Periodontal Procedures

How does periodontal disease develop?
As plaque and tartar containing bacteria build up underneath the gums. The body begins to respond to the irritants, inflammation occurs, pockets around the teeth occur making access to proper cleaning difficult around teeth. As this occurs progression of a pocket occurs, plaque and tarter continue to build up in an unaccessible area the disease progresses and bone damage continues leading to tooth loss and further complications.

What is periodontitis?
In periodontitis, infection and inflammation has now spread to the bone and supporting structures keeping the foundation of your teeth stable. Break down of the support structures surrounding teeth are now progressing. Pockets around teeth now develop which can be detected by your dentist or periodontist as they deepen keeping your teeth clean becomes more difficult leading to further progression. Redness, bleeding, foul odor, tenderness , and swelling may worsen. As bone and supporting structures are destroyed you may notice teeth loosening. As this advances, pockets around teeth can fill with pus. Patient’s experience pain and increased sensitivity. In some cases teeth may need to be removed.

What is non-surgical treatment of periodontal disease?
These treatments are the first line of defense against periodontal disease. They are done to reduce plaque and calculus. This usually includes scaling and root planning which is usually preformed by either your periodontist or a hygienist. During scaling and root planning, a ultrasonic device is used to removed plaque and calculus underneath the gum line. Roots are smoothened after all deposits are removed, this allows for reattachment of the tissues. During nonsurgical phase of treatment your bite will be assess and corrected if necessary. After 4-6 weeks your gum tissues will be re-assessed to see if improvements have been made in your tissues. From this point your periodontist will determine if a maintenance program is necessary or if further surgical treatment is necessary.

What is surgical treatment of periodontal disease?
Periodontal surgery may be necessary after non-surgical therapy. Periodontal surgery may be needed to save your teeth depending on the advancement of disease. Surgery would be done to reduce pocket depths, further debridement of deeper pockets, and aid in regeneration of bone and supporting structures around teeth to prevent tooth loss.

Where is periodontal surgery done?
It is an outpatient procedure preformed under local anesthesia with/ without sedation. Sedation is always recommended to help patient’s have a relaxing experiencing during the procedure.

How long does it take to recover from periodontal surgery?
Each patient’s recovery time is independent, however usually patients need no more that 2 days off from work and resume all activities within 42-72 hours. Our team will give you details of your post operative healing before, during and after your visit.

What puts me at risk for developing periodontal disease?
Smoking
Poor oral hygiene (not brushing or flossing)
Poor controlled diabetes
Stress that may cause grinding your teeth and bite abnormalities
Hormonal changes (pregnancy and puberty)
Weakened immune system
Parents with periodontal disease
Take certain medications

How do you treat periodontal disease?
Special dental cleanings that go underneath the gums, surgery, proper monitoring and maintenance programs to prevent progression of disease are key. Your periodontist, general dentist and dental hygienist will have a team approach to keeping you healthy and happy.
If periodontal disease is caught and treated early your periodontist may be able to reverse some of the damage caused by periodontal disease. If the disease is more advanced, surgery and treatment can stabilize the supporting structures around your teeth and prevent tooth loss.

How does gum disease effect my cardiovascular system?
Through many studies it has been shown that uncontrolled periodontal disease can increase the risk of developing cardiovascular issues. Both these chronic conditions are inflammatory in nature. If periodontal disease is not managed properly by a periodontist inflammation in the body increases leading to other health complications such as cardiovascular disease.

Do I need to take antibiotics to treat my periodontal disease?
Each case varies, a more thorough diagnosis and evaluation is necessary to determine that antibiotics are necessary in conjunction with mechanical removal of plaque calculus and inflammatory tissues.

Can kids develop periodontal disease?
Children rarely develop periodontal disease, however adolescents can. It is important that kids learn proper oral hygiene and see a dentist regularly to develop good habits to prevent the onset of gum disease. Parents should however be aware that children can develop other gum/ oral diseases and should be aware of any bleeding, swollen or red gingiva and be seen right away.

