Periodontal Treatment

Periodontal disease is the top cause of adult tooth loss in the United States. This is particularly sad because gum disease is often preventable. Most cases of periodontitis are linked to lack of proper brushing and flossing. You may brush and floss daily. However, if you don’t do so correctly, there will still be plaque left along your gum line. What starts out as a simple case of gingivitis (which is easy to ignore) can lead to irreversible damage to your gums and jaw. Besides loosening teeth, periodontal disease is linked to a number of very serious systemic health risks including heart disease and stroke. Keeping your mouth healthy is a critical factor in maintaining wellbeing for your whole body.

How Does Periodontal Disease Happen?

When plaque and tartar builds up on the tooth surface just below your gum line, it causes chronic irritation, inflammation and infection of your gums. As periodontal disease progresses, your gums begin to pull away from the surface of the tooth root. This allows bacteria, food debris and waste products from your body’s immune system to build up even deeper in your gums. As these “pockets” of infected material along the gum line deepen, the underlying jaw bone is also affected by constant inflammation in the area. It begins to deteriorate – becoming thinner and more porous. In some cases, it can erode so much that your teeth are no longer held firmly in their sockets.

Warning Signs of Periodontitis Include:

• Patches of redness along your gum line
• Bleeding gums when you brush and floss your teeth
• Gum tissue that is swollen, shiny, mushy and dry to the touch
• Receding gums
• Persistent bad breath
• Loose teeth

Who Gets Periodontal Disease?

There are a number of risk factors besides poor oral hygiene that can increase your chances of developing periodontitis:

• Age (most Americans over age 65 have some degree of gum disease)
• Use of tobacco products (smokers have 4 times the risk of periodontitis as non-smokers)
• Medical conditions such as uncontrolled diabetes (both Type I and Type II)
• Chronic dry mouth (saliva plays an important role in keeping oral bacteria in check)
• Bruxism, bite misalignment and poorly fitted dental restorations (these place additional stress on your teeth and can impact your gums as well)
• Hormonal changes (caused by pregnancy, menopause and certain oral contraceptives)
• A diet high in sugary foods that encourage bacterial growth
• Osteoporosis that contributes to porous jaw bone structure
• Wisdom teeth that are causing persistent gum inflammation

You can’t control all of these risk factors, but you can make dietary changes, stop smoking, have dental problems taken care of promptly and address health issues such as diabetes that make periodontitis worse. The most important step you can take is seeing Dr. Norton for regular cleanings and learning proper brushing and flossing techniques to use at home. You can also use an anti-microbial mouthwash to help keep periodontitis under control. These preventive steps greatly increase your chances of keeping your gums healthy and avoiding tooth loss.

Diagnosis for Periodontal Disease

During your initial visit, Dr. Norton will evaluate your periodontitis to see how far it has progressed. This is a simple process that involves probing between the gum and each tooth to measure each pocket’s depth. Anything beyond 3mm is usually an indication of advancing gum disease. For moderate to advanced periodontitis, your dentist may need x-rays to see if the bone is affected as well. Periodontal disease usually ranges in severity from Type 1 (gingivitis) through Type 4 (lots of bone and gum deterioration and possible tooth loss).

Periodontal Disease Treatment

Scaling and root planing are the first stages of treatment for mild to moderate periodontitis. These procedures accomplish three things:

• Removing tartar and infectious material from the periodontal pockets
• Smoothing the surface of the tooth root to give bacteria less space to grow
• Helping the gums adhere to the tooth root again to keep bacteria and food debris out

Scaling is done by scraping off the buildup of hard tartar below the gums. Root planing involves removing a very small portion of the hard outer coating of the tooth root to make the surface smooth. These procedures are usually done with a numbing agent or a local anesthetic to keep discomfort to a minimum. Many patients choose to have one quadrant of their mouth done at a time to prevent their whole mouth from being too sore afterward. An antibiotic medication may be introduced into the infected pockets. Or, patients may use a mouth tray with antibacterial gel every day to help limit bacterial growth. Some patients need an oral antibiotic after root planing to get rid of any lingering infection.

Surgical Periodontal Disease Treatment

With advanced periodontal disease, deep pockets form between the teeth and gums. Reattaching the gums to the underlying tooth roots is essential for restoring good oral health. These gum surgery procedures are referred to as “pocket reduction” since they make the periodontal pockets much shallower. The gums are temporarily retracted from the underlying teeth and bones to allow full access for tartar removal. The bone may by smoothed out to help gums reattach. A small portion of gum tissue may be removed to make the pockets smaller. This makes it much easier to keep the gum line clean and prevent a recurrence of symptoms. Patients who have lost too much gum or bone tissue may need a graft to restore these structures to their original dimensions.

As you can see, early intervention is the best choice. The further the disease has progressed, the more extensive and difficult treatment tends to be. This is why it’s important to see a dentist at the first sign of gum problems!