Posts for tag: periodontal disease
Periodontal (gum) disease is a serious matter. Not only can it wreak havoc with your gums, it could also cause bone loss in the jaw that supports your teeth.
Gum disease is a bacterial infection that originates from a thin film of food particles on tooth surfaces called plaque. If you're not diligent about removing plaque through daily brushing and flossing, it can become a feeding ground for certain strains of bacteria that trigger gum infections. Left untreated, the disease can advance deeply into the teeth's supporting structures.
We're particularly concerned about furcations, the specific locations where multiple roots of a tooth fork or separate. When these locations become infected we call it a furcation involvement or invasion. The bone along the furcation will begin to deteriorate and dissolve, following a progression of stages (or classes) we can measure by probing the gum tissue or through x-ray evaluation:
- Class I: the furcation feels like a groove, but without any noticeable bone loss;
- Class II: a depression of about two or more millimeters develops indicating definite bone loss;
- Class III: Â bone loss now extends from one side of the root to the other, also known as “through and through.”
Treating furcation involvements can prove challenging because the infection is usually well below the gum line (sub-gingival). As with all gum disease treatment, our primary approach is to remove all plaque and calculus (hardened plaque deposits) where we find it, including around the roots. We typically use specially shaped instruments to clean the root surfaces. We can also employ an ultrasonic device that loosens plaque and calculus with high-frequency vibrations and flushed away with water.
Sometimes, we may need to surgically access involved furcations to clean them and stimulate bone growth with grafting. We can also use surgery to make the areas easier to clean — both for you and for us during your regular office cleanings — to prevent reoccurrences of infection.
Of course, preventing gum disease in the first place is your best defense against oral problems like furcation bone loss. Be sure you brush and floss every day, and visit us for thorough cleanings at least twice a year (unless we recommend more). This will help make sure not only your gums, but the bone that supports your teeth stays healthy.
If you would like more information on treating periodontal (gum) disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “What are Furcations?”
There’s only one way to effectively halt the progressive damage of periodontal (gum) disease — completely remove the bacterial plaque and hardened deposits (calculus) from above and below the gum line that are causing the infection. Although we can accomplish this in most cases with hand instruments called scalers, ultra-sonic equipment or both, some cases may require periodontal surgery to access and clean deeper “pockets” of infection.
As this damaging disease progresses, the supporting bone dissolves and the gum tissues will begin to detach from a tooth, leaving an open space known as a “periodontal pocket.” Besides plaque and calculus pus may also form as a result of the infection. All of this material must be removed from the pocket before healing and, hopefully, tissue reattachment can begin.
Shallow pockets near the gum line are usually accessed and cleaned with hand instruments. But deeper pockets (5 millimeters or greater in depth) may require a surgical procedure to completely clean the area also allowing for regenerative procedures to be done to regain attachment. This will reduce the depth of the periodontal pockets that will make them more accessible for future cleanings and maintenance. Flap surgery is a common type of such a procedure: a small opening (similar to the flap of a letter envelope) is surgically created in the gum tissue to expose the area of infection around the tooth root and bone.
There are also other types of periodontal surgery for repairing and stimulating regeneration of damaged gum tissues. Using grafts or other enhancements, these plastic surgical techniques are especially useful where gum tissues have receded above the natural gum line, leaving more of the underlying tooth below the enamel exposed to disease. These procedures have become more effective in recent years with the development of specialized technologies called “barrier membranes” and biologic growth factors. These materials have allowed bone grafts to be more successful as this technology is engineered for targeted tissue growth and repair, and then dissolve at an appropriate point in the regeneration process.
Periodontal surgery isn’t appropriate for every situation. Still, these procedures do play an important role for many patients to put a halt to the damage caused by gum disease.
If you would like more information on surgical procedures for gum disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Periodontal Surgery: Where Art Meets Science.”
After a dental examination revealed you had periodontal (gum) disease, you began undergoing treatment. Now after several cleaning sessions, the infection has subsided and your gums have returned to a healthy shade of pink.
But your gum care isn’t over — depending on the infection’s severity you may need to visit us more often than the normal six months between regular checkups.
Gum disease arises from dental plaque, a thin film of bacteria and food remnants built up on tooth surfaces due to poor oral hygiene. The bacteria cause an infection in the gums, which initiates a response from the body’s immune system that triggers inflammation.
