Thursday, February 28, 2013

February Dental Month

Are your Two & Four-legged Kids Brushing?

February is a month filled with many holidays such as President’s Day, Valentine’s Day, Groundhog Day, Mardi Gras, and many others.  However, February is also a great month in dentistry!  February celebrates National Children’s Dental Health Month as well as National Pet Dental Health Month.  Drs. Versman, Heller, and Beckman do not practice dentistry on pets, but this is still something to celebrate and bring awareness to.  Let us explore how these two topics bring better dental health to the whole family.

During February, The American Dental Association, Denver Dental Association, Periodontal Associates and other dental offices in Denver and nationally rally together during this month to raise awareness among families about the importance good oral health habits in children.

Dental awareness specifically for kids originally began in Cleveland, Ohio in 1941. Then the American Dental Association held the first national observance of Children’s Dental Health Day on Feb. 8, 1949. This single day observance became a week-long event in 1955, and in 1981 the program was extended to a month-long celebration known today as National Children’s Dental Health Month.
Local dental societies take great pride in celebrating National Children’s Dental Health Month during the month of February.  Dentists, hygienists, and dental assistants throughout Colorado volunteer their time and expertise to conduct oral health screenings and provide educational programs in schools and for community organizations.  In fact, Dr. Eric Beckman worked an entire day giving free exams to children and checked not only for cavities, but for early signs of periodontal problems.  Dr. Beckman was a part of Give Kids a Smile.  This is a campaign that has been running for the past 9 years.  This event was held in Denver, CO on February 3rd this year.  Dentists like Drs. Versman, Heller, and Beckman, as well as general dentists, come together to provide free dental care for thousands of children every year.  Give Kids a Smile focuses on providing dental education and services to not just families without dental insurance but focuses on low income families.  

Dr. Versman, Dr. Heller, and Dr. Beckman hope to raise awareness about the epidemic of untreated dental disease occurring in Aurora, Denver, and across Colorado and across the country.  Low income families and children are more at risk for dental disease as access to dental clinics is limited for families when they are unable to afford proper transportation or a day off of work.  Not only do financially strained families have difficulty seeing a dental professional, but the education about proper home oral care is lacking.  The average person in Colorado only brushes their teeth for thirty seconds which is less than the recommended two minutes twice daily.

Periodontal Associates is a kid friendly periodontal office.  Although we do dental implants on adults, many kids seek out Drs. Versman, Heller, and Beckman to deal with receding gums, especially when going through orthodontic care.  Chronic gingivitis is common in children. Gingivitis is when gum tissue swells, turns red and bleeds easily. More aggressive periodontitis is seen in teenagers, but nevertheless, gum disease does occur in children. 
Drs. Versman, Heller, and Beckman do suggest parents to establish proper oral hygiene habits in their children as early as one year old.  Also, it is important for parents to be a good role model for their children to follow, making brushing and flossing more exciting and not a chore.  Lastly, be sure to schedule regular visits to Periodontal Associates for periodontal exams and cleanings.

February is Children’s Dental Health month and to some families, their pets are their children so it is fitting that February is also Pet Dental Health month.  Dogs and cats can have gum disease?  Yes, many pets suffer from gum disease and tooth decay just like us.  According to the American Veterinary Dental Society, more than 85 percent of dogs and cats show signs of oral disease by age four.  Dr. Ken Versman and Dr. Doug Heller both have dogs, and just as they come to Periodontal Associates for their bi-annual cleanings, their pooches also visit their local veterinarian for deep cleanings.  Just like with humans, food particles and bacteria build up in the dogs’ mouths, forming plaque and tartar, which leads to inflamed gums.  With a lack of oral hygiene, periodontal disease can progress into an irreversible condition causing decay, bleeding gums, bad breath, and tooth loss.  This is the same for both humans and dogs, but most people do not realize when their pet is dealing with gum disease until a tooth becomes stuck in their favorite squeaky toy.   Unfortunately, Drs. Versman, Heller, and Beckman can provide you with dental implants, but your pup would be left with a gummy smile.  The image of a smiling, gummy mouthed dog might be cute, but severe gum disease can lead to infections, sometimes serious enough to cause organ damage or even death.   
Cats also suffer from dental problems.  One significant concern for cats includes tooth resorption. Dental resorption is when the body cells destruct part of a tooth.  It is unknown if this is a result from periodontal disease or an autoimmune disease so it is important to keep your pet on regular oral hygiene maintenance as well as up to date on check-ups.  Whenever these cavity-like defects occur in pets’ teeth, it can become very painful if left untreated.  In most cases, extracting these teeth is best for your furry friend.   However, without proper regular hygiene maintenance dental disease like this and severe periodontal disease can lead to full mouth extractions for your kitty. Drs. Versman, Heller, and Beckman do not treat cats, but the education they give to their patients is still applicable to their pets, too!

