Periodontics

The word "periodontal" literally means "around the tooth." Healthy gum tissue fits like a cuff around each tooth. Where the gum line meets the tooth, it forms a v-shaped crevice called a sulcus. In healthy teeth, this space is usually three millimeters or less.

Periodontal diseases are infections that affect the tissues and bone that support teeth. As the tissues are damaged, the sulcus develops into a pocket that is greater than three millimeters. Generally, the more sever the disease, the greater the pocket depth and bone loss. The enlarged pockets allow harmful bacteria to grow and make it difficult to practice effective oral hygiene. Left untreated, periodontal disease may eventually lead to tooth loss.

Causes and Symptoms

Periodontal disease is cause by bacteria in our mouth. Periodontal disease begins when certain bacteria in plaque (the sticky, colorless film that constantly forms on the teeth and the surfaces lining the mouth) produce toxins and enzymes that irritate the gums and cause inflammation. The resulting inflammation, which may be painless, can damage the attachment of the gums and bone to the tooth.

Tooth loss is not the only potential problem posed by periodontal diseases. Research suggests that there may be a link between periodontal diseases and other health concerns such as diabetes, cardiovascular disease, stroke, bacterial pneumonia, and increased risk during pregnancy. Researchers are trying to determine if bacteria and inflammation associated with periodontal diseases play a role in affecting these systemic diseases and conditions.

There are many types of periodontal diseases and they can affect individuals of all ages from children to seniors. A complete examination will allow a proper diagnosis.

Treatment

Periodontal treatment methods depend upon the type and severity of the disease. If the disease is caught very early (gingivitis), and no damage has been done, you may simply be given instruction on improving your daily oral hygiene.

Scaling and Root Planing

The first non-surgical step usually involves a special cleaning called scaling and root planing to remove plaque and tartar deposits on the tooth and root surfaces. This procedure helps gum tissue to heal and pockets to shrink. This is sometimes referred to as “periodontal” or “deep cleaning” and may take more than one visit.

Periodontal Surgery

When the sulcus develops deep pockets, it is difficult to completely remove plaque and tartar even with thorough daily oral hygiene. If the pockets do not heal after scaling and root planing, periodontal surgery may be needed to reduce the pocket depth and make teeth easier to keep clean.

Surgery allows the dentist to access hard-to-reach areas that require the removal of tartar and plaque. The gums are sutured back into place or into a new position to make tissue snug around the tooth.

Bone surgery including bon grafts, may be used to rebuild or reshape bone destroyed by periodontal disease. Splints, bite guards, or other appliances may be used to stabilize loose teeth and aid the regeneration of tissue during healing. If excessive gum tissue has been lost, a gum graft may be performed.

The procedure used will be selected due to your specific needs.

Prevention

Once your periodontal treatment is completed, your dentist will want to see you at regular intervals. Daily cleaning helps keep the plaque under control and reduces tartar formation, but it won't completely prevent it. Have your teeth cleaned regularly at the dental office to reduce plaque and remove calculus from places your toothbrush and floss may have missed.

For futher information about periodontics, please see the American Academy of Periodontology website at perio.org.