Q: Can laser teeth whitening do any damage at all to my teeth or gums? I’d really like to have whiter teeth, and am trying to weigh the pros and cons of different methods. One thing I’d like to know is if there’s any possibility of permanent damage being done.

A: If you are considering whitening with a laser, find out what kind of laser and the wavelength the doctor will be using. Not all lasers are the same. Some target sensitive tissues if not used correctly. Please also make sure you don’t have any gum disease or gum recession, perhaps seeing a laser trained periodontist before any treatment.

Q: Does laser teeth whitening damage teeth or gums?

A: This should not be an issue for you to have your teeth whitened with a laser. You might want to know which laser the doctor will be using because not all lasers are the same. The wavelength is critical as is the amount of laser energy applied. Be sure to have a periodontal clearance done before treatment and check the doctor’s reviews and perhaps ask for patient references.

Q: Can laser surgery on my gums get rid of a black dot in my upper gum? My dentist said that is was a “mole”, but I really want an answer from an expert.

A: The first thing to get is an accurate diagnosis of what the black dot is. Assuming that it is a lesion that doesn’t need to be biopsied, then a ND/YAG 1064 can be used to remove pigmented lesions in the mouth and elsewhere.

Q: My hard palate cracked during the dental extraction and is now a functional issue. Which doctor is best suited to fix it: an ENT, an Oral surgeon, or a neurosurgeon?

A: You need to see a well-trained oral surgeon. If you need a further referral to an ENT, they will guide you.

Q: How many people see a periodontist for cleaning?

A: Most of our patients who have completed active treatment will be seen on the average every three months to maintain their periodontal health.

Q: Is there any way I can get rid of gum disease without a root canal or buying products?

A: A root canal is different than gum disease treatments. Think of the inside of the tooth as lead in a pencil. The lead has to be removed because of infection in the nerve of the tooth and a rubber material (usually gutta percha) is placed in the canal of the root. Gum disease surrounds the teeth and has little to do with the nerve in most cases. We don’t recommend you buy products.

Q: I had a root canal done and it seems the artificial tooth isn’t fitting properly to my gum. Would it be detrimental to my gum? I know it’s not fitted correctly or the artificial tooth isn’t shaped correctly because whenever I chew on something, my gum starts to ache. After taking couple of aspirin, the throbbing from my gum went away. I called the dentist but their attitude is it would be alright after a while. If I leave it alone with the way my root canal tooth was done, would it be detrimental to my gum and to my overall health? Is the attitude of my dentist something I should complain about to the Dental Association?

A: I would suggest a second opinion with another dentist.

Q: I already had a root canal done. Several months later, I had an x-ray done and there was a small gap between my permanent crown and my gum. And whenever I finish eating, I must floss to get the food out between the space, or it feels very uncomfortable. If I leave it alone, what kind of damage would my gum have? I don’t think there is any sign of infection but I’m afraid it would harden my gum.

A: I am not sure exactly what this “gap” is from your description. Is there a gum pocket present? Does the crown have the proper contact and emergence profile? Is there an open contact? Does the floss drop in the space without any contact? It would be useful to see the x-ray, but short of that, maybe have a Periodontist examine you and give you another opinion.

Q: My gums have receded a little after extraction followed by gum grafting (eye tooth). Is this normal? Now I have spacing between the temporary tooth and gums.

A: It is not uncommon after extractions to have the gum shrink.  We routinely bone graft, laser, and soft tissue augment to avoid this result. You can speak to your dentist about relining the temporary tooth to make it look more natural.

Q: My son has three frenulums on his upper gum. One in the middle attached between his front teeth, and one on each side of his upper gums. When he was four months old, the frenulum under his tongue was clipped, but I never noticed these other ones before. Are they normal?

A: Frenums are normal anatomical structures. They become a problem when they pull on gum tissue causing what we Periodontists/ Dentists call muco-gingival defects. This could lead to gum recession. Sometimes these frenums need to be “clipped” as you have mentioned. Many times these tissue structures prevent teeth from erupting. An experienced Periodontist could take a look and guide you through the process. I highly recommend a Laser trained Periodontist if anything needs to be done.

Q: Thank you for the heads up. When we got his frenulum under his tongue clipped it was with scissors. What is the advantage of the Laser?

A: Quicker, faster healing, no bleeding, minimal post-operative discomfort…we have been using the laser for this and many other procedures for eight years and are teaching this technique to our post graduate residents in Periodontology at Columbia University.

Q: I had an apicoectomy above tooth no.7. Then 6 months later, I had new crowns placed on teeth 7, 8, 9, and 10. Immediately afterwards, my gums flared up, especially above tooth no. 7. The gum there is very puffy and bleeds very easily. Another general dentist told me the new crown was placed too close to the bone – biologic width and whatnot. He said he would either change the crowns (which I cannot do because they’re new and cost a lot) or he would fix it for me, which will most likely recess my gums. I’m very upset. Are there other options? Thank you.

A: I’m so sorry that you are having this issue. If the crown violated the biologic width, then you might have to consider periodontal work and most likely new crowns. I would strongly suggest a consultation with a very experienced Periodontist to see what can be done. Unless you are willing to live with a very unaesthetic result – and most people are not – I would not risk gum recession as a side effect. Maybe you could speak to the dentist that did the original work and see what they suggest?

Q: I have a red bump under a partial on my gums. It does not hurt, but is a little sore when I put my partial in.

A: It is difficult to diagnose without examining you. I would strongly suggest a visit to a Periodontist who will examine the lesion. This could simply be a sore spot rubbing on the area. HOWEVER, I would still get the consultation to be safe.

Q: I survived a brain aneurism, but afterwards my gums hurt badly. I was told that I had periodontal disease and needed my teeth pulled. This was done in 2010. I also have Bell’s palsy. I am in severe pain to this day and I have sharp pain running from my gums to a shunt in my head. I have white lesions and swelling on all of my gums. I cannot even bite into a peanut butter sandwich. When I eat anything my eyes tear up due to the pain!

A: Please see if you can find a Periodontist who will do a complete evaluation and use a quality set of digital x-rays to determine the prognosis of your teeth. It would be preferable if they have laser training using the FDA cleared protocol. The procedure is more patient friendly, with excellent results.

Q: I had the LANAP procedure done in November and am completely happy with the results. My doctor did some grinding to correct the way my teeth “fit” together, not just the bite, but the width of the six front upper teeth. I have been wearing the retainer as instructed and was told that I could just wear it at night now. My problem is that after a couple of hours there is a noticeable gap between my two front teeth, so I wear the retainer almost all the time. Will this problem resolve itself or is there something else that needs to be done?

A: You might want to have some of your teeth evaluated for bonding/splinting to retain the teeth twenty four hours a day in the correct position. I would suggest discussing this with your periodontist in more detail.

Q: How does a mouth tray help in dealing with periodontal disease?

A: If you mean a mouth guard, that’s a piece of plastic that fits over the teeth which prevents you from grinding and clenching them. Grinding and clenching results in what is called occlusal trauma. If you have preexisting gum disease, it makes it more destructive.

Q: Do you recommend the use of a perio tray for gum disease?

A: We don’t use that as a routine procedure in our office because the therapeutic model that we follow makes it unnecessary. We use laser treatment and certain rinses. We’re not big on the perio tray.