There are many commonalities between oral health for both two-legged and four-legged children.  With each category, good early habits are important in making dental care both fun and tolerable in kids and pets.  Regular cleanings, at home and dental offices, and exams by dentists like Drs. Versman, Heller, and Beckman or veterinarians are the only ways to prevent gum disease and maintain a beautiful healthy smile.  

Although, Periodontal Associates cannot answer all of your questions regarding your pet’s health, we strongly urge you to call our office at (303) 755-4500  or click here with any questions and to set up your next exam or cleaning.  Drs. Versman, Heller, and Beckman are specialists in treating gum disease for both you and your child.  To learn more, please visit our website at 

Monday, February 18, 2013

Political Teeth

Mouth Full of Wood?

Happy President's Day!  President's Day is often a day for people to sleep in late, hang with friends, and enjoy one less day of work.  However, the origin and history of President's day is often forgotten, and Drs. Versman, Heller, and Beckman want to share with you the true meaning on this holiday as well as some fun dental facts about our beloved presidents.  

The beginning of President's Day started with George Washington's birthday becoming a federal holiday in 1879.  His birthday was celebrated on the actual day of February 22nd; however, on January 1, 1971, the federal holiday changed to the third Monday in February.  This date places it between February 15 and 21 so it never falls on Washington's actual birthday.  The change worked out well though as it was then renamed as "Presidents' Day" to honor the birthdays of both Washington and Lincoln. Lincoln's birthday is on February 12th so President's Day is a good middle ground to celebrate the birth of two of the most influential presidents in history.

Drs. Versman, Heller, and Beckman love to look back on history but specifically on dental history.  Not only is George Washington the reason for this extra day off work, but Washington has some interesting dental facts and misconceptions.

Washington's teeth has seemed to be a well discussed and misleading topic.  Many people are aware that Washington wore dentures.  In fact, during Washington's inauguration he only had 1 single real tooth.  George Washington could really have used Dr. Versman, Dr. Heller, and Dr. Beckman's help by providing some dental implants, but back then he did not have many options nor knowledge on proper oral hygiene.

It was also believed that Washington's dentures were made out of wood until researchers in Baltimore performed laser scans on a set of the dentures at the National Museum of Dentistry.  What were they made out of then?  The scan revealed gold, ivory, lead, human, and animal teeth as ingredients for these famous chomps.  The dentures also had springs and bolts to assist Washington with opening and closing.  During the times of Washington's life, these dentures were very high tech; however, dental implants have evolved greatly over time and Drs. Versman, Heller, and Beckman provide the highest quality and lifelong lasting dental implants to their Aurora patients (without wood, lead, or animal teeth).

Washington resorted to the use of dentures for multiple reasons.  At Periodontal Associates, our patients come to Drs. Versman, Heller, and Beckman for dental implants as the result of physical harm, gum disease, grinding, bone loss, or other factors.  In George Washington's case, he was an avid horseman which involved some physical accidents, and oral hygiene practices were not what they are today causing him to severe gum disease.

Many people, including other presidents, suffered the consequences from improper oral care.  For example, Ulysses S. Grant smoked 20 cigars a day!  Little did he know that this habit would ultimately cause his death due to oral and throat cancer.  Smoking is a habit that Drs. Versman, Heller, and Beckman strongly suggest their Aurora patients to stray from as  it results in not only cancers but severe gum disease. At Periodontal Associates we know that research has indicated that smoking and tobacco use is one of the most significant factors in the development and progression of gum disease. In addition to smokers experiencing a slower recovery and healing rate, smokers are far more likely to suffer from calculus (tartar) build up on teeth, deep pockets in the gingival tissue and significant bone loss.  If only Ulysses S. Grant was able to come to our office in Aurora, CO, think of the way we could help him! 

But on a lighter note, did you know that Ulysses S. Grant loved to play ding-dong ditch?  He would ring the doorbell at the White House and then run and hide.  I guess no matter our position or age, we are all still kids at heart.

Periodontal Associates honors George Washington and former presidents for their good influences on our country, and it is nostalgic for Drs. Versman, Heller, and Beckman to look back on not only America's history but the also the history of dental health and technology.  Luckily, Periodontal Associates contains specialists in providers of dental implants and treating gum disease without the uses of wood or ivory.  To learn more about the latest in dental implants and how to prevent periodontitis, please contact us at (303) 755-4500 or visit our website at We highly encourage you to call or click here to make an appointment to see Drs. Versman, Heller, or Beckman at our office in Aurora, CO, serving the Denver metro area.   We look forward to helping you have a smile worthy to be placed on the dollar bill!

