Periodontal Disease (or commonly called gum disease) generally affects everyone at some point in their lives. Studies have shown at any one time more than 80% are affected by the disease. It is an extremely common disease that if left untreated is quite progressive. Luckily, for most patients, periodontal disease in its earliest form, gingivitis, is reversible. Kind of gives patients an opportunity to correct any failings they may have regarding at home dental care.
The earliest stage of periodontal disease is gingivitis (or simply inflammation of the gum tissues). This is the earliest and most mild form of periodontal disease. Symptoms include red, swollen (or puffy) and inflamed gums due to plaque-bacteria build-up. The gums may also bleed easily during brushing or eating of hard foods.
During the earliest of stages the periodontal disease process it can be reversed thru proper brushing, flossing and professional dentistry to remove the excess bacterial plaque. If the required oral hygiene does not occur, the periodontal disease then progresses to the next stage. The majority of people with this early form of periodontal disease, do not even know a dental problem exists. This is a crucial period for the patient, as the condition can be reversed (since the bone and connective tissue that hold the teeth in place have not yet been adversely affected) at this point if it is recognized, diagnosed, and properly treated by a dental professional.
Gingivitis is also commonly seen during puberty, pregnancy, times of high stress, and menopause, as raging hormones can make you more prone to inflammation. As for the rest of the population, poor dental hygiene is generally the most common cause, followed by medication and certain medical conditions.
As the periodontal disease progresses it is now becoming harder to treat and control. The difference between gingivitis and periodontitis is that gingivitis only infects the gum tissue that surrounds the teeth while the periodontal disease process also invades the bone that provides support and stability for the teeth. The bacteria eventually invades past the initial the gum line area and destruction begins to the point that gums may begin to separate or pull away from the teeth (taking away support and connective fibers with it). What results are called periodontal pockets. These pockets allow for bacteria to invade below the gum line.
They eventually become loaded with toxic plaque and bacteria that moves and works its way deeper. It begins to erode the bone below the gum line. A patient’s bite will be affected (as the teeth shift or loosen) by the lost support which then affects chewing and other daily functions.
As the periodontal disease process advances further, the fibers and bone that provide support for the teeth are broken down and destroyed. At least half (50%) of the bone support (if not more) will have broken down at this late stage of periodontal disease. It does not grow back naturally. Teeth may begin to loosen. Deep root cleanings and surgical intervention are typical at this stage. This may include cleaning with a periodontal microscope, (Perioscope), grafting of tissue, bone, placement of growth factors, (Emdogain), periodontal antibiotic regimen (Periostat), placement of antibiotics directly into pockets, (Arestin), open periodontal flap surgery, and, possibly even tooth removal.
Below are five common myths about periodontal disease that are dispelled by our dental staff:
- Periodontal disease is not a common problem. As mentioned above gum disease is actually an extremely common dental problem, although it is often left undiagnosed in the earlier stages in patients who do not seek out regular dentistry care.
- You can only get gum disease if you have tooth decay also. Tooth decay and gum disease are two very different oral conditions that can impact the health of your smile. Though both can develop due to poor dental health habits, this does not mean that they are the same. They can develop separately and generally do.
- Tooth loss is guaranteed if you have periodontal disease. When caught in the earlier stages and treated, gum disease can be managed and controlled. With this in mind, many patients can reduce their risk of tooth loss by visiting their dentist to control the periodontal disease process.
- Bad breath is an sign of gum disease. Sometimes but not always. However, patients with advanced stages may have chronic bad breath(halitosis), alongside other symptoms. The earlier stages of gum disease do not often associate with bad breath, which can leave it undetected unless a dentist has determined an infection is present.
- Gum disease can be cured. Gum disease in the later stages, called periodontitis, cannot be cured. However, with the help of a dentist, patients can manage the infection and keep it under control. Dental hygiene maintenance is key in keeping the condition from progressing further.
