Your teeth are intended to last a lifetime-and they can, with proper care. This means thorough daily brushing, cleaning between the teeth, and regular professional cleanings to avoid periodontal diseases. Advanced periodontal diseases are a major cause of tooth loss in adults. But they can be prevented.
There are several types of periodontal diseases. All are started by a bacterial infection which attacks the gums, bone and ligaments that support the teeth and hold them in the jaw. Periodontal diseases are usually painless, and may develop slowly or progress quite rapidly. Unless you have regular dental checkups, you may not be aware you have a periodontal disease until your gums and bone have been so seriously damaged that tooth loss is inevitable.
More than half of all people over age 18 have at least the early stage of some type of periodontal disease. After age 35, about three out of four adults are affected by some form of gum disease. However, periodontal diseases can occur at any age. Even children as young as five or six can have signs of some of these diseases.
Periodontal diseases are caused by certain types of bacteria in plaque, the sticky, colorless film of bacteria that constantly forms on teeth. These bacteria create toxins (poisons) which irritate the gums and result in a break-down of the attachment of gum tissues to teeth. Over time, these toxins can destroy gum tissues, allowing the infection to progress to bone loss.
In addition, plaque that is not removed can combine with other materials and harden into a rough, porous deposit called calculus (tartar). Calculus on the root surface, below the gums, makes removal of new plaque and bacteria more difficult. Unlike plaque, which you can remove, only a dentist or dental hygienist can remove calculus.
While there are many forms of gingival and periodontal diseases, the two most common types are gingivitis and adult periodontitis:
Here is a step-by-step illustration of the progress of gingivitis and periodontitis:
Although periodontal diseases are caused by plaque, a number of other factors can increase the risk, severity and speed of development of the condition.
Most people don’t experience any pain due to periodontal diseases so it is important to have regular checkups including a periodontal exam. In addition, professional cleaning is essential to preventing periodontal diseases. If you notice any of the following signs, see your dentist immediately:
With regular dental visits, dentists can detect developing periodontal diseases early, before the gums and the bone around your teeth are irreversibly damaged. So don’t wait till it hurts!
During checkups, your dentist will examine your gums for periodontal problems. An instrument called a periodontal probe will be used to determine if there is any breakdown in the gum tissue attachment or development of pockets between your gums and teeth. The depth of pockets can be measured with the instrument you see in the picture to the left. Your dentist may also need to take X-rays to determine if any bone has been destroyed.
The method of treatment of periodontal diseases depends upon the type of disease and how far the condition has progressed. The first step is usually a thorough cleaning which may include scaling to remove plaque and calculus deposits beneath the gumline. In some cases, the occlusion (bite) also may require adjustment.
1. Presurgical bony defect
Surgery may be required when deeper pockets (over 4 to 6 mm) are found. Patients can seldom, if ever, keep them clean and free of plaque. Allowing pockets to remain may invite infection and bone destruction.
2. Flap incision allows gingival tissue to be retracted
When pockets are deep and bone has been destroyed, flap surgery may be necessary to allow the dentist to get access to the roots of the teeth in order to thoroughly remove calculus, plaque and any diseased tissue.
3. Gingival tissue is sutured into a new position
Osseous (bone) surgery sometimes accompanies flap surgery. In osseous surgery, some of the bone around the tooth is reshaped. In certain cases, a bone area may be employed to replace lost bone. Splints or other appliances may be used to stabilize loose teeth temporarily and may be necessary after completion of periodontal therapy as well.
4. After periodontal surgery
Other effective procedures are also available for replacing gum tissue and bone destroyed in advanced stages of the disease. These procedures are used for specific periodontal problems. Talk with us about the treatments that may be right for you.