Gum disease, known as periodontitis, is a condition in which the supporting structures of the teeth become chronically inflamed. This becomes clinically evident by redness, swelling and bleeding of the gums-during routine cleanings or during daily brushing. These clinical factors are the body’s response to the higher amounts of bacteria found on the teeth and under the gums. Overtime, the chronic inflammatory response to these bacteria can lead to damage of the supporting structures of the teeth.


So, what does all of that mean?


When we brush our teeth and visit the dentist for regular cleanings, we are able to remove plaque and calculus from our teeth. When we don’t, these things build-up and create periodontal pocketing-a gap between the gums and the roots of the teeth. The normal bacteria we have and need in our mouth suddenly have a place, below our gums and embedded in the plaque, where they can thrive and multiply in numbers-they can change from helpful to harmful.


Certain bacteria in the mouth are necessary to help digest our foods and fight off disease, but too many of the harmful bacteria allowed to multiply without limits causes the release of harmful by-products. Our body has to respond by activating its inflammatory response. The chronic inflammation, combined with the presence of these harmful bacteria, causes loss of bone and attachments to our teeth and they can become loose. Left untreated, otherwise healthy teeth can be lost to periodontal disease.


What else can cause gum disease?


Periodontitis can only occur with the presence of unremoved plaque and calculus. However, things such as smoking or diabetes can weaken the body’s defenses and thus the disease can progress faster.


So, what do we do?


The first line of defense is regular brushing and flossing. This takes care of the easy places to reach inside the mouth. Next, have regular dental cleaning visits to take care of those harder to reach areas. Advanced cases of periodontitis may require surgical interventions from a specialist to help reduce pocketing and making it easier to keep the teeth clean. And finally, make sure to keep the body healthy so that it can have an appropriate immune response.

Dr. Victor Marfo studied Microbiology and Immunology at the University of Washington. After completing his studies at University of Washington he went on to attend the prestigious Columbia University College of Dental Medicine in New York. It was at this institution that Dr. Marfo developed a keen interest in Endodontics. After obtaining his DDS degree from Columbia University he was directly admitted to the university’s renowned Endodontic residency program. While attending this program Dr. Marfo obtained specialized training in Conventional Root Canal Therapy and Microsurgical Endodontics. Over the next few years he travelled extensively across the continent and is extremely excited to return to the place where it all started, which of course is the great Pacific Northwest.

Dr. Marfo’s career has been an excellent one as he’s performed thousands of surgical and non-surgical root canals. 
Although his abilities are highly professional, his attitude remains soft, caring and calming which is what truly sets him apart. His aim is to save the world, even if it has to be one tooth at a time. Dr. Marfo actively participates in continuing education and study clubs. His special interests include dental emergency management especially dental trauma management. Alongside this he also enjoys playing a few rounds of tennis and giving out some good laughs with his stand-up comedy.

Dr. Marfo and his staff assure you that your procedure and post procedure requirements will be taken care of in an efficient and timely manner.

​Brushing your baby's teeth is crucial in the earlier stages of life. Even before their first adorable tooth pops up, you can gently brush their gums. A wet washcloth or a baby finger toothbrush is recommended by most dentists.  Some babies may fuss or chop down and some babies may giggle, but what is important is wiping them down at least twice a day no matter how your little on reacts. Though easily preventable with good care, tooth decay is one of the most common chronic diseases of children and teens ages 6 to 19.

​Early preventative care for your child saves  you money in the long run. By their  first birthday your  child should see a dentist for a check-up. First visits can vary from office to office, but most first check-up for children age 1 and under are fairly quick. 

​It is pretty common as a dentist to hear from our patients "Now doc, I have TMJ, especially when I wake up in the morning." I hear this all the time. 
 
There are many reasons why people have discomfort or just sounds coming from their jaw joint.  But first, a little anatomy lesson.  The joint that connects the lower jaw, or mandible, to the head is called the temporomandibular joint, or TMJ.  This joint is what allows our jaw to both rotate and translate making it possible to talk and chew and do all the necessary things our mouths do. This joint is found directly in front of the ear and if you put your fingers on it and open you can feel it in motion. This joint consists of four basic parts.  First are the bones: the mandiblular connector, or condyle, and the port in the head where this condyle sits, or fossa.  Now if we just had this component we would have bone rubbing on bone and that would not be good. Much like if you have ever tried to slide something heavy like a refrigerator on a bare floor, it's difficult and often leaves scratches and dings in the floor.  However, if you put a towel under this heavy object and push, it slides much easier and no harm is done to the floor.  In the same way, the second component of the TMJ, a disc sits between the condyle and the fossa so that we can move our jaw easily up and down with little friction and no pain. The third component of the joint are the tendons that hold everything tightly in place like bungee cords so that everything functions in harmony. The final component of the joint are muscles that actually move the joint, up and down and from side to side.  These four components make up your TMJ, everyone has two of them, one on each side of your head.
 