Bacteria That Causes Periodontal Disease
Periodontal disease and tooth decay are triggered by different types of bacteria and are considered to be two separate and distinct disease conditions. However, they work hand in hand to break down our teeth and gum tissues if left unchecked. Swollen and receding gums allow the more vulnerable areas of the tooth (root areas) to be exposed to cause an increased incidence of tooth decay. On the other side, patients with extensive tooth decay, the broken down teeth allow for food trap areas which keep periodontal tissue chronically inflamed.
Treatment of Periodontal Disease
The earliest stages of periodontal disease are reversible. This is accomplished thru proper brushing, flossing, and maintaining a regular schedule with your dentist. A professional cleaning by your dentist or hygienist is the only way to remove plaque and tartar especially below the gum line. The hygienist will clean (also called scaling) your teeth to remove the tartar and plaque buildup from above and below the gum line.
If the periodontal disease condition worsens, then a scaling and root planing procedure may be necessary. Root planing helps smooth irregularities on the roots to make it more difficult for plaque to deposit and stick there. Also makes it easier for you to keep your teeth clean at home.
Treatment may also include use of antibiotics. If you have advanced periodontitis, your gum tissue may not respond to nonsurgical treatments and good oral hygiene. In that case, your periodontitis treatment may require dental surgery. This surgical intervention may include:
-Pocket Reduction Surgery (also called Flap surgery). In this procedure, your periodontist makes tiny incisions in your gum so that a section of gum tissue can be lifted back, exposing the roots for more effective scaling and planing. Because periodontitis often causes bone loss, the underlying bone may be recontoured before the gum tissue is sutured back in place. The procedure generally takes from one to three hours and is performed under local anesthesia.
–Soft tissue grafts. Gum tissue is often lost as part of the periodontal disease process making your teeth appear longer than normal. You may need to have damaged tissue replaced to return your cosmetic appearance back to normal. This procedure can help reduce further gum recession, cover exposed roots and give your teeth a more cosmetically pleasing appearance.
–Bone graft. This procedure is needed when periodontitis 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.
-Antibiotics and medicaments – A wide array of antibacterial rinses(Peridex), antibiotics taken in pill form, (Periostat) or localized placement directly into the affected pockets(Arestin), can aide in and promote healing of the affected gum tissue.
-Guided tissue regeneration. This allows the regrowth of bone that was destroyed by bacteria. In one approach, your dentist places a special piece of biocompatible fabric between existing bone and your tooth. The material prevents unwanted tissue from entering the healing area, allowing bone to grow back instead.
-Enamel matrix derivative application. Another technique involves the application of a specialized gel to a diseased tooth root. This gel contains the same proteins found in developing tooth enamel and stimulates the growth of healthy bone and tissue. An example of this is the use of emdogain. To ensure a successful result following periodontal therapy, patient cooperation in maintaining excellent oral hygiene is essential. More frequent professional cleanings can help reduce the likelihood of the periodontal disease ever returning.
By scheduling regular checkups, early stage periodontal disease can be treated before it leads to a much more serious condition. If your periodontal disease is more advanced, treatment in the dental office will be required. Periodontal disease can be managed and controlled for most patients. Following a regular routine of brushing, flossing, and seeing your dentist should be enough for most to keep periodontal disease at bay.
Periodontal disease is a fixable condition in its earliest stages. As it progresses, it can be managed but not cured. It is important to seek out regular dental care to keep your teeth and gums as healthy as possible. Avoiding dental care will only make it worse as time goes on. It will not only increase chance of tooth loss but also increase the financial strain of managing the disease.
If you are ready for a smile makeover, contact Marielaina Perrone DDS at (702) 458-2929 to schedule a no cost cosmetic consultation appointment. We cannot wait to help you with your smile makeover to create the smile of your dreams in Summerlin, Henderson, and Las Vegas, NV.
Marielaina Perrone, DDS, is a highly experienced and dedicated dental professional passionate about delivering exceptional patient care. With over 20 years of experience in the dental industry, Dr. Perrone is widely regarded as a leading authority in her field, with a reputation for providing innovative solutions and personalized care to her patients.