Gum disease is usually caused by plaque, a sticky film of bacteria that constantly forms on teeth. If plaque is not removed with thorough daily brushing and cleaning between teeth, gums become irritated and inflamed. The irritated gum tissue can separate from the teeth and form spaces called pockets. Bacteria move into the pockets where they continue to promote irritation. Left untreated, the process can continue until the bone and other tooth-supporting tissues are destroyed. The early stage of periodontal disease is called gingivitis. It often results in gums that are red and swollen and may bleed easily.
During the first visit, the doctor usually reviews the patient’s complete medical and dental histories. It is extremely important for us to know if any medications are being taken or if the patient is being treated for any condition that can affect periodontal care, such as heart disease, diabetes, or pregnancy.
The doctor examines the gums, checks to see if there is any gum line recession, assesses how the teeth fit together when biting, and checks the teeth to see if any are loose. We will also take a small measuring instrument called a probe and place it between the teeth and gums to determine the depth of those spaces, known as periodontal pockets; this helps the periodontist assess the health of the gums. digital X-rays may also be taken to observe the health of the bone below the gum line.
Treatment for Gum Disease
Non-Surgery Treatment
Professional dental cleaning. During a typical checkup your dentist or dental hygienist will remove the plaque and tartar (plaque that builds up and hardens on the tooth surface and can only be removed with professional cleaning) from above and below the gum line of all teeth. If you have some signs of gum disease, your dentist may recommend professional dental cleaning more than twice-a-year. Dental cleanings are not a treatment for active gum disease. They are, though, an important preventive measure that can help you stave off its development.
Scaling and root planing. This is a deep-cleaning, nonsurgical procedure, done under a local anesthetic, whereby plaque and tartar from above and below the gum line are scraped away (scaling) and rough spots on the tooth root are made smooth (planing). Smoothing the rough spots removes bacteria and provides a clean surface for the gums to reattach to the teeth. Scaling and root planing is done if your dentist or periodontist determines that you have plaque and calculus under the gums that needs to be removed.
Surgical Treatments
Flap surgery/pocket reduction surgery. During this procedure the gums are lifted back and the tarter is removed. In some cases, irregular surfaces of the damaged bone are smoothed to limit areas where disease-causing bacteria can hide. The gums are then placed so that the tissue fits snugly around the tooth. This method reduces the size of the space between the gum and tooth, decreasing the area where bacteria can grow.
Bone grafts. Using fragments of your own bone, synthetic bone, or donated bone to replace bone destroyed by gum disease. The grafts serve as a platform for the regrowth of bone, which restores stability to teeth.
Soft tissue grafts. This procedure reinforces thin gums or fills in places where gums have receded. Grafted tissue, most often taken from the roof of the mouth, is stitched in place, adding tissue to the affected area.
Guided tissue regeneration. Performed when the bone supporting your teeth has been destroyed, this procedure stimulates bone and gum tissue growth. Done in combination with flap surgery, a small piece of mesh-like fabric is inserted between the bone and gum tissue. This keeps the gum tissue from growing into the area where the bone should be, allowing the bone and connective tissue to regrow to better support the teeth.
Bone surgery. Smoothes shallow craters in the bone due to moderate and advanced bone loss.
Regular checkups & hygiene appointments can greatly reduce your risk of gum disease. Contact us for an appointment and more information on promoting your oral and overall health.
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