Periodontal Disease
Common causes for periodontal (gum) disease are genetic susceptibility, smoking, and other illnesses like diabetes. Periodontal maintenance involves removing plaque and tartar from above and below the gum line. Most gum diseases are preventable with proper oral hygiene. However, what can start out as gingivitis (inflamed or bleeding gums) can quickly turn into periodontitis. In such cases, gums pull away from the tooth to create “pockets,” thereby exposing a dental root to infection. It can also lead to prolonged bad breath, loose teeth, painful chewing and other complications.
Diagnosing Gum Disease
Dr. Weaver will examine your gums for signs of inflammation and use a tiny ruler called a “probe” to measure pockets around the teeth. In a healthy mouth, the pockets around the teeth are usually between 1 and 3 millimeters. Deeper pockets can be a sign of periodontal disease. He will also ask about your medical history and will examine your x-rays to check for bone health and other concerns.
Symptoms
Symptoms of periodontitis can include:
• Swollen or puffy gums. • Bright red, dark red or dark purple gums.
• Gums that feel tender when touched. • Gums that bleed easily.
• Bad breath that won't go away. • Pus between your teeth and gums.
• Loose teeth or loss of teeth. • Painful chewing.
• New spaces that develop between your teeth that look like black triangles.
• Gums that pull away from your teeth, making your teeth look longer than usual, called receding gums.
• A change in the way your teeth fit together when you bite.
Treatment
Treatment may be done by a dentist or a periodontist. A periodontist is a dentist who specializes in gum disease. A dental hygienist may work with your dentist or periodontist as part of your treatment plan. The goal of treatment is to thoroughly clean the pockets around teeth and prevent damage to surrounding gum tissue and bone. You have the best chance for successful treatment when you also have a daily routine of good oral care, manage health conditions that may impact dental health and stop tobacco use.
Nonsurgical treatments
If periodontitis isn't advanced, treatment may involve less invasive procedures, including:
• Scaling. Scaling removes tartar and bacteria from your tooth surfaces and below your gumline. It may be done using instruments, a laser or an ultrasonic device.
• Root planing. Root planing smooths the root surfaces. This helps prevent further buildup of tartar and bacteria. It also helps your gums attach to your teeth again.
• Antibiotics. Topical or oral antibiotics can help control bacterial infection. Topical antibiotics can include antibiotic mouth rinses or putting gel containing an antibiotic into gum pockets. Sometimes oral antibiotics are needed to get of bacteria that cause infections.
After Scaling & Root Planning:
Your mouth may feel sore and tender after treatment. Keep brushing and flossing your teeth after each meal. Your hygienist may tell you to rinse with warm saltwater every few hours. Pain medication may be suggested if you need it. An antibacterial rinse may also be recommended
Once Scaling & Root planning have been completed you will need to continue treatment with Periodontal maintenance visits every 3-4 months for at least 2+ years and will be evaluated at each visit for continued care frequency and other necessary treatment.
Surgical treatments
If you have advanced periodontitis, you may need dental surgery, such as:
• Flap surgery, also called pocket reduction surgery. Your periodontist makes cuts in your gums to carefully fold back the tissue. This exposes the tooth roots for more effective scaling and root planing. Because periodontitis often causes bone loss, the underlying bone may be reshaped before the gum tissue is stitched back in place. After you heal, it's easier to clean the areas around your teeth and maintain healthy gum tissue.
• Soft tissue grafts. When you lose gum tissue, your gumline gets lower, exposing some of your tooth roots. You may need to have some of the damaged tissue reinforced. This is usually done by removing a small amount of tissue from the roof of your mouth or using tissue from another donor source and attaching it to the affected site. This can help reduce further gum loss, cover exposed roots and give your teeth a better appearance.
• Bone grafting. This procedure is performed when periodontitis destroys the bone around your tooth root. The graft may be made from small bits of your own bone, or the bone may be made of artificial material or donated. The bone graft helps prevent tooth loss by holding your tooth in place. It also serves as a platform for the regrowth of natural bone.
• Guided tissue regeneration. This allows the regrowth of bone that was destroyed by bacteria. In one approach, your dentist places a special type of fabric between existing bone and your tooth. The material prevents unwanted tissue from growing into the healing area, allowing bone to grow back instead.
• Tissue-stimulating proteins. Another approach involves applying a special gel to a diseased tooth root. This gel contains the same proteins found in developing tooth enamel and stimulates the growth of healthy bone and tissue.