Periodontal Therapy

Periodontitis, commonly called gum disease, is the most common dental disease in adults. Approximately 30% of the population deals with gum disease, and it’s the leading cause of tooth loss in adults.  Many dentures are made because of this affliction.  While periodontitis can’t be cured, it’s generally controllable.  But control requires a consistent strategy, similar to those used to manage other chronic diseases like high blood pressure or diabetes.

Gum disease often advances quietly with subtle signs or symptoms in the early phase of activity. Many patients are surprised to learn about the severe damage occurring in their mouths. Think of the gums and bone around your teeth as the vital foundation that supports the teeth.  The most glamorous building is only as good as its foundation. If the foundation deteriorates, the rest of it goes down too.

Regular dental visits, professional teeth cleanings, and good daily oral hygiene at home are essential to early diagnosis and the strategic monitoring of periodontitis.

What Causes Gum Disease?

Our mouths provide a haven to billions of bacteria...many beneficial, and some harmful.  Bacteria comprise a sticky film, known as plaque, that coats the teeth.  Brushing and flossing effectively remove plaque before it mineralizes to form tartar.  Tartar creates a framework for more bacteria to colonize, which pump out acidic toxins into the gums. 

Around the base of each tooth, a small crevice or pocket formed by the gum tissue exists.  In a healthy mouth, this pocket remains free of tartar. But this warm, damp environment provides ideal habitat for deeper bacterial migration with toxins penetrating into the bottom of the gum collar. Gums respond to this toxic invasion with an inflammatory response regulated by the body’s immune system.

Early inflammation usually produces bleeding gums, a condition called gingivitis.  Untreated, the undisturbed bacteria build a chronic infection in the gum pocket.  In many cases, the bone starts to dissolve around the teeth as harmful bacteria seep deeper into the gums.  While gums may be slightly sore at this stage of disease, there’s often very little discomfort as the bone shrinks.

It’s possible for 50% of the bone around your teeth to dissolve before any tooth movement occurs.  And there still may be minimal pain despite the bone loss.  The bone around teeth doesn’t grow back, so this loss is permanent and becomes more challenging to counter as the bacteria migrate further into the gum pockets.  Untreated gum disease usually results in swelling and widespread tooth loss.

Diagnosis

A diagnosis of gum disease occurs after reviewing objective clinical data.  The small collar of gum around each tooth usually displays 2-3 millimeters of depth. This shallow crevice stays clean by regular flossing or even toothpick use.  Dr. Weaver or our hygienists can measure multiple areas around each tooth with a precise measuring tool.  If these measurements indicate 4 millimeters or more and include bleeding, the disease is confirmed.  Deeper findings suggest advancing gum disease. 

Dr. Weaver also considers the texture and shape of your gum tissue, along with any movement noted by each tooth.  It’s also essential to examine the height, shape, and density of the bone carefully with digital x-rays.  By analyzing a series of findings, a clear picture of your gum condition emerges.

Treatment

After establishing a diagnosis and staging the severity of gum disease, a suggestion for personalized treatment can be created with you.  In early stages of periodontitis involving little to no bone loss, one or two visits with our hygienist may be enough to establish primary control. You’ll also develop strategies for consistent home care and a periodic schedule for professional maintenance.  With this proactive approach, you may need limited additional treatment beyond regular preventive visits. 

If the inflammation has created a measurable loss of bone, more aggressive treatment helps halt the bone destruction.  Usually, we’ll suggest numbing of your gums for comfort during the deeper gum therapy.  We’ll meticulously clean one area at a time, focusing on the area below the gum line.  In many cases, this deep cleaning occurs over several visits.  The mineralized tartar infecting the collar or pocket around each tooth must be cleaned out using hand instruments and other flushing methods.  Polishing of the teeth creates glassy surfaces that resist stain and plaque accumulation.   Along with refining your oral hygiene habits, this polishing usually finishes the initial periodontal therapy.

The Dentiste hygiene team may recommend a special rinse, an electric toothbrush, a Waterpik, or other personalized strategies to increase your effectiveness.  Remember, gum disease is controllable, but it’s unlikely to be cured.  Dedicated daily efforts are vital to your efforts to bring gum disease into line.

Maintenance Matters

Daily home care is a key to arresting the destruction of gum disease. It only takes a few hours after brushing or flossing for the bacteria begin to reproduce and stick to the teeth. If this plaque is left undisturbed, it starts to solidify within 24 hours, forming more tenacious tartar.  And even more diligence is needed in deeper gum pockets to prevent the bacteria from penetrating further into your teeth’s bony foundation. 

Since the deepest gum pockets already damaged by bacteria are difficult to reach at home, a set maintenance schedule with us is critical.  The severity of disease and its response to treatment helps direct the recommended interval for your return visits. But usually, we’ll customize your plan for 2, 3, or 4 visits annually.

In some challenging cases, we’ll suggest a consultation with a trusted specialist. The periodontist’s expertise in gum health often proves invaluable in our overall management and control of advanced gum disease.