Your Guide for Periodontal Disease
Periodontal Disease, a bacterial infection of the gums and bone around your teeth, begins when sticky bacteria, or plaque, and calcified plaque, or tartar, coats your teeth at and below your gum tissues. The bacteria triggers inflammation that leads to bone loss and pocket formation around your teeth. Unfortunately, you get this infection when your resistance to periodontal bacteria is low and disease susceptibility is high. This infection occurs in bursts of activity and becomes worse fairly quickly. If periodontal treatment, such as Scaling and Root Planing (SRP), is suggested, it is important to have the treatment done soon to remove the bacteria causing bone and soft tissue damage.
Symptoms of Periodontal Disease
Periodontal disease, often painless, may not be noticeable until the presence
of advanced bone loss. Symptoms to be aware of include:
- Inflammation – tender or swollen gums
- Bleeding – when brushing or flossing
- Sensitivity – of teeth or gums
- Halitosis – Bad Breath
Consequences is Left Untreated
If untreated, some consequences can be:
- Teeth – become loose or are lost
- Dental Work – teeth replacement (bridges, implants, dentures)
- Worsening Symptoms – abscesses, pain
- Bacteremia – bacteria and inflammation enters your blood; associated with numerous medical conditions (e.g. heart disease, stroke, cardiovascular disease)
Peridontal Probing for Measuring Tissue Depth
The next step to deciding the situation of your oral health is to check your periodontal probe depths. These depths are where the hygienist checks the gum tissue with a periodontal probe. The smaller the number, the healthier the area is. When the number gets bigger, the gums have become infected with bacteria and the dental hygienist might recommend a different dental hygiene cleaning to remove this harmful bacteria. Other measurements during this periodontal probing check to see if there is root exposure, if the gum tissue is no longer attached to the underlying bone, if the teeth have become loose, and if the gums are in need of seeing a specialist due to an advancement in Periodontal Disease.
Who is Susceptible to Periodontal Disease?
Although periodontal disease is caused by bacteria leading to inflammation, several factors can increase the risk of development and the progression of this infection. These risk factors include:
- Poor oral hygiene
- Previous periodontal disease infections
- Deep probing depths: 4mm+
- Infrequent dental cleanings and exams
- Genetic predisposition
- Compromised immune system
- Uncontrolled diabetes
How is Periodontal Disease detected?
At your dental appointments, the hygienist or doctor will look for symptoms of periodontal disease by evaluating:
- Current x-rays for bone loss
- Inflammation or bleeding
- Probing depths around your teeth
Probing depths of 1-3 mm represent good oral health, while probing depths of 4+ mm often signify periodontal disease presence and bone loss. Larger probing depths mean more bone loss and deeper bacteria deposits.
The severity of the bone loss may necessitate a referral to a periodontist. Early to moderate periodontal disease infections can often be treated by your general dentist office with scaling and root planing (SRP).
What is scaling and root planing (SRP)?
Scaling removes the plaque and calculus with dental instruments or ultrasonic scalers. This “deep cleans” at and below the gum line.
Root Planing smooths and polishes the root surface after scaling so it is harder for future bacteria to attach and grow on the root. A smooth, disease-free root also helps your gums heal and attach back onto your teeth. This helps shrink your pockets and reduces the chance for reinfection.
Good oral hygiene is now crucial to prevent new bacteria deposits.
What to expect after treatment
You may feel transient gum tenderness and temperature sensitivity. (Cold sensitivity is common.) These issues should decrease over the first couple of days. Disinfecting mouth rinses, desensitizing agents, and mild pain relievers may be needed during healing. You can return home or to work right after your appointment.
With removal of the bacteria you can expect:
- Healthier gums; firm and pink
- Tighter, more stable, teeth
- Little or no bleeding from gums
- Better breath
How is your treatment response evaluated?
Your dentist will usually evaluate your gums 4 to 6 weeks after treatment by checking the same parameters evaluated during the initial examination:
- The presence and amount of plaque and tartar
- Overall oral hygiene
A less than ideal response may require a referral to a periodontist.
Can Periodonatl Disease return?
Yes. The goal of periodontal disease treatment is to lessen or eliminate all susceptibility factors that play a role in the initiation and progression of the disease. Periodontal disease can come back when new deposits of plaque and calculus are allowed to reform; therefore, good daily oral hygiene and routine dental cleanings, or periodontal maintenance, are critical in disease prevention.
Since disease susceptibility can change over time, periodontal disease is never fully cured, only controlled.
Gum infection tends to occur in bursts of activity and can quickly destroy the supporting bone. It is recommended to start scaling and root planing (SRP) treatment soon to prevent more bone loss.
SRP costs less than many dental procedures and is covered by most dental insurances. The value of treatment is retention of teeth and gum infection control.
Prior to SRP, a numbing mouth rinse or anesthetic will be given to ensure there is no discomfort during the procedure. Bacteria removal deep in the pockets will cause discomfort.
SRP is typically performed by a trained hygienist or a periodontist. The more severe the disease, the more likely you will be referred to a periodontist.
A periodontist is a specialist dentist educated to diagnose and treat gum disease with non-surgical and surgical treatment modalities, including Bone Regeneration and Laser Assisted Periodontal Therapy.
The Good News!
After treatment, your mouth will look and feel more healthy. Chronic bad breath from this gum disease will significantly reduced. In the following months, your gums will further heal and become firm and pink. The pockets around your teeth will shrink as the gums re-attach to your teeth roots. With good oral hygiene and frequent visits to your dentist, the chance of developing deep gum periodontal disease again is much smaller.