Periodontal disease is an infection of the teeth, gums, and the bone that surrounds the teeth. Most people who have periodontal disease aren't even aware of it, because it's rarely painful, especially in the early stages.
The main cause of periodontal disease is the accumulation of plaque. Plaque is the sticky film of food and bacteria that forms constantly on your teeth. If all of the plaque isn't removed each day, it builds up and mineralizes to become tartar, also called calculus.
If tartar isn't removed, it begins to accumulate on the root surfaces. Bacteria that cause periodontal disease thrive in tartar. These bacteria produce toxins, and it's these toxins, combined with your body's response to them, that destroy bone around your teeth. Professional help is required to remove tartar, because there's no way to remove it at home. A toothbrush or floss won't even budge it.
Since you may have periodontal disease without experiencing symptoms, we perform a thorough examination using X-rays and a periodontal probe.
The crevice between a tooth and the surrounding gum is called a sulcus. A healthy sulcus is two to three millimeters deep. When plaque and tartar invade a sulcus and it becomes deeper than three millimeters, it is called a pocket. We measure the depth of all pockets using a periodontal probe. The measurement is from the bottom of the pocket, where the gum is attached to the tooth, to the top of the gums. In general, the deeper the pockets, the greater the extent of periodontal disease.
We also examine the color, shape, and overall condition of the gums. Bleeding is a sign of infection; healthy gums don't bleed. Healthy gums are firm and lightly stippled. In moderate cases of periodontal disease, we see swollen gums.
X-rays also tell us a lot about periodontal disease, because they allow us to monitor your bone levels. In a healthy mouth, the bone comes up high around the necks of the teeth, and the bone level is even throughout the mouth. With advanced periodontal disease, the bone levels are much lower and are uneven.
What are your choices for treating periodontal disease? If you have periodontal disease, your choices are limited. You could
- Delay treatment
- Choose treatment
Delaying treatment is a risky alternative because periodontal disease never goes away on its own. Periodontal disease is an ongoing, degenerative infection of the teeth, gums, and bone that surrounds the teeth, caused by bacteria. The bacteria produce toxins, and these toxins, combined with the body's reaction to them, destroy the bone around your teeth. Bone lost never grows back. If too much bone is lost, teeth get loose and have to be removed. This means you may end up wearing partial dentures or even full dentures.
Choosing treatment for periodontal disease
Treatment for periodontal disease involves a combination of scaling and root planing, new homecare techniques, more frequent dental appointments, and in severe cases, surgery.
You don't have to lose your teeth to periodontal disease. Although periodontal disease can always recur, daily plaque removal and regular treatment removes the infection and keeps the disease under control.
3 Month Recare
If you have a history of periodontal disease, we must monitor the health of your gums closely so that we can prevent a recurrence of this destructive infection.
Periodontal disease can never be cured; it can only be controlled. And if it isn't carefully monitored and controlled, periodontal disease can eventually cause you to lose your teeth.
We must monitor your gums closely If we've diagnosed periodontal disease, we'll usually recommend a form of periodontal therapy called scaling and root planing to remove the infection from beneath your gums. Following this treatment, we'll have you come to see us every few months for ongoing care, which may include x-rays, re-evaluation of your periodontal health and the effectiveness of your homecare, removal of plaque above and below the gum line, and re-treatment with scaling and root planing if necessary. These frequent checkups are vital for controlling your periodontal disease.
Periodontal disease is site-specific. This means that you may experience a flare-up of the infection in just one periodontal pocket out of the possible total of 192 that exist in your mouth. Bone and tissue loss may occur in only this isolated area, or it may be more widespread. If we aren't checking regularly for this type of damage to your gums and bone, you might not notice that it's occurring, and the destruction would continue unchecked.
Some bacteria do remain after treatment, and they may settle back into the pocket and once again begin the process of reproducing and destroying bone and soft tissue. In as few as 90 days, the bacteria can reach destructive levels once again. Because of the episodic nature of periodontal disease, and in light of the fact that periodontal disease can reestablish itself in as few as 90 days, the typical 6-month re-care appointment just isn't enough for those with a history of periodontal disease. Statistics confirm that re-evaluation at intervals of at least every 3 or 4 months is critical for periodontal patients. This helps us break the stronghold of bacteria in your gums, minimize the recurrence of the infection, and slow or eliminate its destructive effects.
Routine cleanings in our office remove plaque and tartar that exist on your teeth above the gum line, but sometimes, especially if you don't floss regularly, plaque, tartar and bacterial toxins can develop below the gum line. The goal of scaling and root planing is to remove this source of periodontal infection from below the gum line on the surfaces of the roots.
Normally, we'll spread scaling and root planing over several appointments. This will maximize your comfort and allows us to check on the healing and help you fine-tune your homecare efforts.
To keep you comfortable, we may give you local anesthetic before the procedure begins. Then we'll use either a small scaling instrument or an ultrasonic scaler to carefully and meticulously remove plaque and tartar from the top of your tooth all the way down to the bottom of the pocket.
Then, we'll plane -- or smooth -- the root surfaces so your gums can heal and reattach to your teeth. If it appears to be necessary, an antibiotic or alternative medication will be placed in the pocket after it's been scaled and planed to control infection and promote healing. Oral antibiotics might also be prescribed to further combat the infection. Once the source of infection has been removed, your gums will begin to heal, and will once again tighten around your teeth.
Homecare is the key to continuing the healing process. Since brushing and flossing only removes plaque about three millimeters below the gum line, you'll need special tools to clean the affected areas. As part of your treatment, we'll provide you with the tools and techniques you'll need to thoroughly clean and maintain these areas.