Tuesday, February 12, 2013

Replace or Save Tooth?

To Save a Tooth or Replace It:  That is the Question

One of the most difficult decisions Periodontal Associates has to make is when to save a tooth and when to remove and replace it.  This is a difficult decision on many levels.  Numerous factors must be considered including the restorability of the tooth, the patient's susceptibility to disease, gingival and papillary conditions, and esthetics in weighing the benefits vs. risks of retaining a compromised tooth.  The decision may be based on one critical issue or on a collection of factors.  In this blog entry, Drs. Versman, Heller and Beckman will discuss these factors which need to be considered in deciding whether to remove or save a tooth.  As always, Periodontal Associates welcomes your comments and suggestions so feel free to comment here, call our Aurora office at (303) 755-4500, or please stop in!

Our goal at Periodontal Associates is to maintain or reinstate good form and function to the dentition with excellent esthetics and health. Fundamental to developing a dental treatment plan, a prognosis must be assigned to each tooth.  Can it be saved?  Should it be removed and replaced with an implant?

Osseointegration and periodontal regeneration are two significant advances in contemporary dental care and each should be utilized when appropriate. The natural dentition responds very well to definitive periodontal treatment.  And there is significant evidence that efficacious periodontal treatment can change the prognosis of a tooth from hopeless to good.  Dr. Versman, Dr. Heller, and Dr. Beckman always try to use periodontal cleanings and treatment first if they believe the tooth is savable. Extracting teeth which had lost supporting periodontium and replacing them dental implants is not always the preferred treatment approach.

Implant replacement is not infallible and does not mean the patient will not experience future complications. While osseointegration has reduced the need to save teeth with a marginal prognosis, there has been a significant rise in the incidence of peri-implant disease and bone loss associated dental implants.

Greenstein et al raise several questions when deciding whether a tooth should be saved or replaced.

These include:
1. Can the tooth be restored effectively?
2 Will endodontic treatment be successful?
3. Is periodontal therapy a reasonable option?
4. What effect will extraction have on the final treatment plan , particularly with respect to esthetics?

Restorative Considerations

Drs. Versman, Heller, and Beckamn know that an effective restoration can return teeth to normal function and acceptable esthetics. Teeth without extensive caries, a favorable crown/root ratio and adequate tooth structure offer the best prognosis for effective restoration.

Fracture and Faulty Restorations.  If a tooth is fractured, Dr. Versman, Dr. Heller, and Dr. Beckman man their best judgement to determine restorability.

Restorations must not infringe on the biologic width which can result in chronic gingival inflammation, pain, and clinical attachment loss.

Problematic teeth in the esthetic zone which require a crown lengthening procedure should be evaluated for replacement because these measures may result in an unesthetic appearance due to excessive tooth length.

Essential to cosmetic success, Drs. Versman, Heller, and Beckman perform a complete evaluation of the smile line and other factors.

Caries.  Decay which extends beyond or to the level of the alveolar bone usually represents a restorative challenge for Drs. Versman, Heller, and Beckman and increased treatment costs for the patient.

If a tooth is restorable, orthodontic extrusion, crown lengthening, or mucogingival surgical procedures may be required to salvage the tooth.  If this is necessary, Periodontal works closely with your general dentist in the Denver area to provide a thorough and individualized treatment plan.

Crown/Root Ratio. Teeth without loss of attachment or destruction of periodontal tissues usually present a favorable crown/root ratio and consequently are good candidates for restoration.

A 1:1 crown to root ratio is the minimum acceptable assuming the periodontium is healthy and the occlusion is controlled.

Remaining Tooth Structure. Teeth with 5mm suprabony structure, 2mm for the biologic width, 2mm for the ferrule and 1mm sulcus depth are candidates for effective restoration.

Often the length of the available tooth structure is insufficient to ensure the preservation of the biologic width and crown lengthening may be required.  Crown lengthening is a routine procedure that periodontists like Drs. Versman, Heller, and Beckman are specialists in.

Depending on if the patient need additional treatment like crown lengthening, this makes the final cost similar change.

The final decision to save the tooth or place an implant is often linked to financial considerations and the concerns for longevity of the results as opposed to the possibility of saving an already compromised tooth. Periodontal Associates prides ourselves in working with our patients to come up with a treatment plan that fits each individual best in terms of finances but most importantly health.