While common, especially in women, not everyone has TMD. TMD, or Temporomandibular disorder, is when one or several of these four major components are not working in harmony.  Common symptoms for this are popping, clicking, limited opening, chronic jaw fatigue, locking open or closed, feeling a sudden change in bite, and discomfort or pain to varying degrees. Understanding which component is out of harmony isn't always easy and should be evaluated by a dentist. Mild symptoms like occasionally clicking may not need any treatment at all, but symptoms that are getting worse and interrupting with daily tasks of biting, talking, chewing, or inhibiting general quality of life should get seen by a trained professional.

- BLAKE C. SESSIONS, DMD​

OK, so I am being asked to comment on this hot topic in the news media for the past few months. This is gaining a lot of momentum based on the fact that majority of my patients that I come across are not hard core flossers.
The question that arises here is WHY people tend to avoid flossing:
* It is time consuming
* It is extra work
* It requires dexterity and technique
* It is monotonous and boring
* I’d rather get in bed then spend a few extra minutes flossing
* Some accuse flossing as damaging rather than benefiting and they say “My gums bleed when I floss”.
I mean, they give me an excuse to avoid this heavy task and a reason not to feel guilty at every dental hygiene appointment when asked this dreadful question, “Have you been flossing regularly?”


In comes this latest news about the “Medical Benefits of Flossing Unproven” or the New York Times article last month “Feeling guilty about not flossing? Maybe there is no need.”
What people are not focusing on is the word ‘maybe’ in the above article title.


One of the main problems is that research is lacking because there is none that was done primarily looking at the medical benefits of flossing.
For the medical benefits to be ascertained, we have to stop flossing and see where the world goes.


So I decided to do some research and look at this topic end to end.


When I first started to look at the other end I came across an invention in the late 1800s and that is toilet paper. It was originally made for areas of the world where there is not enough water to clean oneself. Well, the convenience of this hygiene product made it SO popular that it is a norm to use toilet paper these days. If I go and research further, I cannot find ANY medical benefits to toilet papering either! The use is totally hygienic!
Similarly NOT using toilet paper can cause a rash and a localized infection just as not flossing can lead to the same a rash and localized infection which on gums known as periodontitis and on teeth as decalcification and decay. So, YOU decide if you want to stop using toilet paper since there is no “research” showing any other medical benefit other than “Peri-analitis” (yes, I just made that term up!). I question what kind of medical correlation is needed. Not toilet papering makes the back area stink, not flossing makes the mouth stink. You connect the dots.
It is all in the state of hygiene and cleanliness that flossing comes to play because it goes in between teeth where brush does not go.

~ Dr. Bashar

Sedation dentistry is a medical procedure involving the administration of sedative drugs, generally to facilitate a dental procedure and reduce patients fear and anxiety related to the experience. 
​
Under the influence of sedative drugs, a patient is conscious unlike General Anesthesia where a patient is completely out and paralyzed. Here the patient responds to commands, maintains his own breathing, maintains his cough reflex and can swallow. This way the administration of sedation is safe and reduces anxiety to an extent that an anxious patient can get the necessary dental work done without any fear and a dentist can deliver quality dental work without the worry of a shaky, tense and agitated patent. 
 
Sedation dentistry covers a wide variety of calming agents delivered via different routes of administration including: Inhalation route- Given as a gas that is breathed in, (commonly known as Laughing Gas), Oral route- by mouth in the form of a pill and Intravenous Route (IV)- Injected through a vein. 
 
Laughing gas or nitrous oxide inhalation serves as the most well known form of conscious sedation in dentistry, with roughly 55% of dentists in the United States administering nitrous oxide as an inhalation sedative. Some effects include light headedness, perspiration and a numbing sensation in the arms and legs. It maximally achieves anxiolysis (anxiety relief) in 60- 70% of the patients it is administered to. 
 
This may not be enough for some patients, their underlying anxiety and fear is so strong that they may need more than just this modality. 
 
Oral sedatives render yet a different sedation solution. Normally, the patient consumes these drugs by mouth prior to the appointment. Occasionally, a dentist may well advise you to take it the night before the appointment so the anxiety does not build over night. If a patient chooses this form of sedation, they must adjust their schedules accordingly. They must to be brought to and from the office as they cannot operate a car for 24 hours just after they take the pill. Some oral sedatives include things like Valium and Halcion.  A dentist needs to be trained in this modality and some states require for the dentist to have a special permit to deliver this kind of sedation. 
 
Intravenous delivery of sedatives is by far the most advanced, and in the hands of a trained dentist, the level of sedation can be titrated to effect and patient's level of sedation can be maintained at a comfortable level by giving additional drugs or a mix of drugs within safe limits.

~S. REHAN BASHAR, DDS, BDS, FICOI, FADIA, FAGD

​Sedation offered at Rainier Dental
At Rainier Dental, we offer mild and moderate sedation.

-Nitrous Oxide
-Oral Sedation
-A combination of both inhalation or oral

Today is the Grand Opening of our New Rainier Dental Sumner Office! Thank you to our first patient that was seen today! Our New Rainier Dental Sumner address is: 15306 Main St Suite A, Sumner, WA, 98390