Periodontal Therapy/ Periodontal Disease Treatment

What is periodontal (gum)disease?
Diagnosing periodontal (gum) disease- Periodontal Examination
Types of periodontal (gum) disease
Preventing periodontal (gum) disease
Are you at risk for periodontal (gum) disease?
Perform a self evaluation for periodontal (gum) disease
Treating periodontal (gum) disease: Non Surgical treatments
Treating Periodontal (gum) Disease: Surgical Treatments.
How is periodontal (gum) disease linked to total body health?

What is periodontal (gum)disease?

Periodontal (gum) disease is a bacterial infection often present so deep under the gums that it is hard to visually see. Beginning periodontal (gum) disease is often overlooked but can lead to deep infections in the oral tissue, bad breath, low grade fevers, and bleeding upon flossing. Advanced periodontal (gum) disease is often observed due to swelling, heavy bleeding, and loosening of the teeth.

Research states that 80%+ of the adult population in the United States shows some form of periodontal (gum) disease, therefore our goal is to diagnose periodontal (gum) disease early, thus preventing bone damage around the socket of the teeth. This saves our patients time and money with early treatment.

Diagnosing periodontal (gum) disease- Periodontal Examination

Our practice is committed to evaluating, informing, and treating any area of periodontal (gum) infections present in your mouth. With a simple periodontal examination we can inform patients if there are any areas of periodontal (gum) disease that has occurred in their mouth. This process takes a few minutes, is painless, and is a complimentary part of the new patient and existing patient examination.

The American Dental Association mandates that all general dentists evaluate and document the periodontal (gum) disease status of each patient and educate them about the causes, affects, and long term dental consequences of having gum disease. We take this mandate very seriously and offer this complimentary service at each dental hygiene appointment.

Types of periodontal (gum) disease

Periodontal (gum) disease manifests itself in several forms. Gingivitis is the initial stage of periodontal (gum) disease and affects the gums, not the underlying jaw bone (socket). It can range from slight to severe Gingivitis, is caused by a bacterial infection, and is easily treated.

An advanced bacterial gum infection which invades the deeper gum tissues and jaw bone is called Periodontal disease / pyorrhea / gum disease / periodontitis. This stage of periodontal (gum) disease causes permanent damage to the boney socket which holds the teeth in place. Once the infection has reached this part of

Preventing periodontal (gum) disease

Good oral hygiene practices can help reduce your risk of developing periodontal diseases. Our hygienists develop an individualized oral hygiene routine for each patient in order to lower their risk of developing periodontal disease. This routine may include the use of prescription antimicrobial mouth rinses, electronic devices, and/or customized oral hygiene aids.

Below are a few of the possible recommendations we may offer to begin your oral hygiene regimen:

• Brush your teeth with an automated (electric) toothbrush for a full two minutes, two to three times per day. Battery operated brushes are best for children and pre-teens while automated (electric) toothbrushes with a base charger have higher RPM cycles and are best for adults and teens.

• Floss your teeth with a lightly waxed or unwaxed dental floss one to two times per day. Highly waxed floss products slide easily between the teeth but do not tend to remove the “sticky” plaque that adheres to the teeth. If bleeding occurs during flossing you may have deep periodontal infections which need evaluating by the dental hygienist.

• Use a water irrigator one to two times per day on a low to medium setting with water or an antimicrobial mouth rinse. Follow the directions provided with the irrigator or ask your hygienists for specific instructions best suited for your mouth.

• Eat a healthy balanced diet rich in nutrients and avoid high sugar intake. Supplements may be necessary to help strengthen the connective tissue around your gums. Dr. Wilkey and the hygienist can recommend the best supplements for your dental health.

• We offer a variety of prescription mouth rinses designed to improve the freshness of your breath as well as reducing bacterial infections. However, mouth rinses are only effective on the surface and slightly below the gum line. If chronic mouth odor occurs or a continuation of bleeding is observed, let us evaluate your overall dental health to find possible solutions to long term problems.

Are you at risk for periodontal (gum) disease?

Even with pristine oral hygiene practices some people will develop periodontal (gum) disease anyway. Following all of the oral hygiene recommendations will reduce your chance of developing periodontal (gum) disease but some people are prone to developing the disease due to factors beyond their control. Below are a few of the many risk factors which increase the chance of being afflicted with periodontal (gum) disease:

• Hereditary/Genetics: If anyone in your family has had the disease, lost teeth from gums disease, or wears dentures, you are at a higher risk of contracting periodontal (gum) disease.

• Diabetes: People with diabetes are at a higher risk for infections, especially periodontal (gum) infections.

• Stress: Stress reduces the body’s ability to fight infections by weakening the immune system. Chronic, long term stress can cause the gums to weaken and become susceptible for periodontal (gum) infections.

• Dry mouth: Periodontal (gum) disease causing bacteria prefer a dry environment in which to grow and cause damage to underlying jaw bone. Dry mouth can be due to medications, chemotherapy, or radiation therapy.

• Improper oral hygiene: Flossing only reaches two millimeters below the gum, therefore other oral hygiene devices may be needed to reach the high bacterial plaque. • Tobacco use: Tobacco in any form affects the ability of the gums to respond to beginning oral infections. Bacterial plaque and tartar accumulates faster in tobacco users and increases oral infections.

• Medications: Many necessary medications adversely affect the gum tissues. Drying, overgrowth, and fibrosis can occur as a side effect to some medications and increase the risk of periodontal (gum) infections and disease.

• Auto Immune Diseases: Any disease which affects the immune system (Lupus, Multiple Sclerosis, Fibromyalgia, HIV, AIDS, etc.) increases the risk of developing periodontal (gum) disease.

