Periodontal disease is an inflammation or infection of the bones and gum tissues, or collectively "the supporting structures," of the teeth. It can lead to tooth loss and increase the risk of other serious health issues. It is crucial to make the necessary changes to halt, control and manage this disease. Gum disease is :
Diagnosing Periodontal Disease
The Periodontal examination is a routine part of every oral examination for people 18 and older and treatment decisions are based on the finds from this examination. We not only check for the signs and symptoms of periodontal disease as outlined Table 1, which are the more advanced issues, but measure gum pockets which more effectively alerts us to early problems. To measure, a probe is used, which has a rounded tip and millimeter markings, is gently moved around your gumline to measure, in millimeter increments, the distance from the gumline to the deepest extent of the pocket that surrounds your tooth. Six measurements are recorded around each tooth. When gums are healthy, pockets will measure anywhere from 1 to 4mm. As part of a proper periodontal assessment we may require additional radiographs to assess bone levels around the teeth If signs and symptoms are significant and probing depth are consistently greater than 4mm around the majority of your teeth, we will recommend the appropriate treatment for you. Video: |
Table 1 SIGNS AND SYMPTOMS OF PERIODONTAL DISEASE
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How we get Periodontal Disease
The likelihood and severity of Periodontal disease largely depend on an individual's health and lifestyle. Table 2 highlights several health and lifestyle factors that increase the risk of gum disease. Generally, anything that weakens the body's immune system or its ability to heal will reduce its capacity to combat periodontal disease. Smoking As shown in Table 2, smoking is a major risk factor in the development and progression of periodontal disease. Tobacco suppresses the body’s ability to fight infection. Tobacco users are twice as likely to develop periodontal disease and are more likely to lose teeth than non-smokers. The severity of periodontal disease is related to the amount of daily tobacco exposure and the number of years of exposure. |
Table 2: RISK FACTORS OF PERIODONTAL DISEASE
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Leaving Gum Disease Untreated
Without gum therapy, the progressive destruction of your gums will continue. You may experience or eventually suffer from bleeding, swollen gums, receding gums, loose teeth, bad breath, painful infections, and tooth loss.
Without gum therapy, the progressive destruction of your gums will continue. You may experience or eventually suffer from bleeding, swollen gums, receding gums, loose teeth, bad breath, painful infections, and tooth loss.
How Gum Disease Progresses
Periodontal Disease and Your health
Evidence now links gum disease to a variety of health concerns. Table 3 illustrates the increased risk of numerous health problems associated with periodontal disease, including diabetes, cardiovascular disease, stroke, osteoporosis, and lung infections. Pregnant women who do not treat their gum disease are at a higher risk of delivering preterm, low birth weight infants. These risk factors and health concerns are supported by numerous studies. We would be pleased to provide you with additional information about the connection between your oral health and overall health. Article: Alzheimer's Gum disease link |
Table 3 Health problems you are at risk of with Gum Disease
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Periodontal Treatment
The goal of periodontal treatment is simply to control the bacteria that causes periodontal disease and the body’s response to it. With treatment we attempt to create an environment that is stable (no disease progression) and maintainable (all areas can be cleaned well by you and your hygienist)
Scaling and Root Planing
Using hand and ultrasonic instruments, scaling and root planing involves the removal of the bacteria and deposits (plaque and tartar) that have accumulated above and below the gum line in the periodontal pockets. The root surfaces of the teeth are planed (smoothed) to promote healing and to help prevent future bacterial reattachment. Most of the time, scaling and root planing is done in two to four visits. For patient comfort, the gums can be numbed using a local anesthetic. One-quarter of the mouth is usually treated at the time and treatment of each quarter can take 45 minutes to an hour (three to four hours for the entire mouth). Most patients report minimal discomfort
Oral Hygiene Instruction
Your daily home care is the most important factor in controlling gum disease. So during scaling and root planing appointments, we will review oral hygiene techniques that are aimed at improving your ability to control plaque and to help avoid bacteria from reinfecting the pockets. You also will receive advice on the modification of certain risk factors associated with periodontal disease.
