SERVICES
Treatment of Periodontal Disease
Your dentist and periodontist work together as a team to provide you with the best possible care.
Periodontal Disease
It is astounding that HALF of American adults aged 30+ have periodontal disease, according to the CDC. In adults 65 and older, prevalence rates increase to 70%.
Periodontal disease is a chronic inflammatory disease that affects the gum tissue and bone supporting the teeth (the periodontium). Periodontal disease destroys supporting tissue and bone, forming pockets or spaces around the teeth. Over time pockets - or spaces between the tooth and the gum tissue - deepen, allowing the plaque or bacteria to grow, and destroying bone support. This process ultimately causes tooth loss. It is essential that the pocket depths are in a healthy range so you get to keep your teeth as long as possible.
Periodontal Disease is caused mainly by plaque, which is bacteria. To lower the risk of developing both cavities and periodontal disease, it is important to remove this bacteria with daily brushing and interdental cleaning (e.g. flossing). Nonetheless, periodontal disease can develop even in patients who have impeccable oral hygiene, as genetics, nicotine, stress, various medications, and poor diet play a role in irreversible damage of the foundation around the teeth.
Research has also shown that periodontal disease is associated with other chronic inflammatory diseases, such as diabetes and cardiovascular disease. Bacteria from periodontal disease can travel through the bloodstream and affect other areas of the body. There is a strong mouth-body connection! Many serious medical conditions are exacerbated from lack of attention given to your gums.
We believe that saving and maintaining your natural teeth is the best goal. With proper care and education, periodontal treatment is very successful in saving teeth. While implants are good solutions when teeth can’t be saved, they are no substitute for your own teeth.
Pain is not a sign of this disease! The
main signs of periodontal disease are bleeding gums, swollen and/or reddish gums, loose teeth, changes in the position of the teeth, bad breath or even tooth loss.
Non-surgical Treatment of Periodontal Disease
The early stages of periodontal disease are usually best treated with non-surgical periodontal therapy. Even in severe cases, non-surgical therapy often precedes surgical therapy. This is done to improve the overall tissue quality prior to surgery and also to reduce the number of areas requiring surgery.
Scaling and Root Planing
The objective of these non-surgical, deeper cleanings, is to remove plaque and tartar (A.K.A. calculus), which cause gum inflammation and disease. Scaling and root planing can be used as a stand-alone treatment, a preventative measure, or to prepare your tissues for surgery. With special instruments, your hygienist will remove plaque and calculus, along with cementum and surface dentin that is embedded with unwanted bacteria and toxins. The root of the tooth is smoothed, which promotes healing, and also helps prevent bacteria from easily colonizing in the future. In some cases, antibiotic fibers will be placed in the pockets after scaling and planing.
When deep pockets between teeth and gums are present and exceed 3mm in depth, it is difficult for your hygienist to adequately remove all of the plaque and calculus, and difficult for you to remove all of the plaque on a daily basis. As pockets deepen, more bacteria are able to colonize, causing a chronic inflammatory response by the body to destroy gum and bone. Consequently, surgery may be needed to shrink the pockets so you can maintain them on a daily basis, and your hygienist can maintain them every 3 months.
Surgical Treatment of Periodontal Disease
Scaling and root planing has its limitations. Though some periodontal pockets may improve, some may remain deep and not compatible with periodontal health. If this is the case, your periodontist may recommend surgical therapy to treat your gum disease.
In some instances, a recontouring of the periodontal structures will be necessary. In other cases, a procedure aimed at regenerating lost tissue may be recommended. Your periodontist will spend the time to discuss your options and help you select a plan that best fits your needs and budget.
Osseous Surgery
Osseous Surgery reshapes bone deformities and shrinks pockets so that bacteria can’t live, allowing you to maintain your gum health on a daily basis with brushing/flossing. Toothbrush bristles and floss can only reach so far below the gum, so it is important that the pockets remain small.
Regenerative Surgery
The gum and bone are destroyed with periodontal disease, which can leave deep gaps between the bone and the tooth. Sometimes we can repair the damage by growing new bone with techniques that employ bone grafting, guided tissue regeneration, and biologics/growth factors.
Photos on the left show more bone loss, before regeneration.
Photos on the right show healthy bone levels after bone regeneration.
Periodontal Maintenance
Keeping your smile healthy
After the active phase of periodontal treatment, your periodontist will recommend a personalized maintenance program to keep your condition under control, as periodontitis is a chronic inflammatory disease.
Maintenance therapy is an ongoing program designed to prevent this chronic disease from becoming active again. Adherence to a program of conscientious oral care at home, along with regularly scheduled maintenance visits with your dentist and periodontist, will give you an better chance of keeping your teeth for a lifetime and keeping the disease at bay.
No matter how careful you are in cleaning your teeth and gums, bacterial plaque can cause a recurrence of gum disease from three to four months after your last professional cleaning. Therefore, a dental professional must check for hidden problems and remove the hardened plaque at intervals appropriate for you so that your teeth and gums stay healthy.
Your Maintenance Visit May Include:
- Discussion of any changes in your health history
- Examination of your mouth tissues for abnormal changes
- Measurement of the depth of pockets around your teeth
- Oral hygiene assessment and instructions
- Removal of bacterial plaque and tartar
- X-ray studies to evaluate your teeth and bone
- Examination of your teeth for decay and other dental problems
- Application or prescription of medications to reduce tooth sensitivity or other problems you may have.