Endodontic Treatment

Survival rates for endodontically treated teeth have been estimated to be as high as 95% when associated with an excellent full coverage restoration -- if the tooth is treated with a well-fitting single-tooth crown with adequate ferrule.

Avila et al suggest the clinician should consider removing the tooth and replacing it with a dental implant if:
  • The tooth has a large apical lesion (greater than 5mm).
  • The tooth has had apical surgery.
  • The tooth needs a large post and core for support.
  • The tooth has inadequate ferrule.
  • The tooth has an abnormal root anatomy precluding successful endodontic obturation.
  • Th tooth has a root which is short or thin which will cause a post to predispose the tooth to post loosening or root fracture.
  • There is a misaligned post that will weaken the root structure.
Periodontal Therapy

In deciding whether to save or replace a periodontally involved tooth, the Dr. Versman, Dr. Heller, and Dr. Beckman considers the severity of the periodontal condition and the likelihood of recurrence.  Periodontal Associates in Aurora, CO specialized in treating periodontal or gum disease, and Drs. Versman, Heller, and Beckman are the highest qualified doctors to make this decision.

If the periodontal prognosis is poor and/or the possibility of recurrence of the disease is high, such teeth may be candidates for removal and replacement with dental implants.  However, Periodontal Associates can help treat gum disease better with hygienists who are specifically trained to treat patients with severe gum disease.
Drs. Versman, Heller, and Beckman suggest regeneration will most likely be successful in teeth with pocket depths greater than 6mm.  pocket depths are determines by measuring the gums to see how large a pocket is or how far under the gums bacteria is spreading.  Those with pockets depths beginning at 5mm is considered to have periodontal disease and is in need of immediate and frequent periodontal treatment. Do you have gum disease? Click here to see all symptoms and warning signs.

In addition, Avila et al suggest regeneration will most likely be successful in the following cases:
  • Teeth with mobility greater than normal and up to 1mm in any direction.   In addition to periodontal regeneration, these teeth can also be considered for splinting in case of secondary occlusal trauma.
  • Teeth with no recurrent periodontal abscess.
  • Teeth with less than 30% alveolar bone loss.
  • Teeth with deep, localized narrow intrabony defects.
  • Teeth without invasive furcation involvement.
  • Teeth without interproximal bone levels equal to or apical to the level of the furcaton.
  • Teeth with no root anomalies.
  • Teeth which would benefit from root resection as a conservative, therapeutic option.
Aviva et al suggest teeth should be considered for replacement if:
  • Pockets are deeper than 8mm.
  • Teeth are extensively mobile.
  • Teeth have recurrent periodontal abscesses.
  • Teeth have root anomalies -- cervical enamel projections, enamel pearls or root grooves.
Esthetic Considerations

If function and cosmetics can not be maintained or improved, this may be an indication for tooth removal.  The decision to retain a tooth or remove and replace it with an implant is dependent on the ability to achieve a functional and cosmetic results for our Aurora patients.

The Effect of Retention or Replacement on the Final Treatment Plan

The strategic value of a particular tooth is an important parameter to be considered when designing a  treatment plan.  The decision to extract or retain teeth affects adjacent teeth, especially is the plan is for the teeth to function as abutments for a fixed or removable partial denture.

It is essential to determine if a compromised tooth can withstand the functional load anticipated in the future.

Other Considerations

Other factors in the decision to retain or remove teeth are:
  • Smoking Habits
  • Use of IV bisphosphonates and other drugs
  • Patients with uncontrolled systemic conditions such as Type 1 diabetes

Tooth extraction and implant placement may not be the best therapeutic approach in all patients.  The decision to save a tooth or extract it and place an implant must include a consideration of a multitude of factors. 

To help decide what is best for you, Periodontal Associates strongly suggests you stop by for a FREE dental implant consultation in their Aurora, CO office.  As you have read, every individual can experience different needs, wants, and concerns when deciding what is right for them.  A consultation with Dr. Ken Versman, Dr. Doug Heller, or Dr. Eric Beckman allows one on one time and communication to resolve your questions, and provide you with excellent dental care.

Our office is located in Aurora, but we serve patients from all surrounding Denver metro areas.  Our patients respect Drs. Versman, Heller, and Beckman so much that some patients travel from Wyoming and Colorado cities hours away. 

Please contact Periodontal Associates at (303) 755-4500 or click here for an appointment.  Our website may also provide you more information to any questions that you have, and we urge you to to browse our website at Drs. Versman, Heller, and Beckman are Denver's premiere providers of dental implants and periodontics.  We look forward to meeting you and providing you with a life changing and beautiful smile!