• Hormone changes (puberty, pregnancy, birth control pills): An increase in hormones allows bacteria to grow at an increased rate thus allowing bacterial infections to invade the gum tissue. These infections often deepen and destroy the boney sockets holding the teeth in place.

• Defective restorations: Oral bacteria prefer to hide in the creases of old, worn, and broken restorations. It is almost impossible to adequately remove the bacteria from these hiding places without professional care.

• Relationship factors: Periodontal (gum) disease causing bacteria is transferable from person to person. If you have oral contact with others who have periodontal (gum) disease you are at risk for the disease.

• High sugar or high carbohydrate diets: Oral bacteria grow rapidly in the presence of sugar. High carbohydrate (breads, crackers, chips) diets break down into sugar over time providing oral bacteria with necessary food sources in which to grow.

Perform a self evaluation for periodontal (gum) disease

Want to discover for yourself if you may have some or all of the signs of periodontal (gum) disease? Ask yourself these questions.

• Do my bleed when I brush, floss, or use a toothpick?
          Healthy gums do not bleed unless injured.

• Do I have a bad odor or taste in my mouth?
          Chronic deep gum infections often cause odor.

• Do my gums appear to have pulled away or fallen off of my teeth?
          Teeth that appear longer than normal may have lost gum support.

• Are my teeth separating?
         Gum infections cause the supporting ligaments to weaken.

• Are my gums tender, red, or swollen?
          Healthy gums are firm and resilient.

• Are their unusual stains or build up between my teeth?
          Deposits on the teeth is a sign of “dead” bacteria.

Treating periodontal (gum) disease: Non Surgical treatments

Professional dental cleaning - Plaque and tartar (calculus) is removed professionally from the teeth and antimicrobial irrigation is provided killing the bacteria which causes Gingivitis.

Scaling and root planning - This procedure is a non surgical procedure which involves the use of hand and automated instruments, antimicrobial irrigation therapy, and gum tissue treatments. It is highly effective in helping to eliminate gum infections and doesn’t involve surgical procedures.

Antimicrobial therapy - Antimicrobial therapy is used as a means to reduce the bacterial levels in and around the gum line. There are several methods for reaching bacteria responsible for destroying the sockets that hold the teeth in place.

           Irrigation therapy: This procedure is inclusive in many periodontal (gum) treatments and involves irrigating a broad spectrum antimicrobial liquid under the gums. This procedure is safe and painless.

           Localized antibiotic therapy: This procedure is provided for teeth that have suffered bone destruction, exhibit active infection, and require a longer term treatment. A powered antibiotic is placed under the gum and left in place. The body absorbs the antibiotic and targets the specific site of infection.

           Systemic antibiotic therapy: When periodontal (gum) infections progress to the point where the total body is at risk of infection, an antibiotic pill or capsule regimen is prescribed. Please let us know if you are allergic to an antibiotic.

           Oral antibiotic rinses: Over the counter rinses such as Listerine target the milder forms of oral bacteria and is a good source of daily “preventative” oral hygiene practices. Once Gingivitis or Periodontal (gum) Disease is present however, bacteria can quickly progress to the point of bone destruction and must be attacked with prescription oral antimicrobial rinses.

Treating Periodontal (gum) Disease: Surgical Treatments.

Surgical therapy for treating Periodontal (gum) Disease is considered after non surgical therapies have been performed. If systemic or physical factors prevent the gums from completely healing, surgical procedures may need to be considered.

Our office works closely with the Periodontists in this area to schedule and coordinate surgical treatments and post operative follow up.

How is periodontal (gum) disease linked to total body health?

Informative research by leading physicians and clinicians has shown a relationship between oral bacterial and viral infections and total body health. This information is published in various medical and dental research journals and can be viewed on www.perio.org. Further medical and dental research is ongoing in order to fully understand the links between periodontal (gum) disease and the health of our bodies however we do know that healthy gums can lead to a healthier body.

Based on the research from the last twenty years, there seems to be a link between periodontal (gum) infections and the health of your heart, lungs, vascular system, and reproductive system. The American Academy of Periodontology has published information on the link periodontal (gum) disease:

           Respiratory Disease- Advanced periodontal (gum) infections can affect the integrity of the lining of the lungs, therefore people with a history of pneumonia, chronic bronchitis, asthma, or any condition of the lungs should visit a hygienist and dentist for a periodontal evaluation.

          Diabetes- Medical research shows that diabetic patients are at a higher risk for obtaining periodontal (gum) disease and tooth socket bone destruction. The relationship between periodontal disease and diabetes is two fold in that patients with diabetes are more likely to have uncontrolled blood sugar levels, increased infection, and difficulty reaching dental gum health due to decreased healing and immune response. Now information is emerging showing that people with long term untreated periodontal disease are at a higher risk of developing Diabetes due to the increase in C-reactive proteins in the blood stream due to chronic infection.

           Heart Health and C- Reactive Proteins – Long term infection such as untreated periodontal (gum) disease can cause an increase in C-reactive proteins which causes clogging of the arteries, strokes, heart attacks, and decreased immune system responses. This research is medically based and is ongoing showing a link between periodontal (gum) disease and heart health.

Patients with a history of heart attack, stroke, or long term infection will benefit from a comprehensive periodontal (gum) evaluation. This is a painless procedure which measures the gum tissues and general gum health and takes only a few minutes to perform.

          Pregnancy-Pregnant patients or women wanting to conceive benefit from optimal dental gum health. Research shows that women with gum infections such as periodontal disease are at a higher risk (up to seven times the risk) of having low birth weight babies and miscarriages due to the spread of periodontal (gum) disease bacteria to the cervical area. This spread of infection causes the cervix to weaken and presents problems during the pregnancy. The American Academy of Periodontology suggests a thorough periodontal (gum) disease evaluation as part of prenatal care.