Periodontal disease is more commonly known as gum disease and was referred to as pyorrhea in the old days. It is a progressive inflammatory disease of the gingival and the surrounding tissue (bone) around the teeth. Periodontal disease is the number one cause of tooth loss after the age of 30 and it is believed that around 80% of the population above the age of 30 may suffer from this disease, with varying degrees of severity. It is usually painless and is mainly caused by plaque although pregnancy, diabetes, epilepsy, and such medications as chemotherapy, medication prescribed for heart problems, birth control pills, and antidepressants can all make you more susceptible to gingivitis which is one of the more common forms of periodontal disease.
Treatment will depend upon the type of periodontal disease and progression
There are many forms and stages of periodontal disease.
Gingivitis The first stage of periodontal disease, gingivitis, is the mild inflammation of the gingival caused by plaque build up. Your gingival will be red, swollen, and tender. You may also notice bleeding while you brush and floss. This stage of periodontitis is reversible.
Mild Periodontitis Inflammation will spread to the supporting alveolar bone. Minor bone loss and the formation of periodontal pockets, or food traps, may occur.
Moderate Periodontitis In this stage, there will be increased gingival recession, moderate to deep pockets, moderate to severe bone loss, and mobility of teeth due to the bone loss.
Severe Periodontitis This is the most serious stage of periodontitis. Deep pockets, increased mobility of teeth, movement of teeth out of position, and visible fistulas (boils) will be present in this stage. Pus may develop; bone loss continues, and your teeth may loosen or fall out.
Prevention of gum diseases
The best way to prevent periodontal disease and tooth decay is to maintain good oral health care. Brushing your teeth every day will remove a thin sticky film of bacteria, called plaque that grows on your teeth. Cleaning between the teeth once a day with floss removes plaque from between the teeth – areas where the toothbrush can’t reach. Brushing and flossing are essential in preventing gum disease. Brush your teeth twice a day, with a soft-bristled brush. Use a formula of toothpaste that contains fluoride, which helps protect your teeth from decay. It is also advisable to seek regular dental visits that include a periodontal evaluation.
Oral Hygiene If the disease is still in the first stage (gingivitis) your dentist may prescribe an anti-microbial mouth and advise you to brush and floss on a regular basis. Dental Prophylaxis Treatment for the prevention of periodontal diseases or other dental diseases by the cleaning of the teeth in the dental office using the procedures of Dental Scaling and Polishing. The treatment may include plaque detection, removal of supra- and subgingival plaque and calculus, application of caries-preventing agents, checking of restorations and prostheses and correcting overhanging margins and proximal contours of restorations, and checking for signs of food impaction.
Scaling is procedure that meticulously removes contamination toxins, micro-organisms, plaque, tartar, cementum, dentin that is rough and/or permeated by calculus from around, below and under the gum line down to the bottom of the pocket. This is done to remove biofilm, calculus, and toxin down to the bottom of each periodontal pocket in order to obtain a healing response.
Root Planing Root planing involves smoothing the root surfaces of your teeth with thin curettes so gum tissue can more firmly reattach to roots that are clean and smooth to prevent tooth loss and sensitivity problems. The procedure makes it more difficult for plaque to accumulate along the root surfaces. Because this procedure goes deeper than a regular cleaning, your mouth may be numbed. The cleaning may take two visits to complete. Depending on the extent of the disease you may need one or more sections (quadrants) of the mouth to be treated with scaling and root planing. Treatment may require one or more visits.
Periodontal Flap Surgery is recommended in many cases where pocketing depths have reached a level that makes maintenance or cleansing difficult. It is often associated with areas of bone loss and inflammation of the gum tissue around the teeth.
When scaling and root planing have been unsuccessful in eliminating the entire pocket of decay, or when there has been bone loss that needs to be surgically corrected, then a dentist may perform periodontal flap surgery. In flap surgery, under local anesthesia, small incisions are made in the gum, so that it can be lifted back to expose the tooth and bone. The entire area is carefully cleaned and all tarter and infected granulation tissue are removed and the bone is examined. Because periodontal disease causes bone loss, often the bone will need to be re-contoured in order for the gum to heal properly.
After scraping away the bacteria-laden plaque and tartar, the dentist removes diseased tissue and smoothes the surface of damaged bones. Then the dentist sews the tissue back into place. Removing or smoothing damaged tissue allows the gum tissue to better reattach to healthy bone.
Periodontal flap surgery is sometimes necessary to treat advanced periodontal disease if scaling and root planing proves ineffective. Deep pocketing along with underlying bone defects can prevent the gum tissues from fully healing and staying healthy. The procedure involves the loosening of the gums from around the teeth in order to fully expose and the clean the parts of the teeth which were previously covered by the gums.
Soft tissue grafts can be used to cover roots or develop gum tissue where absent due to excessive gingival recession. A thin piece of tissue is grafted from the roof of the mouth, or gently moved over from adjacent areas, to provide a stable band of attached gingiva around the tooth. The gingival graft may be placed in such a way as to cover the exposed portion of the root. During this procedure, the periodontist takes gum tissue from your palate or another donor source to cover the exposed root. This can be done for one tooth or several teeth to even your gum line and reduce sensitivity.
A soft tissue graft can reduce further recession and bone loss. In some cases, it can cover exposed roots to protect them from decay. Soft tissue grafts and other root coverage procedures are a predictable way to cover unsightly, sensitive or exposed root surfaces, to prevent future gum recession and restore healthy gum tissue. This will reduce further bone loss and recession, make the tooth less sensitive, protect the root from root cavities, and look more natural when you smile. If you are unhappy with the appearance of short unsightly teeth this can be greatly improved by a combination of periodontal procedures by our Periodontic dentist.