Treatment of Periodontal Disease

The main objective of the treatment is to control infection. The number and types of treatment will vary, depending on the extent of the gum disease. Any type of treatment requires that the patient keep up good daily care at home.

Deep Cleaning (Scaling and Root Planing)
The dentist, periodontist or dental hygienist removes the plaque through a deep-cleaning method called scaling and root planing. Scaling means scraping off the tartar from above and below the gum line. Root planing gets rid of rough spots on the tooth root where the germs gather. It helps remove bacteria that contribute to the disease.

Medications
Medications may be used with treatment that includes scaling and root planing, but they cannot always take the place of surgery. Depending on the severity of gum disease, the dentist or periodontist may suggest surgical treatment. Long-term studies will be needed to determine whether using medications reduces the need for surgery and whether they are effective over a long period of time.

Surgical Treatments

Flap Surgery —This might be necessary if inflammation and deep pockets remain following treatment with deep cleaning and medications. A periodontist may perform flap surgery to remove tartar deposits in deep pockets or to reduce the periodontal pocket and make it easier for the patient, dentist, and hygienist to keep the area clean. This common surgery involves lifting back the gums and removing the tartar. The gums are then sutured back in place so that the tissue fits snugly around the tooth again.

Bone and Tissue Grafts —in addition to flap surgery, your periodontist may suggest bone or tissue grafts. Grafting is a way to replace or to encourage new growth of bone or gum tissue destroyed by periodontitis. A technique that can be used with bone grafting is called guided tissue regeneration, in which a small piece of mesh-like fabric is inserted between the bone and gum tissue. This keeps the gum tissue from growing into the area where the bone should be, allowing the bone and connective tissue to re-grow.
Since each case is different, it is not possible to predict with certainty which grafts will be successful over the long- term. Treatment results depend on many things including severity of the disease and the ability to maintain oral hygiene at home. Certain risk factors, such as smoking may lower the chances of success. Ask your periodontist what the level of success might be in your particular case.

What causes Periodontitis?

Periodontitis is defined as an inflammatory disease of the supporting tissues of the teeth caused by specific micro-organisms. Plaque is a result of the bacteria, mucus and other particles that coexist in our mouths. Plaque is colourless sticky film that coats our teeth between cleaning. If plaque is not removed as a result of regular brushing and flossing, the plaque converts into tartar which cannot be removed by brushing and flossing. To remove tartar you would need to visit a dentist or oral hygienist in order to have your teeth professionally cleaned.

Lack of brushing, flossing and regular dentist / oral hygienist visits will result in the tartar on your teeth becoming progressively more harmful in the form of excess bacteria. These bacteria attack the gums which become inflamed, red, swollen and bleed easily. This is known as Gingivitis. Gingivitis can usually be eliminated by regular professional cleaning and daily brushing and flossing. Gingivitis is a mild form of gum disease.

If Gingivitis is not treated, it can result in Periodontitis (infection around the tooth). The gums pull away from the teeth and form “pockets” that are infected. The body’s immune system fights the bacteria as the plaque spreads and grows below the gum line. Bacterial toxins and the body’s enzymes fighting the infection actually start to break down the bone and connective tissue that hold teeth in place. If not treated, the bone, gums, and connective tissue that support the teeth are destroyed. The teeth may eventually become loose and have to be removed.

Contributors

Smoking: Smoking is one of the most significant factors associated with the
onset of Periodontal Disease. Smoking can also lower the chance of success
regarding certain treatments.
Hormonal changes in girls / women (including pregnancy): These changes
can make gums more sensitive and make it easier for Gingivitis to develop.
Diabetes: People with Diabetes are at higher risk for developing infections,
including Periodontal Disease.
Stress: Research shows that stress can make it more difficult for our bodies to fight infection therefore including Periodontal Disease.
Medications: Some medication such as anti-depressants and some heart medication can have an effect on oral health because they decrease the flow of saliva. (Saliva has a protective effect on teeth and gums).
Illnesses: Diseases like Cancer or AIDS and their treatments can also affect the health of gums.
Genetics: Some people are more prone to severe Periodontal Disease than others based on their genetic makeup.

Symptoms

Bad breath that won’t go away
Red or swollen gums
Tender or bleeding gums
Painful chewing
Loose teeth
Sensitive teeth

People who develop the initial symptoms of Periodontitis are generally from the age of 30 and the disease is most prevalent in men. You are advised to begin looking out for signs and symptoms from the age of 30 years.

Heart Disease & Periodontal Disease

Researchers have found that Periodontal Disease sufferers are almost twice as likely to suffer from Coronary Artery Disease as those without Periodontal Disease. Periodontal Disease can also exacerbate existing heart conditions. The first theory is that oral bacteria can affect the heart when entering the blood stream, attaching themselves to fatty plaques in the coronary arteries (heart blood vessels) thereby contributing to clot formation. Blood clots can obstruct normal blood flow, restricting the nutrients and oxygen required for the heart to function properly which can lead to heart attacks. Another theory to consider is that inflammation caused by Periodontal Disease increases plaque build up, which may also contribute to swelling of the arteries.

Prevention

Brush your teeth twice a day (with fluoride toothpaste). Floss every day. Visit the dentist routinely for a check-up and professional cleaning. Eat a well balanced diet. Don’t use tobacco products.

And then, most importantly, we all require a strict Oral Hygiene program where frequency of visits will be determined by your specific need. The Oral Hygienist (Nicky Heenop) is trained to care for all patients specifically those suffering from (or recovering from) periodontal disease. She also assists in the post- operative care for patients who recently undergone periodontal or implant surgery.

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