Periodontal Disease Treatment

Although poor oral hygiene is a huge factor, some people are more at risk of developing periodontal disease than others. Potential risk factors include:

• Smoking or using tobacco products
• Medical conditions that affect your immune system such as cancer, HIV AIDS and leukemia
• Obesity
• Poor nutrition and especially a vitamin C deficiency
• Hormonal changes related to puberty, pregnancy or menopause
• Prescription and non-prescription medications that cause dry mouth or which affect gum health

When your gums are healthy, they are firm to the touch and are pale pink. They should fit snugly around your teeth. People with unhealthy gums and who are developing periodontal disease may notice some of the following signs.

• Gums that are swollen or puffy
• Gums that feel tender when lightly pressed
• Instead of a pale pink color, gums may look red or even purple
• Blood on your toothbrush or in the sink after brushing or flossing
• Persistent bad breath
• Gum recession so your teeth look longer than before
• Pus pockets between your teeth and gums
• Teeth may begin to fit together slightly differently, affecting your bite
• It may become painful to chew
• Teeth start to feel loose

There are two distinct stages of gum disease. In the first stage called gingivitis, symptoms may be very mild or unnoticeable. Without treatment, gum disease will gradually worsen, creating more noticeable symptoms. Eventually, gum disease becomes advanced or is known as periodontitis and will severely affect gum health.

Gingivitis is a mild form of gum disease where the gums become inflamed and is entirely reversible. During this stage, you may notice your gums bleed slightly or that they look redder and perhaps slightly puffier than normal. However, if you smoke, you may notice very few signs because smoking constricts the blood vessels in your gums, preventing them from bleeding so easily. Unfortunately, smoking does increase the risk of gum disease because the constricted blood vessels are less able to transport nutrients and oxygen to the gums and are less efficient at removing harmful toxins.

If you think you may have gingivitis, make an appointment for a checkup and hygiene appointment with us here at Gentle Dental. The sooner you see a dentist, the better the chance we can reverse the gum infection entirely.Our dentist will gently assess your gum health and can quickly determine if you have gingivitis and, if so, the extent of the infection. When we can treat gum disease early, it is usually curable by having your teeth cleaned professionally. A professional dental cleaning removes plaque and tartar (calculus) from your teeth, eliminating the bacteria causing the infection so your gums are more able to fight this disease and can heal.

Because gingivitis is often due to poor oral hygiene, our hygienist will review your oral care routine with you and can provide useful information and practical advice on how to improve it. Improving your daily oral care routine is essential, and within a few weeks, you should notice your gums no longer bleed as they become stronger and healthier.

Failing to seek prompt treatment for gingivitis will allow this disease to progress. Eventually, it will become periodontitis. Periodontitis is a much more serious form of gum disease, and often it is chronic and will require ongoing treatment as we cannot cure it entirely.

The gum inflammation that is causing gingivitis worsens without professional dental care and begins to affect the other structures supporting your teeth, including bone and ligaments.Early-Stage Periodontitis

Gum recession is caused as your immune system tries to fight gum disease, and the subsequent inflammation creates gum recession. During the early stages of periodontitis, the inflammation in gums causes them to pull away from your teeth.

Consequently, pockets called periodontal pockets begin forming between your gums and teeth. These periodontal pockets create the ideal conditions for harmful bacteria to thrive, and as they gradually deepen, they become harder to clean effectively. During early-stage periodontitis, you may notice your gums bleed more frequently during brushing and flossing, and you could experience some bone loss.

Moderate Periodontitis

As the infection worsens, gums bleed more frequently, and they may start to feel painful. Gum recession becomes more noticeable, and the infection will continue to destroy the bone around your teeth. Some teeth may start to feel loose. By this stage, periodontitis can affect your overall health. Bleeding gums allow infectious bacteria to enter your bloodstream, promoting an inflammatory response in your body.

Early-stage or moderate periodontitis does require immediate dental care. Initially, our dentist can diagnose the degree of infection in your gums, and we may take digital dental x-rays to assess any damage to the underlying bone. We use a specialized instrument called a periodontal probe to measure the depth of periodontal pockets around the teeth. Periodontal pocket depth is a good indication of the severity of the disease.When gums are healthy, this pocket depth is typically 3mm or less. Pockets with a depth greater than 4mm can indicate gum disease. If a pocket depth is greater than 5mm, it becomes tricky to clean effectively with a toothbrush or dental floss.

Once we have this information, we can devise a suitable treatment plan to help restore gum health and to prevent further damage from periodontal disease.

Periodontal disease treatment for early or moderate periodontitis focuses on removing as much of the bacteria as possible, so your gums have a better chance of fighting the infection and healing. While sometimes an ordinary scale and polish may be appropriate for removing plaque and tartar from your teeth, often, a deeper form of cleaning is used called scaling and root planing.Scaling and root planing remove plaque and tartar buildup from your teeth and exposed tooth root surfaces, helping to deep clean periodontal pockets that may have begun to form around your teeth. After scaling or scraping away tartar buildup, tooth root surfaces are planed or smoothed. Planing helps to remove any rough spots on the tooth root surfaces, making it harder for bacteria to gather.

If you have a persistent gum infection, we may prescribe antibiotics to help fight this disease. The antibiotic may be given as a mouthwash or as a tablet or capsule or in gel form. We will normally want to see you a few weeks after a scaling and root planing treatment to assess your progress. We can then decide on a suitable treatment plan going forward.

By the time periodontitis has become significantly advanced, the infection will have begun to destroy the ligaments or connective tissues holding your teeth in their sockets. The infection will have caused extensive damage to the gum and bones around your teeth, and it could feel extremely painful to chew or bite food. You will most likely have bad breath and a persistently nasty taste. You may lose at least some teeth.

Treatment for severe periodontal disease may combine surgical and nonsurgical therapies. You will most likely need to have your teeth and gums and teeth cleaned through scaling and root planing, but we may suggest other therapies like laser gum surgery to remove tissues too badly damaged to heal. If the inflammation and infection persist, you might need a surgical procedure called flap surgery to clean your tooth roots further.

Periodontal disease treatment is often very successful when we can catch and treat this disease early. If you have periodontal disease, it’s essential to attend regular follow-ups so we can monitor your dental health closely and can make sure the disease doesn’t progress. For a positive treatment outcome, it’s essential to follow our instructions closely, including oral hygiene advice.When we work together, we can help to ensure you enjoy a much brighter long-term outlook, and you are more likely to enjoy your natural teeth for longer. If you are a smoker, we will strongly encourage you to quit as periodontitis tends to progress more quickly in smokers, and the long-term outlook is poorer.

We much prefer to take a preventive approach toward periodontal disease, providing you with ongoing professional dental care and expert advice on how to maintain an excellent oral care routine at home. If you are ever concerned about your gum health, please contact us as we can provide an accurate diagnosis and the most up-to-date and appropriate treatment.