What can a periodontist do?
Specialize in treating gum disease. They also can extract teeth and place dental implants. Periodontists treat recession that may cause an esthetic concern and root sensitivity. Periodontist play a crucial part in your overall health and dental well being. They set the foundation for your teeth by treating the bone, gums and overall supporting structures that keep your teeth in place.

Are there any signs or symptoms regarding gum disease?
Red and swollen gums
Bleeding during flossing and brushing
Receding gums
Mobile teeth
Separating teeth
Pus
Persistent foul odor from your mouth
Changes in your bite
Pain and tenderness in your gums

However please note that a lot of times patients will not experience pain until the later stages of periodontal disease, so it is important that your dentist and periodontist regularly monitor your overall oral health.

How do I prevent gum disease?
Practicing proper oral hygiene, regular brushing and flossing habits after meals and before bedtime. You should be seeing your dentist or periodontist for regular exams at least twice a year. Prevention is key.

Does genetics play a key in developing periodontal disease?
Yes genetics does play a part in developing gum disease. It can increase your risk for developing periodontitis. But genetics alone does not cause periodontal disease there are multiple factors that go into play before periodontal disease develops.

Is there a link between periodontal disease and diabetes?
Studies have shown that a link between periodontal disease and diabetes. People with diabetes have a suppressed immune system so they are more likely to develop infections. Periodontal issues is one of the most frequently associated complications of diabetes. When gum disease is treated properly blood sugar levels have been shown to stabilize. These two ailments go hand in hand.
Can’t my general dentist treat my gum disease?
You should definitely have a periodontist and general dentist work as a team to better accommodate your dental needs. Your periodontist has years of training and experience in treating gum disease. Together they can give you the best care possible.
If I have periodontal disease how often do I need to see my periodontist?
You should be seeing your periodontist regularly to prevent progression of gum disease. Your periodontist will put you on a maintenance schedule to monitor your chronic condition. It is important that you keep up with your maintenance visits to prevent further damage to the bone and supporting structures around your teeth.
What is periodontal maintenance?
Once periodontal disease is under control, its imperative that your continue with a maintenance care program. Patients with a history of periodontal disease should be monitored regularly and cleaned more frequently than individuals without periodontal disease. This allows for prevention of further damage and breakdown of tissues. And also for professional cleaning of plaque and tartar regular to aid in stopping progression of disease. Patients who are on a maintenance program preserve the nonsurgical and surgical treatment invested into their health. If you do not continue with maintenance regression and worsening of periodontal disease may occur. Studies show those that stay consistent with maintenance programs are less likely to lose their teeth due to periodontal disease.
What is periodontal probing?
At your visit your periodontist will do a thorough evaluation of your gum tissues using a periodontal probe that allows for proper measurements in calculating the amount of structures lost around your teeth. It acts as a tiny ruler that is goes around your teeth very gently.
What role does smoking play in developing periodontal disease?
Research has shown that people who smoke or chew are more likely to develop periodontal disease. Individuals who smoke develop more plaque and calculus than nonsmokers. They are more likely to develop deeper pockets and loss of supporting tissues around teeth. Treatment is less effective in smokers as well.
I have been told I have a “gummy smile” can this be fixed?
Yes with the proper diagnosis and treatment planning your periodontist and dentist can help create a smile you are happy with. Gum tissues can be contoured to your liking to give you the esthetic results you want.
I am missing teeth… is that ok?
Missing teeth are a esthetic and functional concern both your periodontist and general dentist can elaborate on. Missing teeth can cause improper alignment of remaining teeth, bite abnormalities, affect your speech, esthetics, dropping of the tissue around your lips and face, affecting proper nutritional intake, overall function, and emotional well being.
What X-rays will I need?
For proper diagnosis, your periodontist will determine at your visit the proper diagnostic radiographs are necessary.