Periodontal Disease and Treatment

In a healthy mouth, the roots of the teeth have a surrounding ligament attaching it to the bone. The gums then cover the bone and part of the teeth. There is a naturally occurring space between where the gums attach to the root called a sulcus. This space is 1-3 mm in a healthy state and is an effective seal between bacteria in the mouth and the underlying bone.

Periodontal disease, (also called gum disease) is a chronic infection of the support tissues (gums and bone) around teeth. Periodontal disease is caused by the bacteria in plaque and how your body’s immune system responds to the bacteria. Just like the gut, we have both good and bad bacteria in body. Plaque, which accumulates on teeth and gums if we do not brush or floss, is comprised mostly of virulent, harmful bacteria. If we are unable to effectively remove the bacterial plaque off the teeth, they cause the gums to mount an inflammatory response and an infection develops.

The earliest stages of this infection is called gingivitis which is characterized by slightly deepened sulcus depth (called a “pocket”), usually in the 4-5 mm range, with red gums that may bleed with brushing and flossing. Fortunately, this stage of periodontal disease is reversible with early, simple interventions like a cleaning or scaling and root planing (also called “deep cleaning”).

However, is the gingivitis is left untreated, over time the bacteria overwhelm your body’s attempt to fight off the infection. The result is progression from gingivitis to periodontitis and results in irreversible bone loss around the teeth. The “pockets” are now usually deeper than 5 mm and patients may experience signs and symptoms such as:

• Soft, swollen, red and tender gums
• Aching or dull pain in the gums
• Loosening teeth or shifting of teeth
• Bad breath
• Abscess formation or pus in your mouth leading to a bad taste
• Gum recession from the bone loss

If you have any of these signs and symptoms, it is important to see your periodontist to assess for the presence of periodontal disease. Like other chronic inflammatory diseases, patients often do not have pain or readily noticeable symptoms. That is why early detection is critical because early treatment greatly reduces the need for more extensive and involved interventions.

Periodontal Disease Treatment

There are several ways for us to treat periodontal disease depending on the stage and severity of the disease. Should you be diagnosed with periodontal disease, we provide the most predictable care to ensure you achieve your goals of maintaining healthy teeth.

Scaling and Root Planing

This treatment thoroughly cleans any bacterial plaque and tartar (hardened, calcified plaque that is physically stuck on your teeth) between your gums and your teeth. The roots of the teeth are then smoothed over to eliminate any rough spots where bacteria could collect. This is usually only effective in milder cases of gum disease. If your disease is too severe, and especially if you have bone loss, scaling and root planing is still important because it prepares your gum tissues more definitive treatment.

Pocket Elimination Procedure

In some cases, if deep, uncleanable pockets persists, it may be necessary to reduce the pockets to a healthy level of 1-3 mm by way of a pocket elimination procedure. The reason why this is a great treatment for deep pockets is that it allows access to the infected gum tissue, residual tartar, and bad bacteria lingering in deep pockets. Post-operative healing is very routine, and discomfort is usually well managed with only over-the-counter medications such as acetaminophen and ibuprofen.

Tissue Regeneration

If gum and bone tissue have been lost from gum disease, the periodontist can use biomaterials to replace that missing tissue and restore your gum health. We utilize new minimally invasive techniques with magnification to visualize the source of the infection (usually on the roots of the teeth) and thoroughly clean the site out. Afterwards, we use state-of-the-art biomaterials designed to regrow bone, ligament, and gum tissue around tooth roots.

Regardless of which stage of disease you may have, our office tailors specific therapy aimed to treating the disease on an individual patient level. We recognize no two patients are identical in their presentation, risk factors, history, and goals. We pride ourselves in individualizing treatment plans to treat periodontal disease comfortably, predictably, and effectively so you can keep your teeth in function and health for a long time.