Posts for tag: periodontal disease
There are a variety of methods for treating periodontal (gum) disease depending on its severity — from routine office cleanings to periodontal surgery. But the goal behind all of them remains the same: remove bacterial plaque and calculus (tartar), the root cause for gum disease, from all tooth and gum surfaces.
The traditional method for doing this is called scaling in which we use special hand instruments (scalers) to mechanically remove plaque and calculus. Scaling and a similar procedure called root planing (the root surfaces are “planed” smooth of plaque to aid tissue reattachment) require quite a bit of skill and experience. They're also time-consuming: full treatment can take several sessions, depending on how extensive the infection has spread.
In recent years, we've also seen a new method emerge for removing plaque: lasers. Commonly used in other aspects of healthcare, lasers utilize a focused beam of light to destroy and remove diseased or unhealthy tissue while, according to studies and firsthand accounts, minimizing healthy tissue destruction to a better degree than traditional techniques. Procedure and healing times are likewise reduced.
Because of these beneficial characteristics, we are seeing their use in gum disease treatment, especially for removing diseased and inflamed tissues below the gum line and decreasing sub-gingival (“below the gums”) bacteria.
Dentists who have used lasers in this way do report less tissue damage, bleeding and post-treatment discomfort than traditional treatments. But because research is just beginning, there's not enough evidence to say laser treatment is preferably better than conventional treatment for gum disease.
At this point, lasers can be an effective addition to conventional gum disease treatment for certain people, especially those in the early stages of the disease. As we continue to study this technology, though, the day may come when lasers are the preferred way to stop gum disease from ruining your dental health.
If you would like more information on treating gum disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Lasers Versus Traditional Cleanings for Treating Gum Disease.”
After a dental examination revealed you had periodontal (gum) disease, you began undergoing treatment. Now after several cleaning sessions, the infection has subsided and your gums have returned to a healthy shade of pink.
But your gum care isn’t over — depending on the infection’s severity you may need to visit us more often than the normal six months between regular checkups.
Gum disease arises from dental plaque, a thin film of bacteria and food remnants built up on tooth surfaces due to poor oral hygiene. The bacteria cause an infection in the gums, which initiates a response from the body’s immune system that triggers inflammation.
Without proper treatment, periodontitis can come back in which the infection spreads deeper below the gum line. Pockets of infection can reoccur as gum tissues weaken and lose their attachment to teeth. This continuing damage can ultimately lead to both tooth and bone loss.
To stop the disease it’s necessary to remove all the infection-causing plaque and calculus (hardened plaque deposits) from tooth surfaces, including around the roots. This is performed manually and could require surgery once again to access areas below the gum line.
To guard against this it’s necessary for you to undergo regular periodontal maintenance (PM). Besides cleaning, PM gives us an opportunity to check for signs of returning gum disease and, if found, plan for another round of treatment.
Although not written in stone, the interval between PM appointments that seems the most effective for preventing recurrence is every three months. In cases of advanced, aggressive gum disease, appointments may need to occur at even shorter intervals, for example every two months.
PM for susceptible patients with decreased resistance to disease require extra time and effort for the hygienist, along with a renewed daily hygiene habit of effective brushing and flossing by you to keep the disease at bay. But preventing another occurrence of gum disease and its consequences is well worth this extra attention for the health of your teeth and gums.
Surgical treatment for periodontal (gum) disease can go a long way toward restoring your mouth to good health; however, it does not change your susceptibility to the disease. That’s why we recommend that you come in regularly for periodontal cleanings after your treatment. Here are some frequently asked questions about keeping your mouth healthy after gum disease treatment.
How often do I have to come in for periodontal cleanings?
There’s no “one-size-fits-all” answer to that question: It really depends on your individual situation. For example, some individuals may have a more aggressive form of periodontal disease that requires more frequent periodontal maintenance (PM) treatments to maintain control. Others may have greater success controlling the buildup of disease-causing plaque with at-home oral hygiene measures, and therefore need PM less often. However, for people with a history of periodontal disease, getting PM treatments at a three-month interval may be a good starting point.
What happens at a periodontal maintenance appointment?
A thorough cleaning of the crown and root surfaces of the teeth, aimed at removing sticky plaque and hardened dental calculus (tartar), is a big part of PM treatments — but there’s much more. You’ll also receive a thorough clinical examination (including oral cancer screening), a review of your medical history, and x-rays or other diagnostic tests if needed. The status of any ongoing periodontal disease will be carefully monitored, as will your success at maintaining good oral hygiene. Decisions about further treatment will be based on the results of this examination.
