Periodontal Disease Prevention and Treatment
The Bad News: Periodontal Disease Is Incurable
What if we told you that nearly half of adult Americans had an incurable disease that made teeth fall out? Would you be worried?
What if we told you that this disease also contributed to heart problems and diabetes complications? Would you be concerned?
This disease is called periodontal disease and it’s the number one reason people end up with dentures.
The Great News: Periodontal Disease Is 100% Preventable
How would you feel if we told you that periodontal disease is completely preventable? Not only that—it’s EASY to prevent!
All you have to do is keep your gums healthy. Keeping gums healthy means taking care of your gums consistently, both with good daily brushing and flossing habits at home as well as regular professional cleanings at the dental office.
“I already have periodontal disease! What Now????”
If you already have periodontal disease, then maintenance is key to keeping your teeth.
Your dentist will look to see how severe your gum disease is and usually begins with non-surgical treatments to stabilize your gum tissue and control your disease. This step is critical to preventing tooth loss. Non-surgical treatments for gum disease may include deep cleaning, also known as “scaling and root planing”, laser therapy and more frequent follow-up cleanings (called periodontal maintenance).
Sometimes non-surgical treatments need to be followed up with surgical treatments such as pocket reduction or gum grafting to fix specific problem areas where the infection has done the most damage. (Read more about Gum Disease on Mayo Clinic website.)
Non-Surgical Periodontal Therapies: Keeping Teeth Healthy from the Outside
Periodontal means “around the tooth.” So, periodontal therapy is a fancy phrase for “therapy around the outside of tooth.” These therapies are for patients with healthy gums as well as for patients with periodontal disease and include five types of dental cleanings. Each cleaning is designed to match a patient’s gum needs from preventing gum disease to treating bone and gum infections or maintaining those infections.
1. Preventative (Regular or 6-month Cleaning) Perio Therapy: This routine or periodic cleaning may be the most basic type of cleaning. It’s also the most effective way to prevent periodontal disease and tooth loss. These are the every six months cleanings that everyone thinks about as “a cleaning.” Not surprisingly, they are key to keeping gums healthy. Why so important? Because professional cleanings remove the plaque, tartar and debris that everyday brushing and flossing miss. Even the best brusher leaves plaque in the nooks and crannies and this plaque is home to the bacteria that cause periodontal disease. If built up plaque isn’t removed regularly, the bacteria build up to the point that they start moving down the tooth destroying bone and gum tissue as they go.
2. Gum Inflammation (Gingivitis) Therapy: When gums are inflamed with a beginning infection, we call that gingivitis. This usually happens when it’s been more than six months since the last cleaning or when home care is poor. It’s also more common during pregnancy. When gingivitis is present, the gums are newly infected, but there isn’t full blown periodontal disease. At this point, getting the right treatment can prevent full blown periodontal disease from setting in. Gingivitis Therapy involves a basic cleaning PLUS a follow-up cleaning several weeks later. This insures that plaque and bacteria don’t get missed because of inflammation and it allows a clear evaluation of the gum health. Based on how the gums respond to these cleanings, we can offer personalized recommendations for home care products and techniques that will get gums healthy again and keep them that way.
3. “Let’s Clean Things Up So We Can See” (Debridement) Therapy: Sometimes there is too much plaque built up to be able to accurately diagnose what is going on with the gums and bone. The first step in these situations is an initial “power-washing” called a debridement. A debridement clears away the surface build-up so that we can see in and around the gums and teeth and make accurate and helpful diagnoses and recommendations. Not doing a debridement before making treatment recommendations is one of the main reasons people end up diagnosed with periodontal disease that they don’t actually have and NOBODY wants that!
4. Bone Infection (Deep Cleaning) Therapy: If gingivitis goes untreated, the initial infection can work its way from the top of the gums down the tooth root. This is periodontal disease. As the infection moves down the tooth into the bone, it separates the gums from the teeth forming deep pockets in the gum tissue. These pockets become home to bacteria, food and pus. Once periodontal disease has established itself, careful maintenance becomes the key to keeping your teeth. The first step is usually Bone Infection Therapy, which is also called root planing and scaling. Using specialized instruments, built up plaque, tartar and calculus are removed from under the gums, as well as infected and dead tissue. The roots are scaled to be as smooth as possible so that bacteria have a harder time attaching and growing up quickly. Laser therapy removes dead gum tissue and helps the gums re-attach to the teeth. This reattachment is key to healing the gums and protecting the bone. Once roots, teeth, gums and pockets are cleaned and gums have been repaired, the key is to keep the bacterial infection at a minimum. This is accomplished through Maintenance Therapy.
5. Maintenance Therapy: The bacterial colonies that cause periodontal disease take about three to four month to re-multiply after a dental cleaning. The exact rate that a periodontal infection grows back into a damaging disease state in any one person’s mouth depends on that person’s homecare, immune system, genes and other factors. After the initial Bone Infection Therapy, the maintenance therapy cleanings are prescribed every three to four months depending on how quickly the mouth gets re-infected.
Perio Lasers and Adjunctive Therapies:
The use of lasers and special antibiotics delivered directly into the gum pockets around the teeth are modern advances in Periodontal Dentistry. Lasers are light emitting devices with applications in dentistry that greatly benefit patients suffering from gum infections. Similarly, antibiotics also improve the outcome of non-surgical treatments. These adjunctive therapies are great and aid in improving outcomes. We make use of them both in our clinic as clinical cases dictate.