Periodontics

The term “periodontal” means “around the tooth.” Therefore, periodontal disease affects the gums and bone supporting the teeth. Gum, or periodontal, disease can cause inflammation, tooth loss and bone damage. The infection starts when the gums become inflamed due to bacteria in plaque, a sticky, colorless film that forms on your teeth. While this is often the main cause of periodontal disease, other factors can also be attributed to affecting the health of the gums and bone, including:

  • Smoking or Tobacco Use
  • Stress
  • Genetics
  • Pregnancy
  • Medications
  • Diabetes
  • Poor Nutrition

Periodontal disease comes in many forms. Gingivitis is perhaps the mildest form of gum disease. While the gums become red, swollen and bleed easily, there is very little to no discomfort associated at this stage of the disease. Through a good oral hygiene regimen and treatment from your dentist, the results of gingivitis can be reversed.

Periodontitis is another form of periodontal disease and can be aggressive or chronic. Aggressive periodontitis displays rapid bone destruction and attachment loss in clinically healthy patients. Chronic periodontitis is one of the most common forms of periodontal disease and is frequently seen in adults. The stages progress slowly and can be recognized by gum recession and pocket formation.

Treatment and Prevention

In certain cases, periodontal surgery may be recommended to treat periodontal disease when non-surgical treatment is ineffective. We may advise procedures such as pocket reduction, soft tissue grafts or bone regeneration to treat periodontal disease. If a tooth has been lost due to periodontal disease, dental implants are always an option for permanent tooth replacement.

Good oral hygiene and regular visits with your dentist and periodontist can prevent periodontal disease. Daily brushing and flossing can keep plaque to a minimum and, in conjunction with professional cleanings 2-4 times a year, can keep your teeth healthy for life.

Gum Grafts

Aggressive tooth brushing or periodontal disease can lead to gum recession, which ultimately results in exposed tooth roots. When tooth roots are exposed, teeth appear too long and can become sensitive to hot and cold liquids and foods. Also, the exposed roots are in danger of decay.

Soft tissue grafts are available to repair this problem as well as prevent further recession, bone loss or decay. The procedure covers the roots where excessive gum recession is present. Gum tissue is taken from your palate or from another donor source to cover the exposed root, thus, evening your gum line and reducing sensitivity levels.

Regeneration

Much in the same way that gum tissue can be restored with soft tissue grafts, the same can be said for those patients who suffer from bone loss due to periodontitis. Bone in the jaw is kept strong and healthy when a healthy tooth is in its socket. However, when bone loss occurs, the tooth has less support, can become loose and eventually be lost.

Guided Tissue Regeneration (GTR) attempts to regenerate lost periodontal structures, such as bone, ligaments and connective tissue attachments that support the teeth. Biocompatible membranes are used conjunctively with bone grafts for the regeneration to be successful.

If a tooth is lost, a patient may seek dental implants to restore his/her smile. However, even dental implants need a healthy jawbone before they can be placed. Guided Bone Regeneration (GBR) or Ridge Augmentation restores the bone before the placement of implants. Biocompatible membranes and bone grafts keep the tissue out, thus allowing the bone to grow.

The recent advances in technology have led to a higher success rate with this procedure, leading to bone formation and resolving the defect.

Scaling

This process can be done above or below the gum line and involves the scraping and removal of plaque and calculus (tartar) from the tooth. Scaling done at regular teeth cleanings usually involves the crown of the tooth. However, in more extreme circumstances, it is necessary to go further below the gum line to thoroughly remove disease-causing bacteria and its by-products on the root surface. In very advanced cases, flap surgery or gingivectomy may be necessary to allow the doctor free access to the infected tooth root.

Planing

After the thorough cleaning of the tooth surface has been completed above and below the gum line, the root of the tooth undergoes a process called planing. This is a process of smoothing the root of the tooth so that any remaining tartar is removed. This also serves two other purposes: it clears away any rough areas that bacteria below the gum line thrive in, and it makes it much easier for the gingival (gum) tissue to re-attach itself to the tooth, effectively reducing the size of the pockets that the plaque and bacteria hide in. This re-growth of tissue is key in stopping a recurrence of gum disease and happens very quickly once the calculus has been removed.

With either of these procedures, your dentist may prescribe you either local or systemic antibiotics and a specially indicated mouth rinse.