What else can I do to keep gum disease at bay?
Keeping your oral hygiene in top-notch condition — which includes effective brushing and flossing every day — can go a long way toward controlling gum disease.Â In addition, you can reduce risk factors by quitting tobacco use and eating a more balanced diet. And since inflammatory conditions like diabetes, arthritis and cardiovascular disease can make periodontal disease worse (and vice versa), keeping these conditions under control will greatly benefit both your oral health and your overall health.
There’s only one way to effectively halt the progressive damage of periodontal (gum) disease — completely remove the bacterial plaque and hardened deposits (calculus) from above and below the gum line that are causing the infection. Although we can accomplish this in most cases with hand instruments called scalers, ultra-sonic equipment or both, some cases may require periodontal surgery to access and clean deeper “pockets” of infection.
As this damaging disease progresses, the supporting bone dissolves and the gum tissues will begin to detach from a tooth, leaving an open space known as a “periodontal pocket.” Besides plaque and calculus pus may also form as a result of the infection. All of this material must be removed from the pocket before healing and, hopefully, tissue reattachment can begin.
Shallow pockets near the gum line are usually accessed and cleaned with hand instruments. But deeper pockets (5 millimeters or greater in depth) may require a surgical procedure to completely clean the area also allowing for regenerative procedures to be done to regain attachment. This will reduce the depth of the periodontal pockets that will make them more accessible for future cleanings and maintenance. Flap surgery is a common type of such a procedure: a small opening (similar to the flap of a letter envelope) is surgically created in the gum tissue to expose the area of infection around the tooth root and bone.
There are also other types of periodontal surgery for repairing and stimulating regeneration of damaged gum tissues. Using grafts or other enhancements, these plastic surgical techniques are especially useful where gum tissues have receded above the natural gum line, leaving more of the underlying tooth below the enamel exposed to disease. These procedures have become more effective in recent years with the development of specialized technologies called “barrier membranes” and biologic growth factors. These materials have allowed bone grafts to be more successful as this technology is engineered for targeted tissue growth and repair, and then dissolve at an appropriate point in the regeneration process.
Periodontal surgery isn’t appropriate for every situation. Still, these procedures do play an important role for many patients to put a halt to the damage caused by gum disease.
If you would like more information on surgical procedures for gum disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Periodontal Surgery: Where Art Meets Science.”
Did you know that roughly 75% of Americans suffer from some sort of gum disease? Gum disease (also known as periodontal disease) refers to the progressive loss of attachment between the fibers that connect the bone and gum tissues to the teeth, and the consequential loss of the tooth-supporting bone itself.
As you get older, your chances for developing gum disease increase significantly. Here are a few other factors that might put you at a higher risk for developing gum disease:
- Family History. 30% of the population may be genetically susceptible to gum disease. Luckily, there are new tests that can assess if you are at risk. However, even with good oral hygiene, studies have shown that genetically susceptible individuals may be 6 times more likely to develop gum disease.
- Tobacco. Smokers are four times more likely to develop periodontal disease. Smokers have more disease-causing biofilm bacteria and collect it more quickly. They also lose more attachment between the teeth and gums, which leads to more loss of bone that supports the teeth.
- Bleeding Gums. Some people mistakenly think that it is normal for their gums to bleed when they brush. In fact, this is an indication that you are not brushing and flossing effectively and a common symptom of gum disease. Pregnant women are also more likely to have bleeding gums, because elevated hormone levels may cause gum tissues to be more responsive to bacterial biofilm, thus bleeding more easily. That is why we recommend that pregnant women have regular cleanings at three to four month intervals.
We often refer to gum disease as silent, because symptoms may not appear until the disease has advanced. For this reason, you should conduct a self-assessment to identify if you are at risk.
- Have your gums receded and/or do your teeth appear longer?
- Are any of your teeth feeling or getting loose?
- Do your gums appear red or swollen?
- Have you recently had a tooth or teeth extracted because they were loose?
If you answered “yes” to any of these questions, then you may be at risk for gum disease. You should make an appointment with our office so that we can conduct a thorough examination and prescribe treatment, if necessary.
If you would like more information about gum disease, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Assessing Risk for Gum Disease.”