Without proper treatment, periodontitis can come back in which the infection spreads deeper below the gum line. Pockets of infection can reoccur as gum tissues weaken and lose their attachment to teeth. This continuing damage can ultimately lead to both tooth and bone loss.
To stop the disease it’s necessary to remove all the infection-causing plaque and calculus (hardened plaque deposits) from tooth surfaces, including around the roots. This is performed manually and could require surgery once again to access areas below the gum line.
To guard against this it’s necessary for you to undergo regular periodontal maintenance (PM). Besides cleaning, PM gives us an opportunity to check for signs of returning gum disease and, if found, plan for another round of treatment.
Although not written in stone, the interval between PM appointments that seems the most effective for preventing recurrence is every three months. In cases of advanced, aggressive gum disease, appointments may need to occur at even shorter intervals, for example every two months.
PM for susceptible patients with decreased resistance to disease require extra time and effort for the hygienist, along with a renewed daily hygiene habit of effective brushing and flossing by you to keep the disease at bay. But preventing another occurrence of gum disease and its consequences is well worth this extra attention for the health of your teeth and gums.
If you've undergone treatment for periodontal (gum) disease, you know how involved it can be. After several sessions of plaque and calculus (hardened plaque deposits) removal, your swollen, red gums finally begin to regain their healthy pink color.
But with gum disease, the battle may be over but not necessarily the war. If we don't remain vigilant, there's a high chance you'll experience a re-infection.
That's why periodontal maintenance (PM) is so important for gum disease patients after treatment. Plaque, the thin film of bacteria and food particles responsible for the infection, can grow again on your tooth surfaces as it did before. You'll have to practice diligent, daily brushing and flossing to curb that development.
But it's also important to keep up regular dental visits for advanced cleaning to remove hard to reach plaque and calculus. For most people that's usually twice a year, but for gum disease patients it could be up to four times a year, especially just after treatment. And there's more to these visits than cleaning.
Since our goal is to reduce the chances of re-infection as much as possible, we'll thoroughly examine your teeth, gums and any implants for signs of disease (we'll also include an oral cancer screening). We want to assess the health of your teeth and gums and to see how well you're doing hygiene-wise with plaque control.
If we find signs of gum disease, we'll discuss this with you and schedule a new round of treatment. The sooner we initiate treatment, the better your outcome. In some cases, we may perform procedures that make it easier to access and clean areas where plaque tends to build up.
Overall, we want to prevent the occurrence of any future disease and treat it as soon as possible if it re-occurs. Keeping up diligent PM will help ensure your gums continue to stay healthy.
After treating you for periodontal (gum) disease for some time, we may suggest you see a periodontist, a specialist in gum conditions and diseases. There are a number of reasons for a referral, including the specific type of gum disease you may have developed.
Here are 4 more reasons why seeing a periodontist might be advantageous at this stage in your dental care.
Advanced treatment. All dentists are skilled in basic treatment procedures for gum disease, particularly removing plaque and calculus (hardened plaque deposits) that cause and sustain infections. But if your disease has advanced deeper below the gum line and has resulted in infection-filled void pockets between teeth and gums or in gum recession (the tissues shrinking back from the teeth), you may need more advanced techniques and equipment provided by a periodontist.
Advanced Cleanings. Regular, twice-a-year office cleanings are part of every dental care program. But depending on the severity of your gum disease (and your own hygiene efforts) you may need more frequent and advanced cleanings to keep recurring infections at bay. A periodontist can provide this, as well as help you develop a daily hygiene plan that meets your needs.
Your general health. There are a number of systemic conditions like diabetes, cardiovascular disease or pregnancy that can affect gum health. Many of these issues are tied to tissue inflammation, a major component of chronic gum disease, as well as slower tissue healing. As specialists in the gums and their relationship with the rest of the body, a periodontist can develop a treatment approach that coordinates with these other health issues.
Future restoration preparation. One of our treatment goals with gum disease is to try to prolong the life of natural teeth for as long as possible. In reality, though, some or all of your teeth may have a shortened life expectancy. If a comprehensive dental restoration is in your future, a periodontist can help prepare your gums for the inevitable. They may also be able to repair or restore gum tissues that enhance the appearance of a restoration to create a more attractive smile.
If you would like more information on advanced treatment for periodontal disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Referral to a Dental Specialist.”