Periodontal
Disease
Periodontal disease
(gum disease) Is a bacterial infection and must
be treated as such. It can take any one of several different forms.
There might be recession of the gum tissues, which could result in sensitive
teeth or an unsightly appearance. More commonly, there are "pockets" (bone
loss) in the gum tissues that occur around and in between the teeth
that could lead to tooth loss. These deep pockets are unhealthy because
they:
1. Harbor disease causing bacteria and promote more
bone loss;
2. Are a major contributor to bad breath (halitosis);
3. Are sources of bleeding while brushing and flossing;
4. Are almost impossible for you to clean.
5. As pockets progress tooth will become loose and
eventually fall out.
The gum tissues might be swollen and red like a
ripe tomato, which can be uncomfortable and unsightly.
This contributes to foul odors and taste. On the
other hand, advanced, serious periodontal disease can be almost unknown
to the patient. Obvious signs and symptoms are not always present.
Periodontal disease can be eliminated, or at least
controlled, with the proper forms of therapy, and, if treated in its
early stages. The degree of elimination depends upon how much of the
supporting bone around the teeth has been lost, along with other factors.
The age of the patient is a very important risk factor in designing
the correct periodontal treatment. For example, a person with advanced
bone loss who is in their twenties and thirties has a much more serious
situation than a similarly diseased person who is fifty, sixty, or older.
This is why an early diagnosis and beginning early treatment is of the
utmost importance.
Smoking and diabetes are major risk factors that
usually go hand-in-glove with advanced periodontal disease. Diabetes
must be diagnosed and properly controlled before periodontal therapy
can be successful. There is emerging evidence that the presence of untreated
periodontal disease might be related to heart disease and some other
systemic diseases.
As previously mentioned, there can be several signs
and symptoms, which could indicate that you have periodontal disease,
such as:
1. Spaces forming between your front teeth or food
impaction between teeth.
2. Your bite feels uneven or uncomfortable.
3. You have chronic headaches.
4. Some teeth have become very sensitive or sore
to your bite.
5. There are bleeding gums either while you clean
your teeth or while you chew.
6. You suspect that some teeth are loose.
7. You have that uncomfortable feeling of BAD BREATH.
8. You clench and grind your teeth.
9. You have been told previously that you might
have periodontal disease.
10. You have lost some teeth, including wisdom teeth.
Therapy
and maintenance
Once
the correct diagnosis has been made, the overall objective of any periodontal
therapy is to eliminate the gum disease or, at least, to control it.
There are surgical and non-surgical treatments, but both usually begin
with the cleaning of your teeth by Dr Lim, a review of your oral hygiene
procedures by our staff, and the correction of your functional bite.
Then, a decision will be made as to which method of treatment best
suits your situation and your objectives. An improper or an uneven
bite will aid in the progression of your periodontal disease, will
lead to the uneven wearing away of your teeth, breaking of porcelain
crowns, and, can result in tooth fracture. This is a very important
procedure.
NON-SURGICAL
PERIODONTAL THERAPY
If
you do not have extensive periodontal disease and you do not need large
amounts of restorative dentistry, there is a chance that your case
can be managed in a non-surgical manner. This will be determined by
Dr. Lim after your examination and is accomplished through ultrasonic
cleanings, regular tooth cleanings and polishing, good oral hygiene,
and bite adjustments. After that is completed, you might need some
minimal restorative work in the form of crowns, fillings, or bleaching
(click here for more information). This non-surgical care almost never
requires local anesthesia and usually can be finished in a minimal
number of short appointments. Discussions with our staff about the
proper ways for you to clean your teeth will take place at each appointment.
Dental checkups and cleanings at least twice a year afterwards is recommended. Frequent
cleanings will be easier and faster for both Dentist and Patients.
Root
Planing
Whether
performed as initial therapy for advanced periodontal disease or as
non-surgical treatment for less advanced disease, periodontal root
planing is a central procedure in most periodontal treatments. Root
planing is careful cleaning of disease affected tooth roots. The goal
of root planing is to remove plaque, calculus, and the necrotic (dead)
tissue (cementum) on the root surface. The removal of necrotic
cementum is required for creating a healthy root surface. Unlike
a routine dental prophylaxis or cleaning, root planing usually requires
more than one visit and local anesthesia to numb the area prior to
treatment. Research has shown the root planing reduces inflammation,
pocket depths, and changes the type bacteria in the pockets from those
associated with disease toward one associated with health. For
many patients a thorough, well performed root planing coupled with
improvements in oral hygiene is all the active therapy that is needed.
SURGICAL
CARE
Teeth
that have extensive recession of gum tissue can be treated with gum
grafting procedures. This usually produces almost full coverage of
the exposed root surface. It's important to realize that every area
of recession does not have to be grafted. This decision is made after
your complete examination and consultation with Dr. Lim. He will give
to you a detailed description of this procedure.
Surgery
to reduce the pocket depths is a common surgical procedure and is done
to help control your disease. If pocket depths are reduced, your oral
hygiene should improve, and it will become easier to have your professional
cleanings. The elimination or control of diseased pockets makes your
restorative work easier for your general dentist, when making crowns,
bridges, partial dentures, or the placing of dental implants (see page
on DENTAL IMPLANTS). During surgery, the diseased or infected tissue
is delicately removed from under the gum tissues and the root surfaces
are cleaned extensively. These surgical procedures are done in our
office under local anesthesia while you are under the influence of
a mild, oral sedative. The surgery is very tolerable. You will walk
in and walk out following your procedures.
Bone
grafting to rebuild the bone that has been lost due to periodontal
disease might be possible in certain situations. This decision is also
made by Dr. Lim after a complete review of your case.
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