WHAT IS YOUR PERIODONTAL IQ?

Periodontal Disease

Even if you go to your dentist regularly, you may benefit from an evaluation by a Periodontist who has had three additional years of specialized training in the area of periodontics and dental implants.

Periodontal (gum) disease is an ongoing bacterial infection affecting the gums and bone supporting the teeth. As erosion takes place, periodontal pockets become infected. Symptoms are often mild as destruction takes place. Periodontal disease can affect one or several teeth. If left untreated, this can lead to tooth loss or potential health risks associated with diabetes, heart disease, prosthetic joint replacement, and pregnancy.

Symptoms and Diagnosis Accordian Control

Periodontal disease can easily go undetected and, often times, causes no discomfort. As a result, it may not be diagnosed until in an advanced stage. Late detection may result in tooth loss.

Warning signs and symptoms:

Red, swollen, bleeding, tender gums
Persistent halitosis (bad breath)
Bleeding while brushing, flossing or eating
Loose gums, receding gums, or gum tissue that appears to be separating from the tooth
Teeth feeling loose
Teeth having an elongated appearance
Pus or exudate from the gum tissue or between teeth
Sores in the mouth
Poor fitting partial dentures

Healthy

Unhealthy

Professional Diagnosis

Periodontal (gum) disease is diagnosed by measuring pocket depths and evaluating dental radiographs (x-rays) for bone loss during a comprehensive evaluation.

An instrument called a probe is used to gently measure the depth around each tooth.
Deeper pockets determine the stage of periodontal (gum) disease and treatment options.
Dental radiographs (x-rays) are used to evaluate the bone supporting your teeth.
Poor levels of bone are a sign of damage caused by periodontal (gum) disease.
Bone is needed to keep teeth stable and supported.

Causes

The primary cause of periodontal (gum) disease is bacterial plaque consistently forming on your teeth. Bacteria in your mouth are normal. If these bacteria are not effectively removed they will multiply and cause destruction to the tissue and bone supporting your teeth. Other factors can also adversely effect the health of your gums. Each person is uniquely different which means the cause, symptoms, and treatment may differ from patient-to-patient.

LACK OF DENTAL CARE

Improper home care and/or lack of regular dental care is a leading cause of periodontal (gum) disease. Brushing after meals, flossing 1-2 times per day and regular preventive care helps keep periodontal disease at bay. Without this, your gums will harbor more bacteria and deposits thus increasing inflammation and bone loss. Dental professionals have the ability to remove hardened plaque and disrupt bacterial colonies in an effort to keep your mouth healthy.

SMOKING AND/OR TOBACCO USE

Not only is this habit linked to serious health conditions such as cancer, lung and heart disease; it also increases your risk for periodontal (gum) disease. In fact, it may be a significant factor in causing and promoting the disease. Smoking decreases the blood supply and oxygen needed to fight infection and keep tissue and bone healthy.

Smokers are more likely to develop periodontal (gum) disease and have a higher percentage of treatment failure and complications. Smoking cessation should seriously be considered to improve overall health as well as oral health.

DIABETES AND OTHER SYSTEMIC DISEASES

Over 300 million people worldwide are affected with diabetes. It's estimated only half of Americans with diabetes have been diagnosed by a physician. The International Diabetes Federation (IDP) supports previous research: proper management of periodontal (gum) disease can help reduce the risk of developing diabetes and with those who have diabetes, help them to control blood sugar levels. Periodontal (gum) disease is an inflammatory disease which aggravates diabetes, a disease which weakens the immune system, and vice versa.

Recent research supports what healthcare professionals have long suspected: there is a link between periodontal (gum) disease and other systemic diseases such as cardiovascular disease.

GENETIC PREDISPOSITION

According to a study published by the Journal of Clinical Periodontology, up to 30% of the population may be genetically susceptible to developing severe periodontal disease. Despite impeccable home care habits, these people are still very likely to develop the disease.

ADDITIONAL CAUSES

For women, hormonal fluctuations can cause their body, including gums, to react negatively. This increases the risk for periodontal (gum disease). Pregnancy in women is also linked to an increased susceptibility to periodontal (gum) disease which studies suggest heightens the chance of preterm, low birth weight babies.

Certain medications such as oral contraceptives, anti-depressants, and heart medication can adversely affect oral health. Current medications should be updated with your dentist or periodontist at each appointment.

Clenching and/or Grinding can put additional force and stress on the tissues supporting teeth increasing the deterioration of the periodontal tissues. Some patients may benefit from a custom-fit, lab fabricated occlusal guard.

Stress also decreases the bodies ability to fight infection and disease.

Treatments Accordian Control

Treatment for periodontal (gum) disease can vary from patient to patient. An individualized treatment plan will be discussed at the first appointment. Treatment recommendations are intended to improve periodontal health and help patients keep their natural teeth as long as possible.

INITIAL PERIODONTAL THERAPY

Typically, this is the initial phase of treatment in reducing inflammation by removing plaque and hardened deposits. This is accomplished through careful and thorough instrumentation of the tooth's root surfaces to remove plaque, calculus (hardened tartar) and to disrupt bacterial toxins.

After initial therapy has been completed, patients return for their first periodontal maintenance appointment and re-evaluation. At this appointment, bone levels and inflammation will be remeasured. Although improved, non-surgical therapy may not achieve optimum periodontal health. Often times, pocket reduction procedures are indicated to repair destruction from the disease, access debris in areas of advanced disease, and aid in homecare practices. Either way, after treatment, patients will require ongoing therapy to maintain periodontal health.

POCKET REDUCTION PROCEDURES

Periodontal pocket reduction procedures/surgery, often times the secondary phase of treatment, is recommended when initial therapy does not repair unhealthy gum tissue to an optimum level. Ideally, gum tissue and bone should fit tightly around the tooth. Periodontal disease (gum) causes the bone and gum tissue to be destroyed causing pockets around the tooth. Gradually, these pockets become deeper allowing harmful bacteria to flourish. If left untreated, tooth loss or the need for tooth removal is likely.

During pocket reduction procedures, a periodontist will surgically access the most advanced areas of periodontal (gum) disease. The disease causing bacteria and debris will be removed. In some cases, bone can be severely destroyed causing defects. When this occurs, the periodontist may be able to use regenerative materials to reverse some of the negative effects. This can be accomplished by bone grafting which encourages the body to regenerate bone and tissue.

After pocket reduction has been accomplished, individuals will be able to better clean and maintain the newer, reduced pocket depths. The combination of healthier gums, improved home care, and regular maintenance by a professional will significantly increase the likelihood of keeping your natural teeth. The normal recommended interval for periodontal maintenance (cleaning) is every three (3) months. A healthy mouth decreases the chance of serious health problems associated with periodontal (gum) disease.

PERIODONTAL MAINTENANCE (CLEANING)

Routinely referred to as a periodontal cleaning, periodontal maintenance is implemented following initial periodontal therapy and/or after pocket reduction procedures. Maintenance continues at varying intervals but typically a three month schedule. This will be determined by your dentist and periodontist.

Many patients question the need for more frequent periodontal cleanings. Research indicates it takes approximately 90 days for bacteria to recolonize and start causing destruction. The goal is to maintain gains accomplished with treatment and prevent progression of the disease. Keep in mind, there is no cure for Periodontal (Gum) Disease. It can only be managed and maintained.