Periodontal Therapies - Periodontal Disease - 05/19/2003
What is Periodontal Disease?
Periodontal (gum) disease is a condition in which bacteria attack the tissues that surround and support teeth. Simply put, it is an infection that can result in tooth loss if not treated. Because it is often painless, you may not be aware that you have a problem until your gums and bone are seriously affected. The good news is that periodontal diseases often can be treated in the early stages with a treatment called scaling and root planing.
What Causes Periodontal (Gum) Disease?
Plaque is a sticky film of bacteria that clings to teeth and gums. Even if you brush and clean between your teeth every day, you may not completely remove plaque, especially around the gumline. The bacteria in plaque create toxins that injure the gums and underlying bone. Over time, these toxins can destroy gum and bone tissue.
Plaque that is not removed completely every 24 to 48 hours hardens into a rough, porous deposit called tartar, or calculus. Once tartar develops, the only way to remove it is by having your teeth cleaned at the dental office.
Tartar that builds up below (under) the gumline makes it more difficult to remove the film of plaque. This can lead to chronic inflammation and infection.
If you schedule regular dental checkups, your dentist can detect developing periodontal disease before the gums and the bone supporting your teeth are irreversibly damaged. Periodontal diseases are progressive - left untreated, the condition will worsen.
See Your Dentist If You Notice Any of the Following Warning Signs:
- Gums that bleed easily
- Red, swollen or tender gums
- Gums that have pulled away from the teeth
- Pus between the teeth and gums when the gums are pressed
- Persistent bad breath or bad taste
- Permanent teeth that are loose or separating
- Any change in the way your teeth fit together when you bite
- Any changes in the fit of partial dentures
Diagnosing Periodontal Disease
During a checkup, the dentist examines your gums for periodontal problems. An instrument called a periodontal probe is used to gently detect "pockets" between your gums and teeth.
At the very edge of the gumline, gum tissue is not attached to each tooth. Instead, there is a very shallow v-shaped groove called the sulcus between the tooth and gums. The normal space between teeth and healthy gums should be three millimeters or less. With periodontal disease, this tiny space develops into a pocket that collects more plaque bacteria and is difficult to keep clean.
If gum disease is diagnosed, your dentist may provide treatment, or you may be referred to a periodontist, a dentist who specializes in the diagnosis, prevention and treatment of periodontal diseases. Treating the disease depends on how far the condition has progressed.
Gingivitis is the earliest stage of the disease. The gums become red, swollen and they may bleed easily. At this stage, the disease is still reversible. If not treated, it may lead to a more severe condition called periodontitis.
Periodontitis is the more advanced stage of periodontal disease. At this stage, the disease may require more complex treatment to prevent tooth loss. The gums, bone and other structures that support teeth are damaged. Teeth can become loose and fall out - or they may have to be removed.
Prevention and Treatment
The first line of defense is prevention. This includes a good oral hygiene routine at home. Brushing twice a day and cleaning between teeth once a day with floss or an interdental cleaner helps prevent plaque from accumulating. The dental office staff may provide instructions on additional cleaning methods or oral hygiene products to use at home.
Regular dental checkups and cleanings are important in preventing periodontal diseases. If these measures are not taken, the likelihood of disease increases. In some cases, even with these measures, a certain percentage of patients experience some form of periodontal disease that must be treated.
When your dentist diagnoses periodontal disease, one of the treatments is scaling and root planing. Depending on the extent of the disease, your dentist may recommend that one or more sections (quadrants) of the mouth be treated. Treatment may require one or more visits.
Scaling is used to remove plaque and tartar beneath the gumline. A local anesthetic may be given to reduce any discomfort. Using a small scaler or ultrasonic cleaner, plaque and tartar are carefully removed down to the bottom of each periodontal pocket. The tooth's root surfaces are then smoothed or planed to allow the gum tissue to heal and reattach to the tooth.
Once the scaling and root planing treatment is complete, another appointment will be made so the dentist can check how your gums have healed and how the periodontal pockets have decreased. When pockets greater than 3 mm persist after root planing and scaling, additional treatment may be needed.
You'll be given instructions on how to care for your healing teeth and gums. Caring for your teeth and gums after treatment is critical. Practicing good oral hygiene every day will reduce the risk of recurring periodontal disease.
Periodontal disease will not go away by itself. Left untreated, surgery may be needed to save affected teeth. Preventing and treating the disease in the early stages are the best ways to keep your smile healthy.
You'll be given instructions on how to care for your healing teeth and gums. Caring for your teeth and gums after treatment is critical. Practicing good oral hygiene every day will reduce the risk of recurring periodontal disease.
Periodontal disease will not go away by itself. Left untreated, surgery may be needed to save affected teeth. Preventing and treating the disease in the early stages are the best ways to keep your smile healthy.
For more information, visit www.perio.org