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Periodontal Disease- is a group of diseases that affect the tissues that support and anchor the teeth. If untreated, periodontal disease results in the destruction of the gums, alveolar bone (the part of the jaws where the teeth arise), and the outer layer of the tooth root. The earliest form of periodontal disease is called gingivitis. Gingivitis is reversible with proper treatment.

Once a patient is diagnosed with advanced periodontal disease (also called periodontitis), their dentist will recommend procedures above and beyond that of a normal professional cleaning to properly treat and manage the periodontal disease. In the initial stages, most treatment revolves around non surgical intervention but as the periodontal disease progresses surgical treatment is often recommended and required.

Periodontal Disease Treatment

Non Surgical Procedures

-Scaling and root planing. This procedure is a special type of cleaning that removes plaque and tartar from under the gum line and makes the root surfaces smooth. The smoother root surface is thought to promote reattachment of the gum tissue and promote healing. This type of cleaning is the only way to remove tartar from below the gum line. This is usually completed in multiple visits utilizing a numbing anesthetic to make the procedure more comfortable..

-Drug Therapy. In some cases, antibiotics or antimicrobials may be used to supplement the effects of scaling and root planing. In most cases of early periodontal disease, scaling and root planing in addition to continued daily cleaning at home (flossing, brushing , and rinsing) will achieve a satisfactory result of reversing periodontal disease.  A wide array of antibacterial rinses such as Peridex, antibiotics taken in pill form such as  Periostat, or localized placement directly into the affected pockets with an antibiotic such as Arestin, can aide in, and promote healing of the affected gum tissue.

-Periodontal maintenance or supportive periodontal therapy: Following a scaling and root planing, routine specialized  cleanings (every 3-4 months)  to target your periodontal problem area, can minimize the recurrence or progression of periodontal disease.

Surgical Procedures

-Pocket depth reduction procedures: Your dentist or periodontist will open up the affected gum tissue so that periodontal disease causing bacteria and calculus build up can be easily seen and removed. Some cases may require contouring and smoothing of the damaged bone and root surfaces to allow the gum tissue to reattach to healthy bone during the healing phase. The procedure also repositions the gum tissue so that it is easier to keep clean going forward.

-Perioscope cleaning: A deep cleaning requiring a microscope to be placed below the gum line to remove tartar, cement, or other debris.

-Regeneration. Your dentist will treat the affected gum tissue in the same way as in pocket depth reduction procedures, with the additional procedure of using membranes, bone grafts or tissue-stimulating proteins to stimulate the body’s natural ability to regenerate healthy bone and gum tissue. A good example of this is a bone and tissue growth factor called Emdogain.

-Soft tissue grafts. Your dentist will take synthetic tissue such as Alloderm, or healthy gum tissue from the roof of the mouth (palate) or other areas of the mouth and use it to repair receding gums and cover exposed root surfaces.

-Hard Tissue Bone Grafts.  This procedure is needed when periodontal disease has destroyed the bone surrounding your tooth. The bone graft helps prevent tooth loss by holding your tooth in place. It also serves as a platform for the regrowth of natural bone. The dentist can use your bone, cadaver bone, cow bone, or a lab created calcium based bone matrix material.

Conclusion

If you have been diagnosed with periodontal disease please take the news very seriously. Periodontal disease is a progressive disease that will continue to get worse without treatment. Periodontal disease  leads to tooth loss and oral infections. Your dentist can help you with diagnosis, prevention, better oral hygiene methods and instruction, and proper treatment for your particular needs.  Studies have shown time and again that there is a link between oral health and your general health. Keeping your mouth healthy will lead to better overall health. As always visit your dentist regularly for dental examinations and regular professional cleanings to stave off the onset of periodontal disease.

Is the sipping of hot coffee or the eating of cold ice cream sometimes a painful experience for you? If your answer is YES, you may have a common problem called sensitive teeth.

Tooth sensitivity is tooth or teeth discomfort that is provoked by hot, cold, sweet, or acidic foods and drinks, or breathing in cold air. The pain can be sudden, sharp, and shoot deep into the nerve endings of your teeth.

There are two very different types of sensitivity:

Dentinal Sensitivity. This occurs when the middle layer (dentin) of a tooth is exposed to the outside. Dentin is usually covered by enamel above the gum line and by cementum (bone like connective tissue covering the root of a tooth) below the gum line. There are tiny openings called tubules in the dentin. Inside each tubule there is a nerve branch that comes from the tooth’s pulp (the nerve center of the tooth). When the dentin is exposed, these nerve branches can be affected by hot, cold, or certain foods. This causes tooth sensitivity.

When the outer protective layers of enamel or cementum wear away the dentin becomes exposed to the outside. This can affect one tooth or multiple teeth. Dentin exposure can be be caused in a variety of ways. These can include:

1. Aggressive brushing. The enamel layer can be worn away from brushing too hard.

2. Plaque build up. The presence of plaque on the root surfaces can cause sensitivity.

3. Tooth wear that occurs over time from chewing and brushing.

4. Untreated dental cavities.

5. Gingival recession. When the gums recede they expose the tooth’s roots. Receding gums often are caused by periodontal diseases or by aggressive brushing. Receded gums are very common and up to four fifths of people have gum recession by the time they are 65.

6. Periodontal surgery (gum surgery) that exposes the tooth’s roots.

7.  Tooth whitening.

8. Frequently eating acidic foods or liquids.

Pulpal sensitivity. This is a reaction of the tooth’s pulp. The pulp consists of a mass of blood vessels and nerves in the center of each tooth. Sensitivity of the pulpal tissue tends to affect only one tooth. Causes of this type of sensitivity can include:

1. Dental cavities or infection.

2. Placement of a recent filling.

3. Excessive pressure from grinding or clenching your teeth.

4. A cracked or broken tooth.

If you feel a sharp pain upon biting, you may have a broken or cracked filling. Pain when you release your bite is a sign of a cracked tooth.

sensitive teeth

toothpaste for sensitive teeth

You dentist will be able to diagnose the type of sensitivity you have. You want to rule out pulpal sensitivity as that requires more extensive treatment. If it is decided you have dentinal sensitivity then we will suggest a few options for you. The most conservative way is by use of a sensitivity toothpaste. I recommend Colgate Sensitive Pro-Relief which I believe to be the best on the market today. I have found it to be the most effective in eliminating or limiting the symptoms of tooth sensitivity. Other options include use of a fluoride varnish or a bonded desensitizing agent that we would apply in office. As well as use of an at home fluoride rinse.

In severe cases of hypersensitivity that is persistent and cannot be treated by other ways, your dentist may recommend endodontic (root canal therapy) treatment to eliminate the sensitive teeth issue.

If you or a loved one is experiencing either type of sensitivity, the best approach would be to schedule a dental appointment for further evaluation.