Periodontal (Gum) Treatment

Periodontal disease, or “gum” disease, affects four out of every five adults. This makes periodontal disease one of the most common diseases affecting mankind, and is the leading cause of tooth loss in adults. It is caused by the presence of bacterial plaque. Plaque is formed by the action of the bacteria normally found in your mouth on remaining food debris. The result of this bacterial plaque is the formation of acids causing tooth decay, and other chemicals causing gingivitis, or inflammation of the gums. In its early stages gingivitis may result in slightly sore, red, swollen gums that may bleed when brushed. The early stages of gingivitis are so mild that most of us have accepted this condition as normal. Bleeding gums are not healthy! Bleeding tissue is normally a sign of damage, and with minor exception is usually a sign of developing disease.

As gingivitis progresses inflammation of the bone that holds in the tooth occurs. When inflamed, bone does not become swollen, but rather resorbs, or literally dissolves away! Chronic ongoing bone loss causes loosening of teeth and their eventual loss if not effectively treated.

Contemporary dentistry can successfully treat progressive periodontal disease if it is diagnosed early enough. The type and extent of treatment will depend on the severity of the problem, but with your help successful treatment is possible. The following are some of the types of treatment utilized in comprehensive family dentistry to eliminate periodontal disease. The actual approach to your problem will be discussed with your dentist, your hygienist, and possibly a periodontist.

Routine Prophylaxis (Cleaning)

This is the routine “cleaning” that everyone associates with comprehensive family dentistry. It is meant to preserve the mouth’s existing state of health. Its purpose is to remove plaque and calculus (tartar) that has developed above the gum line. Prophylaxis is appropriate treatment for those who have healthy gums or mild gingivitis. Excessive amounts of calculus due to inadequate home care or delayed treatment will first require a debridement to enable effective removal of all disease causing calculus during a subsequent prophylaxis.

Note that a diagnosis of healthy or mildly inflamed gingiva must be made before instituting prophylaxis as a definitive treatment. Prophylaxis is not effective treatment in the presence of gum pocketing or bone loss. Because the symptoms of periodontal disease are usually minimal, the absence of discomfort or overt symptoms is not an indication of relative health.

The following procedures are used to treat patients diagnosed with periodontal (gum) disease:

Scaling and Root Planing (deep scaling)

Gingivitis has progressed, gum pockets have developed, and some loss of tooth-supporting bone is evident. If the bone loss is substantial, loosening of teeth will be detected. The ongoing exposure of root surfaces to the disease promoting toxins found in plaque cause the root surface to become softened, thereby harboring additional bacterial plaque. Scaling and root planing is performed to remove calculus below the gum line, reduce the level of disease producing bacteria on the root surface, and smooth the root surface to promote healing.

Irrigation of the gum pocket with antibiotics is frequently performed. Localized, minor gum pocketing may successfully be treated in this fashion. More severe gum pocketing may not be totally resolved solely by scaling and root planing, and may require additional therapy.

Periodontal Surgery

If you’re diagnosed with advanced periodontal disease surgical correction may be recommended. Long standing periodontal disease invariably takes its toll. Tooth-supporting bone is lost as a result of the chronic inflammation caused by disease producing bacteria. Significant gum pocketing develops along with tooth loosening and bone loss, and makes it increasingly difficult to control the disease with even the most meticulous oral hygiene efforts. The deep gum pockets associated with periodontal disease cannot be effectively cleansed to control the disease process. While there are varying types of periodontal surgical procedures available to comprehensive family dentistry, the intended outcome of all these procedures is to eliminate the gum pockets. In severe cases where periodontal surgery cannot repair the structures that hold the tooth in place, tooth extraction may be needed.

What do I do if I lose teeth because of periodontal disease?

The loss of teeth always has some negative, sometimes severe, long-term impact. You doctor will discuss the potential for future problems due to tooth loss, address your concerns with you and make appropriate recommendations.

Download a helpful guide to Periodontics here, and feel free to contact us if you have any questions.