Periodontal diseases range in scope and severity but they all have the commonality of loss of attachment of the tooth to the bone. Of course, the treatment of periodontal disease comes with an accurate diagnosis which includes not only a clinical evaluation of the issue but also may include a laboratory component of a saliva sample sent for analysis. A detailed report then helps us make better decisions for your specific condition in regards to treatment options. Think of it as a blood work-up for your mouth.
Periodontal diseases can be accelerated by a number of different factors such as diabetes, and xerostomia (dry mouth). However, it is primarily caused by oral bacteria. There are over 900 potential species of bacteria known to exist in the oral environment and most are harmless or beneficial. Others are bad players and contribute to periodontal disease and can be found in other areas of your body as previously mentioned. There are bacteria we target with comprehensive periodontal therapy.
The goal of periodontal treatment is ZERO areas of bleeding. This is very very important. If your gums do not bleed bacteria cannot get into your blood stream. Inflammation is the killer of gums and many other systems in your body.
Preventing Gum Disease
The best way to help prevent gum disease is effective daily brushing and flossing as well as regular professional examinations and cleanings. Additionally altering any risk factors will be helpful such as smoking cessation, improve glycemic control (for diabetics). Unfortunately, even with the most diligent home dental care, people still can develop some form of periodontal disease. Once this disease starts, professional intervention is necessary to prevent its progress.
Bacteria found in plaque produce toxins or poisons that irritate the gums, which may cause them to turn red, swell and bleed easily. It is the immune response of the host (you) that determines the extent of the attachment loss. There is a complex pathway of immuno-responses that occurs and contributes to the environment necessary for periodontal disease. The aim of therapy is to interrupt the pathway with not only mechanical removal of the bacteria but management with local and systemic antibiotics as indicated. On occasion, patients will not respond to treatment and will require a deeper level of exploration such as a DNA evaluation to determine if there are underlying genetic factors that are responsible for the continued disease.
Scaling & Root Planning
When the deposits on the roots and teeth have hardened, it is not possible to remove them with a toothbrush, floss, or a rubber cup. The build-up needs to be removed with specialized hygiene instruments or ultrasonic scaling or a combination of both. Generally, the area is anesthetized and the hygienist cleans the area(s). By having the area numb, they can get to the bottom of the pocket (sulcus) and removed the bacteria comfortably. Each quadrant of the mouth is generally cleaned on separate appointments depending upon the patient’s clinical needs. The entire mouth should be cleaned in one appointment. Important follow-up will occur in 6-8 weeks following the initial therapy then every 3-4 months following for the first year. After all the disease is treated then we can re-evaluate and recommend the frequencies of cleanings.
Following initial non-surgical gum treatment, we will place you on a recommended frequency of periodontal maintenance to continue to address any problematic areas that arise. Typically this is 3-6 months depending upon your clinical needs.