Posts for tag: periodontal disease
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.
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.”
As we continue to learn about the delicate balance between the body’s various organ systems, we’re discovering what affects one part of the body may affect other parts. This is particularly true for patients with periodontal (gum) disease and one or more other systemic diseases — researchers have identified a number of possible links between them.
Here’s a snapshot of three such diseases and how patients who suffer from them and gum disease may be affected.
Diabetes. Both diabetes (caused by the body’s inability to produce insulin that regulates blood sugar levels) and gum disease can trigger chronic tissue inflammation. Because of inflammation, diabetics are more prone to infectious diseases like gum disease. From the other perspective, uncontrolled gum disease and its resultant inflammation can worsen blood sugar levels. Some research has shown treatments that reduce oral tissue inflammation in diabetics with gum disease may also help bring their blood sugar levels into normal range.
Cardiovascular Disease. Diseases of the heart and blood vessels can eventually lead to heart attacks and strokes, the world’s leading causes of death. There’s evidence that some types of bacteria that cause gum disease may also contribute to higher risks for cardiovascular disease. Reducing the levels of these bacteria in the mouth through periodontal treatment can help lower the risk of cardiovascular disease.
Osteoporosis. Like gum disease, osteoporosis causes acute bone loss, although from a hormonal imbalance rather than as the result of bacterial infection. The major link between the two conditions, though, relates to their treatments. On the positive side, the antibiotic doxycycline has displayed positive effects on both conditions when administered in low doses. On the other hand, a class of drugs known as bisphosphonates used to treat osteoporosis may limit bone regeneration after tooth extraction and could have implications for using dental implants to replace extracted teeth.
There’s still more research needed on the relationship between gum disease and these and other systemic conditions. There’s widespread optimism, though, that such research could yield new treatment approaches and procedures that bring better healing to the mouth as well as the rest of the body.
If you would like more information on the connection between oral and general health, 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 “Good Oral Health Leads to Better Health Overall.”
Periodontal gum disease is a relentless enemy to dental health that destroys gum tissue and the teeth’s attachment to the jaw. As it ravages these tissues it often creates periodontal pockets, hidden spaces between the teeth and bone that fill with infectious bacteria capable of accelerating damage to teeth and gums.
The primary treatment goal for gum disease is to create an environment that is cleansable below the gum tissues, in order to remove as much bacterial plaque from the tooth, gum and root surfaces as possible. Periodontal pockets pose a challenge to this goal as they are extremely difficult to access using standard cleaning and root planing techniques the deeper they become. Cleaning and treating these deep pockets, however, is made easier with a procedure known as periodontal flap surgery.
This procedure is not a cure, but rather a way to access the interior of a periodontal pocket to remove infection and diseased tissue. In effect, we create an opening — like the hinged flap of a letter envelope — to gain entry into the affected pocket. Not only does this opening enable us to clean out infection within the pocket, but it can also facilitate cleaning the tooth’s root surfaces.
It also provides an opening for us to insert grafting materials to regenerate lost bone and tissue. It’s nearly impossible for this tissue regeneration to occur if bacterial infection and inflammation persist in the affected area. Periodontal flap surgery provides us the critical access we need to effectively remove these contaminants that stymie healthy growth.
This procedure is normally performed with local anesthesia and usually results in little bleeding and minimal post-operative effects. Once we have finished any procedures to clean the pocket and other affected tissues, or installed grafts for future bone and tissue growth, we would then seal the flap back against the tooth using sutures and gentle pressure to promote blood clotting around the edges. We might also install a moldable dressing that re-secures the edges of the flap to their proper position and prevents food debris from interfering with healing.
Periodontal flap surgery is the result of years of research to find the best techniques for treating gum disease. It’s one of many weapons in our arsenal for winning the war against decay and gum disease, and helping you realize a healthier dental future.
If you would like more information on periodontal flap surgery, 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 Flap Surgery.”