Periodontal Maintenance

What is periodontal disease?

The word periodontal means “around the tooth”. Healthy gum tissue fits like a cuff around each tooth. Where the gum line meets the tooth, it forms a slight v-shaped crevice called a sulcus. In healthy teeth, this space is usually 3 millimeters or less. Periodontal diseases are infections that affect the tissues and bone that support teeth. As the tissues are damaged, the sulcus develops into a pocket that is greater than three millimeters. Generally, the more severe the disease, the greater the pocket depth and bone loss. The enlarged pockets allow harmful bacteria to grow and make it difficult to practice effective oral hygiene. Left untreated, periodontal diseases may eventually lead to tooth loss.

How would I know if I had periodontal disease?

It’s possible to have periodontal disease without apparent symptoms. That’s why regular dental checkups and periodontal examination are very important.

Several warning signs can signal a problem If you notice any of the following, you should have a periodontal screening exam.

  • Gums that bleed easily
  • red, swollen or tender gums
  • gums that have pulled away from your teeth
  • persistent bad breath
  • pus between the teeth and gums
  • loose or separating teeth
  • a change in the way your teeth fit together when you bite
  • a change in the fit of partial dentures

What causes periodontal diseases?

The mouth is filled with countless bacteria. Periodontal disease begins when certain bacteria in plaque produce toxins and enzymes that irritate the gums and cause inflammation. The resulting inflammation, which may be painless, can damage the attachment of the gums and bone to the teeth.

Good oral hygiene, brushing twice a day and flossing or using another interdental cleaner once a day helps to reduce the plaque film. Plaque that is not removed regularly can harden into rough porous deposits called calculus or tarter. Once the hardened tartar forms, it can only be removed when teeth are cleaned at the dental office.

The periodontal-systemic disease inter-relationships

Tooth loss is not the only potential problem posed by periodontal diseases. Research suggests that there may be a link between periodontal diseases and other health concerns such as diabetes, cardiovascular disease, stroke, bacterial pneumonia and increased risk during pregnancy. Researchers are trying to determine if bacteria and inflammation associated with periodontal diseases play a role in affecting these systemic diseases and conditions.

There are different types of periodontal disease.

Gingivitis which is the mildest form of periodontal disease It cause the gums to become red, swollen and bleed easily. There is usually little or no discomfort at this stage. Gingivitis is reversible with professional treatment and good oral care at home.

Chronic Periodontitis
This is a form of periodontal disease that results in inflammation within the supporting tissues of the teeth. Patients experience progressive loss of tissue attachment and bone. Chronic periodontitis is characterized by pocket formation and recession of gum tissue. It is prevalent in adults, but can occur at any age. Progression of attachment loss usually occurs slowly, but periods of rapid progression can occur.

Aggressive Periodontitis
This is a highly destructive form of periodontal disease that occurs in patients who are otherwise clinically healthy. Common features include rapid loss of tissue attachment and destruction of supporting bone around teeth. This disease may occur in localized or generalized patterns.

Treating Periodontal disease

Periodontal treatment methods depend upon the type and severity of the disease. If the disease is caught very early and no damage had been done you may simply be given instructions on improving your daily oral hygiene.

The first step to treat the disease involves a special cleaning called scaling and root planing. This procedure removes plaque and tartar deposits on the tooth and root surfaces. this helps gum tissue to heal and pockets to shrink, which makes it more difficult for plaque to accumulate along the root surfaces. This is sometimes referred to as a “deep cleaning” and usually takes two visits to accomplish.

Sometimes medications are used to treat the disease. These medications could include a pill, a mouth rinse, or a substance that the dentist places directly in the periodontal pocket after scaling and root planing. It is also important to control any systemic disease like diabetes.

If deep pockets develop and it is difficult to completely remove plaque and tartar even with thorough daily oral hygiene and if the pockets do not heal after scaling and root planing, periodontal surgery may be needed. At that point the patient is usually referred to a gum specialist called a periodontist for treatment of these more advanced cases of periodontal disease.