Periodontal Disease

What Is Periodontal Disease?

Periodontal disease is a bacterial infection of the gums and bone that, if not treated, can cause you to lose your teeth. Medical research now shows that these bacteria in your mouth can also travel through your bloodstream into other organs in the body. This bacteria has been found to increase the risk and severity of other health-related issues such as:

• Diabetes
• Heart disease and stroke
• Respiratory infections and diseases
• Pre-term and low birth-weight babies
• Osteoporosis

How Did I Get This?

The earliest form of the disease is gingivitis, where the bacteria irritate the gums and cause them to become inflamed and bleed. If gingivitis is not treated, it can advance to periodontal disease.

You're not alone. The American Dental Association (ADA) states that nearly 75% of U.S. adults over age 35 have some form of gum disease. Contributing factors include:

• Genetics
• Changes in hormones such as with puberty or pregnancy
• Poor nutrition
• Medications
• Other systemic diseases such as diabetes or heart disease
• Stress
• Habits such as tobacco or excessive alcohol use
• Poor home care

Plaque is the sticky film that covers your teeth and makes them feel "fuzzy." It can be brushed off or removed from between the teeth with dental floss.

Calculus is plaque that has remained on the tooth surfaces and hardens. It needs to be removed professionally by your dentist or hygienist using dental instruments called scalers.

Symptoms

• Red, puffy, or bleeding gums
• Foul odor or taste in your mouth
• Loose or shifting teeth
• Gums that recede, or shrink, and make the teeth appear longer

But My Gums Always Bleed. What Is the Problem?

Healthy gums do not bleed, even during the dental hygiene appointment. Loaded with bacteria, the plaque and calculus can cause an infection where the first sign is bleeding gums. Periodontal disease doesn't typically hurt until it is in the advanced stages. Bleeding is the body's way of indicating that something is wrong.

Diagnosis

We do a comprehensive exam that includes periodontal charting, where we take measurements and record the spaces or "pockets" between your teeth and gums. In healthy gums, the pockets measure 1 to 3 millimeters in depth and there is no bleeding. Deeper measurements or pockets that bleed indicate a problem.

We look for bone loss on your X-rays and note any loose and missing teeth or areas where your gums have receded. Bone is the stable support for your teeth. The infection causes the bone to shrink, leaving the teeth to become loose.

Treatment

Non-Surgical Periodontal Therapy

If your disease is in the early or moderate phase, we will treat it with non-surgical periodontal therapy. This includes a procedure called scaling and root planing, or "SRP."

• Scaling is the removal of plaque and calculus with a scaler
• Root planing is a more involved procedure that consists of removing the bacteria and toxins from the pockets around your teeth

These procedures may take more than one visit depending on the extent of your disease. In many cases we use anesthetic so that you are comfortable during the procedure. We will also flush the debris out of the pockets with medication and apply local antibiotic to help fight your infection.

Ongoing Maintenance

Once your initial phase of treatment is completed, you will need to return more frequently for periodontal maintenance. At these appointments, we closely monitor and re-evaluate your condition and remove the destructive bacteria at the bottom of the pocket where normal brushing and flossing at home do not reach.

Since periodontal disease is episodic, your course of treatment may be modified to keep your disease under control. If we are unable to control it in our office, we will refer you to a periodontal specialist who will evaluate your condition for possible surgery.

Common Questions

Why Can't I Just Have My Regular Cleaning?

The prophylaxis, or your "regular cleaning," is done to prevent disease. It is for "healthy" gums only. Once you have the disease, more aggressive treatment is needed to get it under control.

What If I Choose Not to Get Treatment?

Periodontal disease is a bacterial infection. It can spread throughout your mouth and to other parts of your body and compromise your overall health. If left untreated, you could lose your teeth. The gums generally respond best when treated in the early phase of the disease, so it is important that you get treatment as soon as possible.

Physicians and surgeons commonly request that a patient have "dental clearance" prior to any type of surgery, due to the possibility that the bacteria can travel throughout the body and cause an infection at the site of the surgery.

How Do I Keep My Disease Under Control?

Getting it under control is the first step in an attempt to prevent its progression. Unfortunately, there is no cure for periodontal disease. After treatment some bacteria do remain. These bacteria reproduce and can reach destructive levels again in as few as 90 days. It is very important to return for your regularly scheduled periodontal maintenance appointments so we can monitor your disease.

What Should I Do at Home?

Up to 70% of your success in maintaining your disease depends on your home care. After periodontal therapy, the gums will begin to heal. To maintain this, your habits will need to change at home. This may include more frequent flossing, using a power toothbrush, and other recommended oral health care aids to help remove plaque more effectively.

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