Dr. Linden’s Response to Mayo Clinic Health Letter Article on Periodontal Disease

Article is on Page Four of this PDF.

Dr. Linden’s response, in a letter to the editors of the publication:

The article on Periodontal Disease was quite informative and clearly written.  While I am in agreement with various treatments included in the health letter, I would like to bring your attention to important information that was not included.   In the last 10 years the introduction and use of laser therapy has played a significant role in the treatment of  periodontal and implant disease.  This modality is extremely effective and less invasive than “traditional” methods of treatment as described in the article. The percentage of Periodontists utilizing a laser approach is approximately  25-50% internationally.  There are many different wavelength lasers that are currently used in a periodontal practice.  Although laser trained periodontists may utilize  “traditional” treatments, the laser approach is often more effective, less invasive, and often provides regeneration of bone tissue around the diseased teeth and implants. The laser targets the “bad or pathogenic” bacteria, reduces inflammation, and preserves the good tissue that is needed for regeneration of healthy gum tissue and new bone.

Posted in Periodontal Treatment

My tooth is grey but isn’t dead. If I got braces, would this affect my treatment?

Q: 6 months ago one of my side canines became darker than the rest of my teeth. I consulted a private root canal specialist. A number of tests/x rays confirmed that the tooth is vital and alive. I’m thinking about getting braces and wondered if this situation would affect my treatment? The tooth has never hurt and doesn’t give me any pain whatsoever.

A: If the endodontist concluded that your discolored teeth were vital and alive, then moving ahead with your braces (orthodontic treatment) should be fine, with the stipulation that you are monitored every month by the endodontist.

Posted in Related Procedures

One month following root canal it hurts to chew hard things and is sensitive to touch. What options do I have to treat this?

Q: I got a root canal 2 months ago. I had a crown on the tooth so the dentist went through the crown. A week after the RC, I had discomfort when I chewed food or touched one side of the tooth. It went away until 2 weeks ago when the pain came back. Now it hurts to chew hard things, sensitive to touch the tooth with my tongue, toothbrush, etc. The pain is worse in different parts of the tooth. I wear a night guard. I’m out of my dental insurance for the year so I’m not sure what options I have.

A: If the root canal tooth is hurting, particularly when you bite down on food or simply touch it, then there is a good chance that the tooth could be fractured or the bite is excessive on the tooth. I would suggest a consultation with an experienced periodontist to get an opinion.

Posted in Related Procedures

My permanent bridge doesn’t fit. It’s fallen off twice and I need a new one. What can I do?

Q: My permanent, 6-unit bridge does not fit and has come off 2 times. After almost a year of treatment, the doctor doesn’t know what to do. He told me he’ll make a bridge a 3rd time and send it to the lab. Last week he told me I need an implant. If I say no to that, he may try to change my plan. I have already spent a lot and don’t know what to do.

A: Sounds like there is a problem with the fit of the new bridge? I would seek a 2nd opinion from a prosthodontist (specialist in bridges) and see what they can tell you about your dental issues and how to rectify them.

Posted in Dental Implants

Would it be beneficial for me to get laser gum surgery? I hate my small teeth and gummy smile.

Q: What else could I do to get a better smile? Veneers or luminescent after laser?

A: It might be possible to have cosmetic laser gum surgery to attain a better appearance when you smile. The important thing is to have the appropriate laser used (with the correct wavelength) so there won’t be any damage to underlying bone and supporting structures in the mouth. It is also advisable to seek the services of an experienced laser periodontist who uses multiple lasers so you can have the safest laser for your treatment.

Posted in Crown Lengthening

I Hate my Gummy Smile. Should I Have Gum Reduction Surgery Before Getting Crowns/Veneers?

Q: Would you suggest gum-reducing surgery, and then crowns/veneers? I have some bonding now that is chipped and discoloring. Is a gum lift/grafting a smart choice before veneers/crowns?

A: Usually, the best way to do a case like you are describing is to have a well-qualified cosmetic dentist or prosthodontist work in conjunction with an experienced laser periodontist who uses multiple laser wavelength machines to ensure that the safest laser is used that will not damage any of the supporting structures in your mouth. In fact, ask to see pictures of cases that the cosmetic dentist and periodontist have completed. Then you can you see what you might expect to look like after your treatment.

