Dental Library- Periodontics

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Gum disease, or periodontal disease, is an infectious and inflammatory disease that destroys the periodontal tissues and is the number one cause of adult tooth loss. The periodontal tissues consist of the gums, periodontal ligament and the jawbone that support the teeth. Left undiagnosed and untreated gum disease leads to the loss of the jawbone that surrounds and supports the roots of the teeth, loss of the periodontal ligament that attaches the roots of the teeth to the jawbone for support, gum abscesses which cause swelling and pain and gum recession which exposes the roots of the teeth in the mouth. Gum disease leads to foul tasting and smelly discharges and is a leading component of halitosis, or bad breath. The bacteria associated with gum disease has been linked to heart attacks, stroke, diabetes, hypertension (high blood pressure), osteopenia (loss of bone mass), respiratory infections, premature and low birth weight babies, so your entire systemic (general) health is at risk when you have gum disease. Gum disease affects 3 out of 4 adults and is caused by a growing colony of living bacteria called plaque.

The insidious nature of gum disease stems from the fact that in its early stages there is little or no pain; therefore patients don't notice the gradual onset of their gums becoming red and puffy or their gums bleeding. Proper brushing and flossing do not cause healthy gums to bleed, if you have bleeding when performing proper home care see your doctor immediately! You wouldn't put off seeing your doctor if your hands or face bleed when simply washing them with soap and water so don't delay seeing your dentist at the first signs of bleeding gums. Gums that bleed are not healthy and need immediate medical attention. Without thorough removal of the plaque and the accretions that it adheres to the bacteria and the toxins they produce will cause the gum disease process to continue.

During your checkup, the dentist will perform a periodontal examination. An instrument called a periodontal probe is used to gently measure the space, or pocket depth, between each tooth and the gum. A pocket depth of three millimeters is considered normal unless gum recession is present. Greater pocket depth is an indication of periodontal disease, and generally the greater the depth the more severe the disease. The method and extent of treatment depends on how far the condition has progressed.

The first treatment modality is usually administering a thorough cleaning that may include scaling to remove plaque and tartar deposits beneath the gum line. The tooth roots may also be planed to make the root surface smoother, allowing gum tissue to heal and re-attach to the tooth. In some cases, the patient's occlusion (bite) may require adjustment.

Antibiotics or irrigation with antimicrobials (chemical agents or mouth rinses) may be recommended to help control the growth of bacteria that create toxins that cause periodontitis. In some cases, antibiotic fibers may be placed in the periodontal pockets after scaling and planing. This is done to control infection and to encourage normal healing.

When deep pockets between teeth and gums 4 to 6mm or greater are present, it is difficult for the dentist to thoroughly remove plaque and tartar. Patients can seldom, if ever, keep these pockets clean and free of plaque. Consequently, surgery may be needed, so call today and don't let this happen to you.

Extractions are needed when teeth are unable to be restored (fixed with a filling or crown) or are impacted they need to be extracted (removed from the mouth). Extractions can range from a simple extraction of an erupted tooth (one that is above the gum line) to complex surgical extractions of teeth that are impacted entirely within the jawbone or residual roots of broken down teeth that remain in the bone. The more complex the surgery the longer the treatment time for the extraction, the more bone that has to be removed to facilitate the extraction, the greater likelihood of needing sutures (stitches) as a part of the extraction treatment, the more post extraction discomfort and the longer the post extraction healing time will be required until the patient is completely comfortable again.

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