John M. Neeb, D.D.S.
Periodontal Disease & Treatment
Resources: American Dental Association available at http://ada.org
Periodontal disease is an infection of the tissues that support your teeth. Your gum tissue is not attached to the teeth as high as it may seem. There is a very shallow v-shaped crevice called a sulcus between the tooth and gums. Periodontal diseases attack just below the gum line in the sulcus, where they cause the attachment of the tooth and its supporting tissues to break down. As the tissues are damaged, the sulcus develops into a pocket: generally, the more severe the disease, the greater the depth of the pocket.
Periodontal diseases are classified according to the severity of the disease. The two major stages are gingivitis and periodontitis. Gingivitis is a milder and reversible form of periodontal disease that only affects the gums. Gingivitis may lead to more serious, destructive forms of periodontal disease called periodontitis.
It is possible to have periodontal disease and have no warning signs. That is one reason why regular dental checkups and periodontal examinations are very important. Treatment methods depend upon the type of disease and how far the condition has progressed. Good oral hygiene at home is essential to help keep periodontal disease from becoming more serious or recurring. 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.
Some factors increase the risk of developing periodontal disease:
- Tobacco smoking or chewing
- Systemic diseases such as diabetes
- Some types of medication such as steroids, some types of anti-epilepsy drugs, cancer
- therapy drugs, some calcium channel blockers and oral contraceptives
- Bridges that no longer fit properly
- Crooked teeth
- Fillings that have become defective
- Pregnancy or use of oral contraceptives
Several warning signs that can signal a problem:
- Gums that bleed easily
- Red, swollen, tender gums
- Gums that have pulled away from the teeth
- 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 change in the fit of partial dentures
If left untreated, this disease may lead to so much destruction of bone that supports the teeth, that teeth can be lost due to lack of support. Fortunately, there are treatments that can be completed to diminish the effects of this disease progression.
Treatment for periodontal diseases
When periodontal disease is present, simple removal of deposits on the teeth is no longer an appropriate choice. In the presence of periodontal disease, periodontal debridement (also called therapeutic scaling and/or root planting, and known as "nonsurgical periodontal therapy") is indicated. These procedures can be the definitive treatment for gingivitis or early periodontal disease. Once periodontal therapy is complete, supportive periodontal maintenance care is implemented. This includes continuing care visits where the patient's oral health is monitored and debridement procedures are performed to prevent the return to a disease state. Other components of nonsurgical periodontal therapy and supportive periodontal maintenance care could include sub gingival antimicrobial irrigation and treatment for dentinal hypersensitivity.
If the disease is severe, however, referral to a periodontist is necessary. This professional specializes in treatment of the bone, which supports the teeth.
How can I prevent periodontal (gum) disease?
The good news is that you can help prevent periodontal (gum) disease by taking good care of your teeth every day and having regular dental checkups. Here's how to keep your teeth and gums healthy:
Brush your teeth well twice a day.
This removes the film of bacteria from the teeth. Be sure to use a soft-bristled toothbrush that is in good condition. Toothpastes and mouth rinses containing fluoride strengthen the teeth and help prevent decay. Choose products that bear the American Dental Association Seal of Acceptance, your assurance that they have met the ADA's standards for safety and effectiveness. The ADA reviews all advertising claims for any product bearing the Seal. The Seal on a product is an assurance for consumers and dentists against misleading or untrue statements concerning a product's safety and effectiveness.
Clean between your teeth every day.
Cleaning between your teeth with floss or interdental cleaners removes bacteria and food particles from between the teeth, where a toothbrush can't reach. Early periodontal (gum) disease can often be reversed by daily brushing and flossing. If you use interdental cleaners, ask your dentist how to use them properly, to avoid injuring your gums.
Eat a balanced diet.
Choose a variety of foods from the basic food groups, such as breads, cereals and other grain products; fruits; vegetables; meat, poultry and fish; and dairy products, such as milk, cheese and yogurt. Limit between-meal snacks.
Visit your dentist regularly.
It is important to have regular dental checkups, and professional cleaning is essential to prevent periodontal diseases.
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