Posts for tag: periodontal disease
After several treatment sessions your periodontal (gum) disease is under control. But, while we may have won this battle, the war rages on. To keep an infection from re-occurring we'll have to remain on guard.
Gum disease begins and thrives on a thin film of bacteria and food particles on tooth surfaces called plaque. The infection usually begins as gingivitis, which causes the gums to become red and swollen (inflamed). Untreated it can develop into periodontitis, a more advanced form that progresses deeper into the gum tissues resulting in bone loss.
To treat the disease, we must remove all the plaque and calculus (hardened plaque deposits) we can find no matter how deeply they've penetrated below the gum line. Since the deeper it extends the more likely surgical techniques may be necessary to consider, it's better to catch the disease in its earliest stages when plaque can be removed with hand instruments or ultrasonic equipment.
The appropriate treatment technique can effectively stop and even reverse gum disease's effects — but it won't change your susceptibility. Constant vigilance is the best way to significantly reduce your risk of another episode. In this case, our prevention goal is the same as in treatment: remove plaque.
It begins with you learning and applying effective brushing and flossing techniques, and being consistent with these habits every day. As your dentist, we play a role too: we may need to see you as often as every few weeks or quarter to perform meticulous cleaning above and below the gum line. We may also perform procedures on your gums to make it easier to maintain them and your teeth, including correcting root surface irregularities that can accumulate plaque.
Our aim is to reduce the chances of another infection as much as possible. "Fighting the good fight" calls for attention, diligence and effort — but the reward is continuing good health for your teeth and gums.
If you would like more information on continuing dental care after 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 Cleanings.”
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.”
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.”
If you suspect you have periodontal (gum) disease, it's important to get a correct diagnosis and begin treatment as soon as possible. The sooner you begin treatment the better the long-term outcome.
Gum disease is a bacterial infection that's most often triggered by plaque, a thin film of food particles on tooth surfaces. Plaque buildup most often occurs when a person doesn't practice effective oral hygiene: daily brushing and flossing and professional cleanings at least twice a year.
The most common type of gum disease, gingivitis, can begin within days of not brushing and flossing. It won't always show itself, but you can have symptoms like swollen, red or bleeding gums, as well as bad taste and breath. You could also develop painful abscesses, which are localized pockets of infection within the gums.
If we don't stop the disease it will eventually weaken the gum attachment to the teeth, bone loss will occur and form deep pockets of infection between the teeth and bone. There's only one way to stop it: remove the offending plaque from all tooth surfaces, particularly below the gum line.
We usually remove plaque and calculus (hardened plaque deposits) manually with special hand instruments called scalers. If the plaque and calculus have extended deeper, we may need to perform another procedure called root planing in which we shave or “plane” the plaque and calculus (tartar) from the root surfaces.
In many cases of early gum disease, your family dentist can perform plaque removal. If, however, your gum disease is more extensive, they may refer you to a periodontist, a specialist in the treatment and care of gums. Periodontists are trained and experienced in treating a full range of gum infections with advanced techniques, including gum surgery.
You can also see a periodontist on your own for treatment or for a second opinion — you don't necessarily need a referral order. If you have a systemic disease like diabetes it's highly advisable you see a periodontist first if you suspect gum disease.
If you think you might have gum disease, don't wait: the longer you do the more advanced and destructive the disease can become. Getting an early start on treatment is the best way to keep the treatment simple and keep gum disease from causing major harm to your teeth and gums.
If you would like more information on the diagnosis and treatment of 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 “When to See a Periodontist.”
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.