Periodontal Treatment

Human-torsoThe word periodontal means “around the tooth”. Periodontal disease attacks the gums and the bone that supports the teeth. Plaque is a sticky film of bacteria, food debris and saliva. If plaque is not removed, it turns into calculus (tartar). When plaque and tartar are not removed, the biofilms associated with them produce toxins (poisons), and they begin to destroy the gums and bone. Periodontal disease is characterized by red, swollen and bleeding gums.

Four out of five people have some form of Periodontal Disease and don’t even know it! Most people are unaware of it because the early stages are usually painless.

Not only is it the number one reason for tooth loss, research suggests that there is a link between periodontal disease and other diseases such as stroke, bacterial pneumonia, diabetes, cardiovascular disease, and increased risk during pregnancy. Research has determined that inflammation and bacteria associated with bacteria and periodontal disease is directly related to these systemic diseases and conditions. Smoking also increases your risk for periodontal disease.

Good oral hygiene, a balanced diet and regular dental visits can help reduce your risk of developing periodontal disease.


Diagnosis

Signs and Symptoms of Periodontal Disease:

  • Bleeding gums – Gums should not bleed even when you brush vigorously or floss.
  • Loose teeth – Caused by bone loss and weakening of the periodontal fibers (fibers that support the tooth to the bone).
  • Persistent bad breath (halitosis) – Caused by the bacteria and their byproducts in the mouth.
  • Pus around the teeth and gums – Sign that there is an infection present .
  • Receding gums – Loss of gums around the tooth.
  • Red and puffy gums – The tell-tale sign of inflammation.
  • Tenderness or pain – The swelling puts pressure on the nerves causing tenderness and sometimes severe pain.

Is Periodontal disease contagious?

  • If you have a family member with periodontal disease. Research suggests that the bacteria that cause peridontal disease can pass through saliva. This means the common contact of saliva in families puts children and couples at risk for contracting the periodontal disease of another family member.

Prevention

smoke-diab-med copyAdults past the age of 35 lose more teeth to gum diseases than cavities. Three out of four adults are affected at some time in their life. The best way to prevent cavities and periodontal disease is by good tooth brushing and flossing techniques, performed daily, and regular professional examinations and cleanings. Unfortunately, even with the most diligent home dental care, people still develop some form of periodontal disease. Once this disease starts, professional intervention is necessary to prevent its progress.

Other important factors affecting the health of your gums include:

  • Tobacco Usage
  • Diabetes
  • Stress
  • Clenching and Grinding Teeth
  • Medications
  • Poor Nutrition

Periodontal Disease and Tobacco

You are probably familiar with the links between tobacco use and lung disease, cancer and heart disease.

Current studies have now also linked periodontal disease with tobacco usage. These cases of gum disease are more severe than non-smokers. There is a greater incidence of calculus formation on teeth, deeper pockets between gums and teeth as well as greater loss of the bone and fibers that hold teeth in your mouth. In addition, your chance of developing oral cancer increases with the use of smokeless tobacco.

Chemicals in tobacco such as nicotine and tar slow down healing and the predictability of success following periodontal treatment. Using tobacco causes lung disease, cancer, heart disease, mouth sores, gum recession, loss of bone and teeth, bad breath, severe tooth staining and less success of dental treatments such as implants and gum therapy.

Diabetes and Oral Health

Individuals suffering form diabetes, especially uncontrolled diabetics, have a higher risk of developing bacterial infections of the mouth. These infections may impair your ability to process insulin, resulting greater difficulty with controlling your diabetes. Periodontal diseases will be more severe than those of a non-diabetics and treatment will be more difficult. You can help resist periodontal infection by maintaining control of your blood sugar levels and by always keeping your mouth clean.


Women and Periodontal Health

female signThroughout a woman’s life, hormonal changes affect tissue throughout the body. Fluctuations in hormone levels occur during pubery, pregnancy and menopause. At these times, the chance of periodontal disease may increase, requiring special care of your oral health.

  • Puberty – During puberty, there is increased production of certain hormones. These higher levels incerase gum sensitivity and lead to greater irritations from plaque and food particles. The gums can become swollen, turn red and feel tender.
  • Menstruation – Similar symptoms ocassionally appear several days before menstruation. There can be bleeding of the gums, bright red swelling between the teeth and gum, or sores on the inside of the cheek. The symptoms clear up one the period has started. As the amount of hormones decrease, so do these problems.
  • Pregnancy – Your gums and teeth are also affected during pregnancy. Between the second and eighth month, your gums may also swell, bleed and become red or tender. Large lumps may appear as a reaction to local irritants. However, these growths are generally painless and not cancerous. They may require professional removal, but usually disappear after pregnancy. Periodontal health should be part of your prenatal care. Any infections during pregnancy, including periodontal infections, can place a baby’s health at risk. The best way to prevent periodontal infections is to begin with healthy gums and continue to maintain your oral health with proper home care and careful periodontal monitoring with your doctor and hygienist.
  • Oral Contraceptives – Swelling, bleeding and tenderness of the gums may also occur when you are taking oral contraceptives, which are synthetic hormones. You must mention any prescriptions you are taking, including oral contraceptives, prior to medical or dental treatment. This will eliminate risk of drug interactions, such as antibiotics with oral contraceptives – where the effectiveness of the contraceptives can be lessened.
  • Menopause – Change in the look and feel of your mouth may occur if you are menopausal or post menopausal. They include feeling pain and burning in your gum tissue and salty, peppery or sour tastes. Careful Oral hygiene at home and professional cleaning may relieve these symptoms. There are also saliva substitutes to treat the effects of dry mouth.

Treatment Methods

Arestin StoryBoardMany times, the early stages of periodontal disease are 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 help limit the areas requiring surgery.

Scaling and Root Planing

The initial stage of treatment is usually a thorough cleaning that may include scaling to remove plaque and tartar deposits beneath the gumline.

The tooth roots may also be planed to smooth the root surfaces allowing the gum tissues to heal and reattach to the tooth.

Antibiotics, irrigation and antimicrobials(chemical agent or mouth rinses) or antibiotic fibers may be recommended to help control the growth of bacteria that create toxins and cause periodontitis. In some cases, antibiotic fibers, chips or beads (see right) may be placed in the periodontal pockets after scaling and root planing to control infection and encourage normal healing.

When deep pockets between the teeth and gums are present, it is difficult to thoroughly to remove plaque and tartar. Hence it is difficult for patients to keep these pockets clean and free of periodontal disease. As a result, surgery may be needed to restore periodontal health. A specialist called a Periodontist may be necessary to perform this more advanced treatment. Dr. Camfield works with some very qualified Periodontists in the area and will discuss that option with you should this type of treatment be deemed necessary.