Posted in Crown Lengthening

Seal Crowned Tooth with Root Canal?

Q: I had a crowned tooth break off. The tooth had a root canal done on it so it doesn’t hurt. Can I get it sealed?

A: You should be seen by an experienced laser periodontist to determine if there is enough tooth structure to place another crown safely. Sometimes a crown lengthening procedure might need to be done to do a replacement crown on a broken tooth. In extreme cases, the tooth cannot be saved and other options might need to be considered such as an implant or conventional bridge. Of course, an x ray and exam is mandatory.

Posted in Crown Lengthening, Dental Implants

Would you suggest a gum lift? Or another type of surgery?

Q: I don’t like my gummy smile. It’s not major. By that I mean you can’t see my gums when I talk, but you can see them when I smile. Is gum lift the better option? Could you give me an approximation of the cost? Thank you!

A: It is difficult to quote fees on a forum like this because each patient presents differently at the time of the exam. The treatment might require a different laser or possibly a different approach to attain the cosmetic result that the patient is seeking. Find an experienced laser periodontist who uses a number of different lasers so they can choose the safest and best one for your clinical situation.

Posted in Crown Lengthening

Dr. Eric Linden: An Innovator and Teacher of Laser Dentistry

Dr. Eric Linden: An Innovator and Teacher of Laser Dentistry

Dr. Eric Linden, a Clinical Professor of Periodontics and Oral Medicine at Columbia University College of Dental Medicine in New York, has become a specialist and teacher among Periodontists and other dental professionals in the use of lasers to treat gum disease, place and maintain dental implants, and related procedures.

Conventional Methods vs. the Laser

Many Periodontists treat gum disease surgically using scalpels and sutures. This modality can sometimes be painful and involve a lengthy recovery. About ten years ago, a type of laser protocol known as LANAP™ (Laser-Assisted New Attachment Procedure), was introduced. In most cases, LANAP™ allows the specially trained Periodontist to treat gum disease without invasive cutting and stitching.

Dr. Linden was one of the first Periodontists to utilize this laser technology. After applying traditional surgical techniques for over twenty years, he was so impressed with his successful clinical results and positive experiences for his patients treated with the laser that he replaced or supplemented conventional surgery with LANAP™ in the majority of his cases. Realizing the significance of dental laser surgery compared to traditional gum surgery for gum disease and dental implants, Dr. Linden investigated and implemented the use of additional lasers.

Different Lasers for Different Procedures

There are a variety of dental lasers. They include:

  • ND/YAG, the kind used in LANAP™
  • Erbium laser
  • CO2 laser
  • Diode laser

Many dental professionals who use a laser for gum surgery use LANAP™, however Dr. Linden has incorporated four different types of lasers in his Manhattan and New Jersey periodontal practice. Each laser has a specific effect and application. According to Dr. Linden, “Often, the key to a successful periodontal and implant treatment outcome is to use the appropriate laser, based on a thorough evaluation and clinical diagnosis.” When a patient presents with a periodontal/implant/soft tissue problem, Dr. Linden can customize and fine-tune the treatment and choose the appropriate and most effective laser for the best clinical outcome.

Benefits from the use of various lasers include treatment for the following:

  • cosmetic gum reshaping,
  • gum de-pigmentation,
  • periodontal disease,
  • bone loss,
  • pocket reduction,
  • gum (soft tissue) disease,
  • bleeding,
  • aiding placement and repairing bone loss around implants,
  • achieving bone regeneration,
  • site preservation during extractions for ridge preservation and future dental implant sites, and
  • oral pathology (biopsies).

Additional benefits of using different wavelength lasers include:

  • bio-stimulation,
  • pain management,
  • maintaining current patient medication regimens,
  • minimal down time,
  • accelerated healing response,
  • no post-op bleeding, and
  • minimal post-op swelling and pain.

Teaching and Clinical Instruction

In 2012, Dr. Eric Linden was appointed Clinical Professor in Dental Medicine at Columbia University College of Dental Medicine in New York, where he teaches both traditional and laser surgical approaches to the post graduate periodontal and implant residents.

