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Treatment of Periodontal or Gum Disease
Periodontal diseases range from simple gum inflammation to more serious disease which results in damage to the supporting structures of your teeth which include the soft tissue and supporting bone. With more severe periodontal disease teeth are often lost. Periodontal disease has been linked to other serious health problems such as diabetes and heart disease.
Periodontal disease is caused by bacteria. Our mouths are full of bacteria. These bacteria reside on sticky, colorless "plaque" on teeth. Brushing and flossing help us get rid of plaque. Plaque that is not removed can harden and form bacteria-harboring "tartar" that brushing and flossing can’t remove. Only a professional cleaning by a dentist or dental hygienist can remove tartar.
Periodontal disease can be diagnosed early as gingivitis. As plaque and tartar remain on teeth, they accumulate more bacteria. The body senses these bacteria and mounts an immune response against the bacteria which causes inflammation of the gums that is called "gingivitis." In gingivitis, the gums become red, swollen and can bleed easily. Gingivitis is a mild form of gum disease which can usually be reversed with daily brushing and flossing, and a regular cleaning.
When gingivitis is not treated, it can advance to "periodontitis" (which means "inflammation around the tooth.") In periodontitis, the gums pull away from the teeth and form "pockets" that are infected. The normal pocket space between tooth and gum is usually 1-3 mm. Pockets 4 mm and greater signify periodontal disease. As the body's immune system fights the bacteria present in the tartar, bacterial toxins and the body's enzymes fighting the infection actually start to break down the bone and connective tissue that hold teeth in place causing deeper pocket depths. If periodontal disease is not treated, the loss of bone support causes teeth to become loose and they eventually need to be extracted or pulled.
There are several risks factors that are associated with developing periodontitis. Smoking is one of the most significant risk factors associated with the development of periodontitis and smoking also hinders the treatment of periodontal disease. People with diabetes are at higher risk for developing infections, including periodontal disease. Research shows that stress can make it more difficult for our bodies to fight infection, including periodontal disease. Some people have genetic susceptibility and are more prone to severe periodontal disease than others.
Symptoms of periodontal disease include bad breath that won't go away, red or swollen gums, tender or bleeding gums, painful chewing, loose teeth and/or sensitive teeth. Because periodontitis progresses slowly people usually don't pay attention to the symptoms of gum disease until they get a sudden swelling and/or a loose tooth which needs to be pulled. Men are more likely to have periodontal disease than women and although teenagers rarely develop periodontitis, they can develop gingivitis, the milder form of gum disease.
The main goal of treatment is to control the infection by removing the plaque through a deep-cleaning method called scaling and root planing. Scaling means scraping off the tartar from above and below the gum line. Root planing gets rid of rough spots on the tooth root where the germs gather, and helps remove bacteria that contribute to the disease. After scaling and root planing you will need to be seen every three months for periodontal maintenance. It is almost impossible to clean pockets deeper that 3 mm at home and so when pockets are present greater than 3 mm it is important to have a periodontal maintenance visit every three months. At this visit we will measure your pockets to see if your periodontal disease is getting better or worse and treat accordingly.