MANAGEMENT OF PERIODONTAL DISEASE
WHAT IS PERIODONTAL DISEASE?
Inflammatory periodontal diseases are a group of bacterially driven infectious inflammatory disorders affecting the health and integrity of the supporting structures of the teeth.
Untreated gingivitis can progress to periodontitis and can eventually lead to tooth loss and other health problems.
You may have been referred for a periodontal consultation by your general dentist or dental specialist if they see signs of periodontal disease during the course of a standard check-up or other dental appointment. You may also have contacted us on your own due to symptoms such as:
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Bleeding while brushing or eating normal foods. This is the most common sign of a periodontal infection.
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Ongoing halitosis (bad breath), which continues despite rigorous oral cleaning, can point to periodontitis, gingivitis or the beginnings of a gum infection.
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Longer-looking and/or loose-feeling teeth can indicate recession of the gums and/or bone loss as a result of periodontal disease.
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Related health concerns such as heart disease, diabetes, osteopenia or osteoporosis. People with these conditions are often diagnosed with related periodontal infections.
GINGIVITIS
Gingivitis is the mildest form of periodontal disease. It causes the gums to become red, swollen, and bleed easily. There is usually little or no discomfort at this stage. Gingivitis is often caused by inadequate oral hygiene. Gingivitis is reversible with professional treatment and good oral hygiene.
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Factors that may contribute to gingivitis include: poor oral hygiene, diabetes, smoking, aging, genetic predisposition and systemic diseases. Other conditions that may be involved include stress, poor nutrition, puberty, hormonal fluctuations, pregnancy, substance abuse, HIV infection, and certain medication.
PERIODONTITIS
Untreated gingivitis can progress to periodontitis. With time, bacterial plaque (biofilm) can spread and grow below the gum line leading to the formation of a periodontal pocket whereby the gum detaches from the tooth. Toxins produced by the bacteria in plaque irritate the gums. The toxins stimulate a chronic inflammatory response in which can destroy the tissues and bone that support the teeth. Research has clearly established smoking and diabetes as risk factors for the progression of periodontitis.
As the disease progresses, the pockets deepen and more gum and bone tissue are destroyed. Often, this destructive process has very mild symptoms. Eventually, teeth can become loose and may have to be removed.
NON-SURGICAL PERIODONTAL TREATMENT
Treatment guidelines stress that periodontal health should be achieved in the least invasive and most cost-effective manner. This is often accomplished through non-surgical periodontal treatment.
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However, non-surgical periodontal treatment does have its limitations. When it does not control periodontal infection, surgery may be indicated to restore periodontal health.
SCALING AND ROOT PLANING
Scaling and root planing is a careful cleaning of the root surfaces to remove plaque and calculus [tartar] from deep periodontal pockets and to remove bacterial toxins. Scaling and root planing is sometimes followed by adjunctive therapy with antibiotics, this is decided on a case-by-case basis.
In addition, most periodontists would agree that after scaling and root planing, patients will require ongoing maintenance therapy to sustain health.
