biofilm. But remember, antibiotics cannot touch the bacterial infection if the biofilm is established.

When your exam is complete, the Ultrasonic or Piezo Scaler should be used. This method of spraying water disturbs the biofilm and provides an opportunity to treat the infection causing bacteria.

Remember, we all need healthy biofilm. Just as your skin protects your body, biofilm housing good bacteria protects your body. The bacteria in the biofilm replicate every twenty minutes. If your body has healthy bacteria, low levels of hydrogen peroxide are produced by the biofilm, preventing harmful bacteria from residing. Harmful bacteria do not like oxygen.

At your exam, we will take measurements around your teeth checking for “pockets”. The higher the number, the deeper the pocket giving more room for harmful bacteria where there is no oxygen. Ask what your numbers are and be involved in restoring your healthy biofilm.

One of the most important parts of staying healthy as we grow older is being open to learning new ways of staying healthy! While worrying about braces or wisdom teeth might be a thing of the past, there are new dental concerns that come with mature years. Taking care of our gums is one way to maintain not only our dental health, but to look out for our overall health as well.

• Periodontal disease is preventable for older adults

While gum disease is all-too-common among older adults, it isn’t really a result of the aging process itself. If you have been keeping a regular schedule of brushing and flossing (two minutes twice a day), and have been making routine visits to our office for exams and cleaning, you probably have avoided gum disease. But if you have been neglecting your dental care, gingivitis and periodontitis are conditions that only become more serious over time.

The first symptoms of gingivitis include puffy, swollen gums that may bleed easily. Persistent bad breath and changes in the bite or the fit of dentures are also indications of gum disease. As gum disease progresses it leads to periodontitis. The gum tissue pulls away from the teeth, leaving deep pockets of tissue where plaque can collect and infections can develop. Infection, left untreated, can lead to loose teeth and even bone and tooth loss.

The good news? It is never too late to treat gum disease. Most gingivitis is reversible, and modern periodontal treatment makes use of deep cleaning, antibiotics, and even gum surgery to restore gum health. Don’t let past neglect lead to future tooth loss. We are happy to see you any time to treat your gums and teeth and to let you know ways to protect them for a happy, healthy future.

What new concerns do we face as we age?

• Our gums recede.

This natural recession can lead to the exposure of the root areas of the teeth, which are more vulnerable to cavities. It’s very important to keep up with brushing, flossing, and regular check-ups to catch potential small problems before they become big ones.

• Old fillings and dental work can break down.

Call our Eagle River office any time you notice a problem with a filling, and keep up with exams, where we can pinpoint fillings that need replacement and detect cavities that can develop near the edges of old work.

• Medications can cause side effects that affect our gums.

Some medications cause the growth of puffy gum tissue. Some can cause dry mouth, which can lead to gum disease. Always let us know about any health conditions you have or medications you may be taking. We can suggest a number of options to reduce or eliminate effects on your mouth and gums.

• Gum health and our overall health—what’s the connection?

While no one has discovered an absolute relationship between gum disease and other health problems, there is growing evidence that higher rates of diabetes complications, heart disease, and stroke are linked to higher levels of gum disease. Make your medical and dental health a priority.

• Smoking risks increase with age.

Studies have shown smokers have not only a greater risk of gum disease, but more severe gum disease as well. Your risk of developing oral cancer also increases with every year you smoke. It is never too late to quit! Talk to us about suggestions for breaking the habit once and for all, and be sure to keep up with regular checkups for early detection and treatment of any oral diseases caused by smoking.

Please let us know any changes that have taken place in your dental habits, medical condition, or medications. Talk to us about any periodontal concerns you may have, or the latest dental procedures we offer for gum care and treatment. We can let you know about products that can make brushing and flossing easier as you age.

It’s never too late or too early to think about taking care of yourself. We are happy to offer suggestions for maintaining or restoring your dental health that will serve you well in any chapter of your life.

TMJ is the quick way of referring to your Temporomandibular Joint. Pardon the pun, but that’s quite a mouthful! What is this joint, what does it do, and, if your Drs. Darrin and Greg Gremban and our team have told you that you have a TMJ disorder, what can we do to help?

