Periodontal Therapy

Don't Let Disease Get the Best of You

Periodontal disease, commonly known as gum disease, is the most common dental issue among adults. About 30% of the population experiences gum disease and it's the number one cause of tooth loss in adults. Many denture cases are a result of the destructive tendencies of this condition. While gum disease is not curable, it is controllable. However, it requires a focused strategy and it's best to identify this condition early to avoid severe consequences. 

The early stages of gum disease can advance with few noticeable signs or symptoms. Many patients with this condition are very surprised when they are initially diagnosed. In simple terms, consider the gums and bones around your mouth are the foundation of your teeth. Just like a house, the foundation must be sound regardless of the beauty of the house. When the foundation crumbles, the rest of it goes with it.

Regular dental exams, professional cleanings, and good oral hygiene practices at home are essential to detecting and strategically managing periodontitis.

What Causes Gum Disease?

Our mouths provide a home to millions of bacteria, that can be beneficial and harmful. Some bacteria can form plaque, a sticky substance that adheres to the teeth. Brushing and flossing help remove plaque before it mineralizes into tartar. Tartar becomes a colony for more bacteria and adds to their population, pumping out toxins into the gums.

Gums react to this bacterial invasion with an inflammatory response under the direction of the immune system. Around the base of each tooth, a small collar of gum tissue exists that forms a small crevice or pocket. This warm, dark environment provides a perfect habitat for deeper tartar and bacterial penetration, with their toxins seeping into the base of the collar.

Early inflammation results in bleeding gums, known as gingivitis. Bacteria left untreated and undisturbed successfully creates a chronic infection in the gum collar. In many cases, the bone begins to deteriorate around the teeth as the bacteria burrow deeper into the gums. While gums may be slightly tender at this stage, there's generally minimal discomfort as the bone dissolves.

More than 50% of the bone around your teeth can disappear before any signs of looseness or pain begin to appear. The bone around teeth never regenerates. This loss becomes permanent and harder to control as the bacteria hide deeper into the gums. It is essential to identify gum disease in the early stages because if left untreated it leads to abscess and generalized tooth loss in advanced cases.

Diagnosis

We draw on objective clinical data to form a gum disease diagnosis and to grade the severity of the condition. The small collar of gum around each tooth usually sits 2-3 millimeters deep, a small crevice easily cleaned by floss or toothpicks. Dr. Noreen Goldwire or our hygiene team can measure and chart multiple areas using a small measuring device. If these measurements register beyond 3 millimeters and include bleeding areas, the disease is present. Deeper findings indicate more advanced disease than shallower readings.

Dr. Noreen Goldwire will also consider the texture and shape of your gums, and any movement detectable in each tooth. It's also vital to examine the levels, shape, and density of the bone around your teeth on digital x-rays. By drawing together these numerous findings, a clear picture forms about your gum condition.

Treatment

After establishing a diagnosis defining the severity of gum disease, we will establish a personalized treatment plan with you. In milder forms with little or no bone loss, one or two visits with our hygiene team may bring the condition under control. If you commit to keeping up with your home care, little additional treatment may be needed. 

If the inflammation has advanced with measurable bone loss, a proactive approach to halting the destruction will be strongly advised. Often we will suggest gentle numbing of your gums for your comfort during the deeper cleaning process. One area at a time undergoes meticulous cleaning above and below the gum line, usually over several visits. The infected collar or pocket around each tooth, including the mineralized tartar, must be carefully cleaned out with hand and ultrasonic instruments. The initial therapy will end in polishing the teeth, which will establish glassy surfaces that help repel stain and plaque accumulation.

Dr. Noreen Goldwire may suggest a medicated rinse, an electric toothbrush, a Waterpik, or other specific strategies to help you with your at-home efforts. Remember, gum disease can be controlled, but not cured. Dedicated daily efforts must be consistent to control the disease.

Maintenance Matters

Regular home care is critical to arrest the progression of gum disease. Within a few hours of a careful cleaning, the bacteria begin to repopulate and adhere to the teeth. If plaque is left undisturbed, it will start to harden and mineralize within 24 hours. The deeper gum pockets will require even more diligent care to prevent the bacteria from burrowing further into the foundation of your teeth.

Since the deepest sections of gum pockets previously damaged by bacteria can be difficult to reach at home, a specified maintenance schedule with us will be vital for your gum health. We can customize your plan to include 2-4 visits a year depending on the severity of the disease, its response to treatment, and your commitment to home care.

If our combined efforts don't stop your gum disease progression, we will suggest referral to a trusted specialist, known as a periodontist. With specialized training in many gum conditions, further treatment may be recommended by them.

Mouth-Body Connection

Current research continues to establish clear links between bacterial disease in your mouth and ailments in other parts of the body. Studies show a link between oral bacteria and conditions such as heart disease, stroke, arthritis, Alzheimer's, and types of cancer. It is essential to take good care of your teeth not only for a pretty smile but also for your overall health.

Bleeding gums provide a direct pathway into the bloodstream, allowing a pathway for toxic oral bacteria. If bleeding gums connected into one single patch, it would create a 2 x 2-inch square. If an open wound of this size existed on your skin, infection would be a great concern. Bleeding and infected gums offer an open door for harmful bacteria to enter your body. This also explains why researchers continue to identify oral bacteria deposits in places all over the body. 

Diabetes and other auto-immune disorders lower the body's ability to fight infection, which allows uncontrolled gum disease to advance faster and with more irreversible destruction. Research also confirms that the inflammation in the mouth can aggravate diabetes, making it harder to control. This two-way relationship between two chronic conditions emphasizes the importance of optimal oral health.