Periodontal Disease and Treatment

Treatment for periodontal disease
Special dental cleanings, medications, and surgery are among treatments for this disease. The sooner you're treated, the better your outcome, although much of the outcome is up to you. You'll need to commit to taking better care of your teeth at home. You'll also need regular maintenance (upkeep) dental care.

How periodontal disease develops
The disease starts when tartar and bacteria under the gumline lead to infection. As the body fights the infection, the gums become inflamed. Pockets are formed between the tooth and the gum, making plaque hard to remove with everyday brushing and flossing. As the disease advances, bone damage occurs and can lead to tooth loss.

The periodontal exam
At your exam, your doctor will check the gums for bleeding, swelling, firmness, recession, and sensitivity. She will also check for mobility of the teeth that can be caused by bone loss or the bite.

Scaling and root planning
A dental hygienist performs this treatment by using special instruments to remove heavy deposits. The plaque and tartar are removed and the root surfaces are smoothed. This helps keep the area free of bacteria and will result in reduction of pocket depth.

Bite correction
Problems with your bite such as an uneven bite can contribute to bone loss. Grinding and or clenching can also worsen the problem. A biteguard or occlusal adjustment can help reduce pressure and help control the damage of the bone loss.

Osseous surgery (pocket reduction surgery)
The gum is flapped away from the tooth and all diseased tissue is removed. Then reshaping and smoothing of the bone is performed. The tissue will then be sutured back into place. (In some cases, osseous surgery is combined with regenerative procedures)

Bone graft placement
A graft helps your body replace lost bone. The graft can consist of synthetic bone, bone from a tissue bank, and sometimes a gel containing growth materials to stimulate growth.

Guided tissue regeneration (GTR)
A membrane is placed between the gum and the bone to prevent the tissue from filling the space where the bone was lost. New bone will have time to grow where needed.

Soft Tissue Graft

Crown Lengthening

Ridge preservation
When a tooth is extracted, the ridge can lose up to 60% of its bone content. Ridge Preservation can be performed to prevent this. This is normally done at the time of the extraction. A special material is placed in the socket where the tooth was extracted. The bone will grow and preserve to become your own. So that at a later date you can have an implant placed where the tooth was missing.

Ridge Augmentation
Once teeth are extracted without bone placement the bone will shrink and heal with a narrower ridge, which will not be adequate in width or height for implant placement or partials. Bone is then added to increase the height and width of bone for subsequent implant placement.

Implants

Gingivitis
Gingivitis Gingivitis is the mildest form of periodontal disease. The gums become swollen and inflamed. The space between the gum and the tooth deepens and this forms a pocket. Gums can become red, swollen, and bleed with brushing and flossing. Most patients have no symptoms with gingivitis. Gingivitis can often be reversed with regular cleanings, brushing, and flossing. If untreated, gingivitis will become periodontitis.

Periodontitis
When a patient develops periodontitis the infection and inflammation spreads throughout the supporting bone and teeth. The ligament that supports the tooth breaks down causing the gum to recede. Pockets deepen which can make it very difficult for the patient to clean. Inflammation, swelling, and bleeding may begin or worsen. As the bacterium multiplies the infection begins to destroy the bone. As the bone is destroyed, the teeth will loosen.

Advanced Periodontitis
With advanced periodontitis the infection advances and some teeth can fill with pus. The bone loss continues to worsen. The teeth at this point may begin to develop symptoms such as pain and or sensitivity. The teeth will continue to loosen and at this point may need to be removed to improve the health of the patients mouth.