The Temporomandibular Joint

Your two temporomandibular joints are amazing works of anatomical design. These are the joints where the temporal bone in the skull meets the mandible bone of the jaw, and allow our mouths to open and close, move back and forth, and slide from side to side. Muscle, bone, and cartilage work together to provide easy movement and to cushion the joint. But sometimes, the joint doesn’t work as smoothly as it should, and this can lead to Temporomandibular Joint Disorder, or TMD.

When Should You Suspect You Have TMD?

You might have TMD if you experience any of these symptoms:

• Painful chewing
• Pain around your TMJ, or in your face or neck
• Earaches
• Changes in your bite
• Jaws that are limited in movement or lock open or shut
• Clicking, popping or grating noises when you open and shut your jaw

There are many conditions linked to TMD. If you grind your teeth at night, have arthritis in the jaw, have suffered an injury or infection in the area, or have problems with your bite, for example, you might be more likely to have TMJ problems. If you suspect you have TMD, or suffer from any of the symptoms listed above for an extended period, give us a call.

Treating TMD

During your visit to our Eagle River office, we will check your medical history, and examine your head and neck. We can take an X-ray or scan if needed for further examination of the joint. Because there is no real scientific agreement yet about the best way to treat TMJ disorders, a conservative treatment plan is often best. If you do show signs of TMD, we might first suggest relaxation techniques, over-the-counter pain relievers, or the use of ice packs or moist heat compresses. A change to a softer diet can help, and you should stop chewing gum and making any exaggerated jaw movements.

If these self-care practices aren’t effective, we might suggest a nightguard. This appliance is a comfortable and flexible mouthguard custom fitted for you, and will bring relief from teeth grinding when worn at night. If this treatment is not effective, talk to us about other options.

Luckily, most cases of TMD are temporary and don’t become worse over time. But any persistent discomfort is a good reason to visit us. Whether you have TMD, or any other problem causing you pain in the head or jaw, we want to help.

Snoring may not be something you take seriously. You might even laugh or joke about it. But the fact is, anytime you or your partner snore to the point of waking, it could be a sign of serious health problems.

Sleep Apnea and Its Effects

Sleep apnea is a sleep disorder that is potentially dangerous, and the most common symptom is loud snoring. Breathing repeatedly starts and stops throughout the night, and you wake up feeling tired. Other serious effects from sleep apnea could be potentially dangerous to your health if left unaddressed.

Besides losing a good night's sleep, you may experience difficulty concentrating. Depression, risk of heart attack, irritability, high blood pressure, memory loss, sexual dysfunction, and chances of stroke all increase when sleep apnea is not treated.

Sleep apnea occurs when the muscles in the back of the throat relax to the point of inhibiting natural breathing. The muscles used to support the soft palate relax and the airway closes, causing breathing to stop for ten to 20 seconds. This lowers the oxygen level in the brain. As the brain senses the inhibited oxygen levels it rouses the sleeper awake so the airway can reopen. Normally, the reawakening is so brief the person won't remember it.

If you think you may have sleep apnea, visit our Eagle River office and let Drs. Darrin and Greg Gremban determine what treatment is needed. Without it, you could risk losing more than a restful night's sleep.

Prevention and Treatment

Anyone can develop sleep apnea, but it is more common among middle-aged adults who are overweight. Drs. Darrin and Greg Gremban can help you determine the cause and suggest positive treatment.

A common treatment for apnea is the placement of oral devices that are designed to help keep the airway open. By bringing the jaw forward, the device opens the airway and thereby discourages snoring. We are experienced in sleep apnea appliances, and Drs. Darrin and Greg Gremban can prescribe a fitted device and monitor its success with follow-up therapy.

A continuous positive airway pressure mask, known as a CPAP, is among the other treatment options. A mask is fitted over the mouth and forces oxygen through the throat while you sleep. The pressure holds the soft tissue and throat muscles open.

Our professionals at Gremban & Gremban Dental can advise you of other ways to prevent sleep apnea, including weight loss, avoiding alcohol, or alternative sleeping positions. We can help you sleep return to easy sleep, knowing you are safer and healthier during your resting hours.