A dazzling smile involves a lot more than beautiful teeth. It begins with periodontics, the arm of dentistry that focuses on the supporting structures of the teeth.
“Often, people don’t think of periodontal disease until they have pain,” points out Peggy Munley, D.D.S., who practices periodontics and general dentistry in Wilmington. “If you catch it early, it’s easy to treat. If you wait too long, you wind up losing teeth.”
Periodontia—Greek for “around the teeth”— involves the gums and bone that hold teeth in place. A periodontist specializes in the prevention, diagnosis and treatment of periodontal disease and in the placement of dental implants.
Thanks to advances in periodontics, there are a lot more options these days to keep mouths healthy. Human placenta is used as a regenerating product in treating receding gingiva, or gums. Cadaver bone material can be grafted to bone eroded by advanced periodontal disease. Computer programs guide the placement of dental implants.
Those discoveries were decades away when Munley decided to go to dental school in the 1970s at the urging of a dentist who recognized the extraordinary dexterity in her hands she developed from doing crewel work and counted cross stitch.
When she graduated in 1978, 13 of her fellow 130 students were women. “10 percent [was] huge back then,” she recalls. “When I started working in Delaware, only three women were taking the boards.”
Today, slightly more than half of students in U.S. dental schools are women, according to the American Dental Association. That’s due, in part, to advocates like Munley who have supported women entering the field.
Darla Brice, D.D.S., a periodontist at Silverside Dental, was mentored by Munley as she rose in her career, starting as a hygienist, going to dental school, and then completing a three-year postdoctoral residency in periodontia.
There’s a strong link between gum disease and other illnesses, including stroke, heart attacks, hypertension and thyroid disease. Scaling and root planing to remove tartar and reduce inflammation of the gums can help to improve diabetes. Brice frequently collaborates with her patients’ family dentists, endocrinologists and cardiologists to ensure the highest level of care.
“It’s a very multidisciplinary approach,” Brice says.
She also does cosmetic contouring to reduce the puffy gums that sometimes result from orthodontia. Teens might request aesthetic crown lengthening before taking their senior portraits.
“Some people have short teeth. You can only see about half the tooth because the gum is covering the enamel,” Brice explains. “If you look at pictures of Beyoncé, you will see that she has a very gummy smile.”
Dental implants are replacements of teeth and roots meant to match the natural teeth. The root is typically a small titanium post anchored into the bone socket of the missing tooth. As the jawbone heals, a process that takes six to 12 weeks, the bone grows around the metal post. Then a connector post and artificial tooth are attached.
One-day implants are another option, although the success rate with those procedures is slightly lower.
Munley, who teaches at the dental clinic at Wilmington Hospital, says recognizing signs of gum disease is important because early treatment usually results in better outcomes for patients.
“You can see instantly when someone begins to take care of their gingiva, how much better their mouth looks,” she says.
Her advice for anyone who wants to ensure healthy gums? Floss every day. And if you can’t floss every day, commit to flossing at least three times a week.
“Flossing is the most important thing you can do for your teeth. If I had to choose between brushing and flossing, I would choose flossing,” she says.