NJ Periodontology Specialty Permit #3925

100 Town Center Drive

Warren, New Jersey

Tel: (908) 222-3337

Fax: (908) 222-0032

Periodontal Disease Treatment/Prevention

Periodontal Disease

Periodontal disease is caused by the bacteria in dental plaque. Plaque is a sticky substance that forms on the teeth soon after we brush. The primary cause for gum disease is poor oral hygiene which leads to accumulation of dental plaque at the gum line.

Periodontal (gum) diseases, including gingivitis and periodontists, are serious infections that left untreated can lead to loss of the tooth. Periodontal means Perio= around, and odont= tooth. However, the word periodontal literally means around the tooth. Periodontal disease is a chronic bacterial infection that affects the bone and the gums that support the teeth.

Gingivitis

Gingivitis is the mildest form of periodontal disease. It causes the gums to become, red, swollen, and bleed easily. There is usually little or no discomfort at this stage. Gingivitis is reversible with professional treatment and good oral home care.

Untreated gingivitis can advance to Periodontitis.

Periodontitis

Periodontitis involves progressive loss of the alveolar bone around the teeth, and if left untreated can lead to loosening of the teeth and subsequently to loss of teeth. Plaque can spread and grow below the gum line. Toxins produced by the bacteria in plaque cause irritation to the gums. These toxins stimulate a chronic inflammatory response. This inflammatory process causes the body to in essence turn on itself, and the tissues and bone that support the teeth are broken down and destroyed.

Along this process the gums separate from the teeth, forming periodontal pockets (spaces between the teeth and the gums) which allows more accumulation of plaque. Undisturbed plaque calcifies and forms calculus, which is commonly called tartar. As the disease progresses. The pockets deepen and more gum tissue and bone are destroyed. Often this destructive process has very mild symptoms.

Eventually, if untreated at this stage teeth can become loose and may have to be lost.

Treatment of Periodontal Disease

Removal of bacterial plaque is essential to establish periodontal health. In most cases the first step in treatment of Periodontitis involves a non surgical cleaning below the gum line. This procedure is called scaling and root planning.

Scaling and Root Planning

The procedure is performed following use of local anesthetics. This prevents undue discomfort, and allows the doctor to do detailed debridement. Ultrasonic, and other mechanical cleaning devices are commonly used in conjunction with hand-held curettes/scalers to cleave calcified deposits, stains from the tooth/root surfaces. The actual scaling and planing of the roots reestablishes a smooth root surface (above and below the gum line), to allow the gum tissues a clean surface on which to heal/reattach.

The patient is reevaluated in 3-4 weeks after the initial scaling and root planning to determine if the procedure was successful in reducing the pocket depths and eliminating inflammation.

Periodontal Surgery

In some case a surgical therapy is necessary to manage the signs of disease activity. There are many surgical approaches used in treatment of advanced periodontitis. The best approach for each case is determined by the Dr.

Osseous Surgery

Osseous (meaning bone) surgery involves removing or reshaping the bone under the gum. Gum disease is its attendant infection that spreads below the gums and destroys the bone structure. In some cases this causes the bone to become irregularly shaped and prevents the gums from lying flat, which makes it harder for the patient to clean. However the reshaping of the bone might be necessary to allow the patient to better clean and maintain the area.

Gingivectomy

A Gingivectomy is necessary when the gums have pulled away from the teeth causing the tissues to be retractable, and also the pockets are very deep. The procedure involves removing and reshaping loose, diseased gums.( Does not involve remodeling of the bone)

Pocket Reduction (Flap Surgery)

Flap surgery is performed to remove tartar deposits or to reduce the periodontal pocket to make it easier for the patient and the dental professional to clean. This procedure involves lifting the gums back and cleaning the tartar. The gums are sutured back in place so that the tissues can fit snuggly around the teeth. In some cases irregular surfaces of the demerged bone are smoothed to limit areas were disease-causing bacteria can hide. This allows the gum tissue to better reattach to healthy bone.

Prevention of Periodontal Disease

There is really no mystery in the prevention of periodontal disease. The cornerstone of successfully preventing periodontal disease is establishing excellent oral hygiene.

Daily oral hygiene measures that prevent gum disease include:

  • Brushing properly on a regular basis( at least twice a daily)
  • Flossing and using intradental brushes (if there is a sufficiently large space in between the teeth), as well as cleaning behind the last molar in each quarter of the mouth.
  • Use a soft tooth brush and aim for the mid section of the tooth to prevent damage to tooth enamel and sensitive gums.
  • Regular dental check ups and professional teeth cleaning as required. The dental check-ups monitor your oral hygiene methods, and also monitor attachment around teeth, identify any early signs of periodontitis.

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Copyright © 2012 Anthony T. Chin, D.D.S. All rights reserved.