What is periodontal (Gum) Disease

 

Periodontal diseases are a collection of inflammatory disorders characterized by loss of supporting bone and/or tissues that anchor one’s teeth.  The presence and severity of disease is based on a person’s genetic susceptibility, level oral hygiene (ability to control bacteria in plaque), history of tobacco use, and other factors.  For example, Person A may have poor oral hygiene and have substantial bacterial plaque and tartar, but from a genetic standpoint, Person A may not be as susceptible to bacteria that cause periodontal disease.  On the other hand, Person B may have excellent oral hygiene, but still develop periodontal disease due to susceptibility of certain bacteria at inaccessible areas.  These two cases represent extremes.  Most people diagnosed with periodontal disease usually fall somewhere in between.


Symptoms and signs:  In many instances, there are no symptoms or signs of periodontal disease.  Common symptoms are: bleeding, redness and or puffiness of the gums, halitosis (bad breath), loosening of teeth, unexplained ‘spacing’ of teeth, and in rare instances pain or soreness.


Significance:  Periodontal disease not only results in the loss of teeth.  Current research has shown an increased incidence of cardiovascular disease in association with advanced periodontal disease.  People with poorly controlled diabetes are found to have an increased severity of periodontal disease when present. Control of periodontal disease has also been shown to have beneficial effects on the control of diabetes.  Research has also shown that the presence of periodontal disease presents a pregnant mother with the risk of giving birth to a pre-term, low-birth weight infant.


Treatment:  While mild and moderate forms of periodontal diseases are treated by scaling and root planing (deep cleaning), advanced chronic periodontal diseases are best treated by periodontal surgery.  The purpose of surgery is to systematically reduce or eliminate defects in bone in which the roots of the teeth are anchored.  This may be accomplished through the use of guided tissue regeneration via bone grafts, or osseous resection.  Local anesthetic is used to make the procedure painless, and if you are extremely anxious, we can use intravenous sedation (you’re recollection of the events of the procedure will be minimal).  Moderate soreness of a day up to one week can be anticipated.  This is best treated by taking Tylenol 500 mg and Ibuprofen 400 – 600 mg every six hours for the first few days after the procedure.  In almost all instances, we’ll give you a stronger narcotic-based prescription in case you need it. Additionally, antibiotics may be administered.  Take all prescriptions as directed.  Initial healing takes one to two weeks – definitive healing usually takes 4-6 weeks.  You may also experience sensitivity to hot and cold over the next two to six weeks – this will diminish with time.


Maintenance:  Periodontal diseases are controllable, but are not curable.  In order to prevent progression of disease, recall visits are vital.  It is recommended that healthy dental patients are seen twice per year for preventative maintenance.  It is therefore recommended that those of us with periodontal diseases are seen more often, usually three or four times per year for preventative maintenance.  In some instances, a few areas of disease or inflammation may persist after treatment.  These areas may be addressed and arrested individually at maintenance visits, before they progress to advanced disease.  Numerous studies have shown that the majority of people who fail to follow the recommended maintenance intervals after periodontal treatment regress to the moderate or advanced stages of periodontal disease.


Oral Hygiene:  Without proper oral hygiene, no periodontal treatment is effective.  Oral hygiene instructions are administered frequently during visits to our office.  Additionally, we recommend the use of brushing with an electric toothbrush (i.e. Braun OralB or Sonicare) and flossing at least twice daily.  Electric toothbrushes offer a few advantages over conventional brushes.  First, brushing should ideally last for two minutes to be effective.  Electric toothbrushes have built-in timers.  Second, electric toothbrushes regulate the correct amount of manual pressure.  Flossing is often neglected, but this is perhaps the most important portion of oral hygiene.  Bone loss most frequently takes place between teeth.  This is also the most common location for plaque and bacteria to accumulate.  This is not a coincidence.


In closing, it is our sincerest hope that we have provided insight into the importance of properly arresting, treating and preventing recurrence of this disease.  We look forward to helping you.