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Gum Disease & its Treatment


What Is Periodontal Disease/Gum Disease?


Gum disease is an infection of the tissues that surround and support your teeth. Because gum disease is usually painless, you may not know you have it. Also referred to as periodontal disease, gum disease is caused by the bacteria that is constantly forming on our teeth.

Here Are Some 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

There are many factors that increase the risk of developing gum disease, including: smoking, pregnancy and diabetes. It is important to visit Dentistry with Smiles if you suspect you have gum disease, because the sooner you treat it the better.

The Early Stage of Gum Disease Is Called Gingivitis


If you have gingivitis, your gums may become red, swollen and bleed easily. At this stage, the disease is still reversible and can usually be eliminated by a professional cleaning at your dental office, followed by daily brushing and flossing.

Advanced Gum Disease Is Called Periodontitis


Chronic periodontitis can lead to the loss of tissue and bone that support the teeth and it may become more severe over time. If it does, your teeth will feel loose and start moving around in your mouth. It usually gets worse slowly, but there can be periods of rapid progression.

Aggressive periodontitis is a highly destructive form of periodontal disease that occurs in patients who are otherwise healthy. Common features include rapid loss of tissue and bone, and may occur in localized areas or in the entire mouth. Periodontal disease cannot be cured, however, we have measures to help slow or stop the progression.

Research between systemic diseases and periodontal diseases is ongoing. While a link is not conclusive, some studies indicate that severe gum disease may be associated with several other health conditions such as diabetes or stroke.

Regular dental checkups and periodontal examinations are very important. The treatment methods that our dentist diagnoses will depend upon the type of disease and how far the condition has progressed. Good dental care at home is essential for helping to keep periodontal disease from becoming more serious.

Prophy (Regular Cleanings)


A prophy includes a series of procedures where plaque, calculus and stain are removed from all surfaces of the teeth above the gum line. This is done with hand instruments, ultrasonic scalers, and coronal polishing. Only a licensed dental professional is qualified to determine the need for oral prophylaxis. Only a dentist, dental hygienist or a trained dental assistant can perform the procedure.

Periodontal Maintenance
A periodontal maintenance procedure (PMP) is defined as a procedure that is recommended following periodontal treatment (such as scaling and root planing) and continues at varying intervals, determined by the clinical evaluation of the dentist.

These intervals can be as frequent as every two months and they can be extended as long as six months, depending on the patient. Keeping up your PMP interval is important because periodontal disease can recur without adequate follow-up.

PMP includes removal of plaque and tartar above and below the gums, scaling and root planing of specific areas, and polishing. PMP is always completed following active periodontal treatment such as scaling and root planing or more extensive gum surgery.

Scaling and Root Planing
Scaling and root planing is a special type of treatment that goes deeper BELOW the gum line to remove contaminated debris and bacteria, most often performed on patients with active periodontitis.

This seems to be a procedure that causes much confusion for patients trying to understand the difference between "just a cleaning" and scaling and root planing, and the need/reason for this procedure.

A professional polishing or prophy removes only the soft sticky plaque and hard crusty calculus that is ABOVE the gum line on the crown of the tooth. Scaling and root planing is done to remove soft sticky plaque and hard crusty calculus that is loaded with bacteria, around and BELOW the gum line on root surfaces. It is a method of treating gum disease when pockets formed around the teeth have a measurement of greater than 3mm and there is evidence of bleeding and tissue attachment loss.

Scaling
Scaling is a procedure that meticulously removes contaminated biofilm, plaque, calculus, microorganisms and toxins from around the gum line down to the bottom of each periodontal pocket, in order to obtain a healing response.

Root Planing
Root planing involves smoothing the root surfaces of your teeth with thin instruments so gum tissue can more firmly reattach to roots that are clean and smooth, to prevent tooth loss and sensitivity problems. This procedure makes it more difficult for plaque, calculus and bacteria to accumulate along these root surfaces.

Because this procedure goes deeper than a regular cleaning, your mouth may be numbed. The cleaning may take one to six visits to complete. Depending on the extent of the disease, you may need one or more quadrants of the mouth to be treated with scaling and root planing.

Some Reasons Why Root Planning May Be Necessary
•  To control the growth of harmful bacteria
•  Help the pocket wall reattach firmly to the clean root surface
•  Prevent further bleeding of the gums from disease
•  Reduce inflammation
•  Reduce discomfort
•  Prevent bone loss
•  Prevent gum disease related tooth loss
•  Reduce systemic disease

Home Care After Root Planing and Scaling
Rinse with warm salt water every few hours (1/2 tsp. salt in 8 oz. water) for the remainder of the day to encourage healing and sooth discomfort. Be careful not to bite or chew your lip, cheek or tongue while they are numb. Avoid chewing for 2 hours after this procedure or until numbness has worn off. Keep your fingers and tongue away from the areas that have been treated. Take Tylenol or ibuprofen according to directions on the manufacturer label for a couple of days to help with the discomfort; do NOT take aspirin because it may prolong bleeding.

Rinse your mouth with Closys or Chlorohexidine, if prescribed by your dentist, to reduce oral bacteria. Do not smoke or chew tobacco for 72 hours after the procedure to allow for healing. Gently brush and floss your teeth after each meal. How you care for your teeth and gums at home after treatment is critical to reducing the risk of recurring periodontal disease.
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