Periostat
Periostat is a low dose Doxycycline(20mg) which is used in conjunction with Scaling and root planing to help reduce the body’s response to the inflammation. Although doxycycline is typically used as an antibiotic in higher doses, at lower doses it helps slow the breakdown of collagen (the main constitute of bone, ligament and gum tissue), by inhibiting the action of the collagenase enzyme. At low doses Doxycycline has none of the negative side effects of regular dose antibiotics.
It is recommended for a period of 3 to 9 months on those with moderate to severe periodontal disease.
Directions for use: Twice daily, 1 hour prior to morning and evening meals. Take the capsule with a full glass of water.
Information on Periostat
Periostat Product sheet
Post Treatment Care
For several days after a scaling expect Teeth to:
· Be sensitive to temperature,
· Be sensitive to pressure and biting and
· Feel loose
· Gums to be tender and bleed more readily
Eating to prevent periodontal disease
Re-Evaluation
Four to six weeks after completion of scaling and root planing, a periodontal re-evaluation must be completed. The purpose of this exam is to assess the response to treatment and determine if there is a need for further treatment. In some cases it may be necessary to refer you to a periodontist (gum specialist) to continue treatment.
The goal of periodontal treatment is simply to control the bacteria that causes periodontal disease and the body’s response to it. With treatment we attempt to create an environment that is stable (no disease progression) and maintainable (all areas can be cleaned well by you and your hygienist)
Scaling and Root Planing
Using hand and ultrasonic instruments, scaling and root planing involves the removal of the bacteria and deposits (plaque and tartar) that have accumulated above and below the gum line in the periodontal pockets. The root surfaces of the teeth are planed (smoothed) to promote healing and to help prevent future bacterial reattachment. Most of the time, scaling and root planing is done in two to four visits. For patient comfort, the gums can be numbed using a local anesthetic. One-quarter of the mouth is usually treated at the time and treatment of each quarter can take 45 minutes to an hour (three to four hours for the entire mouth). Most patients report minimal discomfort
Oral Hygiene Instruction
Your daily home care is the most important factor in controlling gum disease. So during scaling and root planing appointments, we will review oral hygiene techniques that are aimed at improving your ability to control plaque and to help avoid bacteria from reinfecting the pockets. You also will receive advice on the modification of certain risk factors associated with periodontal disease.
Periostat
Periostat is a low dose Doxycycline(20mg) which is used in conjunction with Scaling and root planing to help reduce the body’s response to the inflammation. Although doxycycline is typically used as an antibiotic in higher doses, at lower doses it helps slow the breakdown of collagen (the main constitute of bone, ligament and gum tissue), by inhibiting the action of the collagenase enzyme. At low doses Doxycycline has none of the negative side effects of regular dose antibiotics.
It is recommended for a period of 3 to 9 months on those with moderate to severe periodontal disease.
Directions for use: Twice daily, 1 hour prior to morning and evening meals. Take the capsule with a full glass of water.
Information on Periostat
Periostat Product sheet
Post Treatment Care
For several days after a scaling expect Teeth to:
· Be sensitive to temperature,
· Be sensitive to pressure and biting and
· Feel loose
· Gums to be tender and bleed more readily
Eating to prevent periodontal disease
Re-Evaluation
Four to six weeks after completion of scaling and root planing, a periodontal re-evaluation must be completed. The purpose of this exam is to assess the response to treatment and determine if there is a need for further treatment. In some cases it may be necessary to refer you to a periodontist (gum specialist) to continue treatment.
Links and References
www.1stgumdisease.com
www.adha.org/oralhealth
www.perio.org/consumer
www.ada.org/public/topics/gum.html
www.1stgumdisease.com
www.adha.org/oralhealth
www.perio.org/consumer
www.ada.org/public/topics/gum.html