Dr. Linden currently lectures at universities, dental meetings, and symposia around the country. Additionally, Dr. Linden teaches the principles of laser physics, laser periodontal surgery, and practice management to groups of dentists from places such as Japan, Australia, Canada, and the US.

Dr. Eric Linden, a Certified Laser Instructor with the Institute of Advanced Laser Dentistry is currently researching new treatment protocols with various lasers.

Posted in Articles

Gum Disease Prevalence Surpasses Diabetes with Nearly 65 Million Affected

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Dr. Eric Linden Urges New York/New Jersey Residents to Take Action against Highly Prevalent, Yet Seriously Overlooked Disease

Dr. Eric Linden wLaserNew York, 4/29/2014 – With one in every two adults age 30 and older suffering from periodontal disease (commonly referred to as gum disease), the American Academy of Periodontology (AAP) and its 8,300 members are calling for Americans to Love the Gums They’re With. Periodontal disease can lead to receding gums, bone damage, loss of teeth, and can increase the risk of other health problems such as heart disease and diabetes. Despite its prevalence, periodontal disease is hardly ever discussed, resulting in a lack of urgency for people to properly care for their gums. Simple steps like brushing twice a day, flossing daily, and receiving an annual comprehensive periodontal evaluation from a periodontist can help detect and prevent gum disease.

Periodontal disease is an inflammatory condition that, if left untreated, may cause damage to the tissues and bone surrounding the teeth,eventually leading to tooth loss. According to the Centers for Disease Control and Prevention, 64.7 million Americans are affected by periodontal disease. In addition to diabetes, periodontal disease has been linked to other chronic diseases, including cardiovascular disease, rheumatoid arthritis, Alzheimer’s disease, and even cancer.

“The potential repercussions of periodontal disease upon an individual’s oral and physical well-being is a very serious – but often overlooked – health issue,” said Dr. Linden. “With more Americans suffering from this disease than diabetes, the AAP created ‘Love the Gums You’re With’ to educate the public on the importance of prevention and early diagnosis of periodontal disease.”

Periodontal disease typically does not cause pain until it’s in an advanced stage, at which point much of the damage has been done and tooth support destroyed. To raise awareness and to help health consumers better understand periodontal disease, the AAP is teaming up with TV personality Chris Harrison to launch the Love the Gums You’re With educational effort. As host of ABC’s “The Bachelor,” Harrison knows that first impressions are important in successful relationships.. Just as personal relationships thrive on daily attention and care, so does the relationship with your gums.

What New York Patients Can Do

To aid in the prevention of periodontal disease, Dr. Linden recommends establishing good oral hygiene habits including brushing at least twice a day, flossing daily, and discussing gum health with a dental professional.To learn more, patients can take a brief quiz on perio.org to evaluate the current state of their gum health, learn the signs and symptoms of periodontal disease, and receive tips on how to properly care for their gums. Each patient is unique, and a dental professional can make a referral to a periodontist — a dentist who specializes in the prevention, diagnosis and treatment of periodontal disease — for a comprehensive periodontal evaluation and specialized periodontal treatment plan to help support a life-long commitment to healthy gums.

About Periodontal Disease

Periodontal disease is caused by bacteria in the mouth that form plaque below the gum line. There are more than 500 bacterial species that can be found in plaque, and brushing alone does not remove the bacteria that live below the gum line. Poor oral hygiene is one cause of periodontal disease, but smoking is also a significant risk factor in the development and progression of the disease. While periodontal disease is mostly preventable and treatable, the early warning signs can be painless, making it necessary for individuals to establish strong oral hygiene habits and to discuss their periodontal health with a dental professional. With an appropriate diagnosis, the damage from periodontal disease is reversible in many cases.

About the American Academy of Periodontology

The American Academy of Periodontology (AAP) is the professional organization for periodontists – specialists in the prevention, diagnosis, and treatment of diseases affecting the gums and supporting structures of the teeth, and in the placement of dental implants. Periodontists are also dentistry’s experts in the treatment of oral inflammation. They receive three additional years of specialized training following dental school, and periodontics is one of the nine dental specialties recognized by the American Dental Association. The AAP has 8,300 members worldwide. For more information, visit perio.org.

Posted in Articles