What is Periodontal Disease?
Periodontal disease is an infection of the tissues and bone that support your teeth. The infection occurs in the shallow crevice between your teeth and gums, called a sulcus. As the tissues are damaged, the sulcus develops into a pocket. The more severe the disease, the greater the depth of the pocket will be, which often leads to bone loss around the teeth.
What causes Periodontal Disease?
Some of the plaque-forming bacteria on your teeth can produce by-products that can irritate the gum tissues and damage the attachment of the gums, periodontal ligament, and bone to your teeth. You can greatly decrease your risk of periodontal disease by removing plaque with a thorough oral hygiene routine. Brush your teeth twice a day and floss them once a day.
Do some factors increase the risk of developing Periodontal Disease? Yes. The following factors can increase the risk of developing periodontal disease:
- Smoking or chewing tobacco
- Some systemic diseases, such as diabetes, can lower your body’s resistance to infection, making periodontal disease more severe.
- Many medications, such as steroids, some types of anti-epilepsy drugs, cancer therapy drugs, some calcium channel blockers, and oral contraceptives can affect the gums. In addition, medications that reduce your salivary flow can result in a chronically dry mouth, which can irritate your oral soft tissues. Let Dr. Bennett, Dr. Arnold or Dr. Woody know about your medications and update your medical history at the dental office when any changes occur.
- Crowns and bridges that no longer fit properly, crooked teeth or fillings that have become defective can contribute to plaque retention and increase your risk or developing periodontal disease.
- Pregnancy or use of oral contraceptives increases hormone levels that can cause gum tissue to be more sensitive to the toxins and enzymes produced by plaque and can accelerate growth of some bacteria. The gums are more likely to become red, tender and swollen, and bleed easily.
Types of Periodontal Diseases:
Periodontal diseases are classified according to the severity of the disease. The two major stages of the disease are gingivitis and periodontitis.
Gingivitis: Gingivitis is a milder and reversible form of periodontal disease that only affects the gums. It develops as toxins in plaque irritates gums, making them red, tender, swollen, and likely to bleed easily. It can usually be eliminated by daily brushing, cleaning between your teeth, and regular dental cleanings.
Periodontitis: Gingivitis may lead to more serious, destructive forms of periodontal disease called periodontitis. There are several forms of periodontitis, with the most common being chronic adult periodontitis. Periodontitis occurs when toxins, enzymes, and other plaque by-products destroy the tissues that anchor teeth into the bone. The gum line recedes, which can expose the tooth’s root. Exposed roots can become susceptible to decay and sensitive to cold and touch.
The sulcus deepens into a pocket in the early stage of periodontal disease. Plaque that collects in these pockets can be difficult to remove during regular brushing and interdental cleaning. By-products from the plaque that collects in these pockets can continue to damage the gums, periodontal ligament, and bone. In some cases, so much ligament and bone are destroyed that the tooth becomes loose. Usually, Dr. Bennett, Dr. Arnold or Dr. Woody can still treat the disease at this point. In the worst of cases, a loose tooth may need to be extracted.
Checking for Periodontal Diseases:
During your checkups, your gums will be examined, which is called a periodontal examination. An instrument called a periodontal probe gently measures the depth of the sulcus surrounding each tooth. The healthy sulcus depth is usually three millimeters or less.
Dental X-rays, or radiographs, also may be taken to evaluate the amount of bone supporting the teeth and to detect other problems not visible during the clinical examination. If periodontal disease is diagnosed, treatment will be provided, or may need to refer you to a periodontist, a dentist who specialized in the treatment of periodontal disease.
How are Periodontal Diseases treated?
Treatment methods depend upon the type of disease and how far the condition has progressed. The first step usually is a thorough deep cleaning that includes scaling to remove plaque and tartar deposits. The tooth roots also may be planed to smooth the root surface, allowing the gum tissue to heal and reattach to the tooth. In some cases, the occlusion, or bite, may require adjustment.
Dr. Bennett, Dr. Arnold and Dr. Woody may also recommend local delivery of antibiotics to help control infection, pain, and to promote healing. This medication is placed directly in the periodontal pocket after scaling and root planing.
Is surgery sometimes needed?
When very deep pockets between teeth and gums are present, it is difficult to thoroughly remove the plaque and tartar even with dental instruments. Likewise, you may have trouble keeping these pockets clean.
If the pockets do no heal after scaling and root planing, periodontal surgery may be needed. One of the goals of periodontal surgery is to reduce the depth of the periodontal pockets to make them easier to keep clean.
With surgery, we can access hard to reach areas that require the removal of tartar and plaque. The tooth root is cleaned and smoothed. Sometimes the bone around the tooth also is smoothed to help remove these pockets. The gums then are sutured back into place or into a new position that will be easier to keep clean at home.
Bone surgery may be used to rebuild or reshape bone that has been destroyed. Grafts of the patients bone or artificial bone may be used, as well as special membranes. Splints, bite guards, or other appliances are used to stabilize loose teeth and to aid the regeneration of tissue during healing. If excessive gum tissue has been lost from the tooth root (gum recession), a gum graft may be performed. After surgery, a protective dressing over teeth and gums is usually applied. An antibiotic and mild pain reliever may be prescribed.
How do I prevent periodontal disease from recurring?
Good oral hygiene at home is essential to help keep periodontal disease from becoming more serious or recurring. We will want to see you at regular intervals, too. You may need to schedule more frequent visits than you have in the past. You don’t have to lose teeth to periodontal disease. Brush, clean between your teeth, eat a balanced diet, and schedule regular dental visits for a lifetime of healthy smiles.