Periodontal disease is a chronic infection of the gum and bone that hold your teeth in position. It is frequently painless, and you may not be aware that you have a problem until the gums and supporting bone are seriously damaged. Almost everyone will have some degree of gum disease at some time and it is the most common cause of tooth loss in adults.
Some symptoms you may have are:
More importantly perhaps there is a strong link between periodontal disease and other common diseases such as diabetes, cardiovascular disease (heart disease and stroke) and adverse pregnancy outcomes.
All gum disease is caused by bacterial plaque. This is a film of bacteria which forms on the surface of teeth and gums every day. Effective removal of plaque by brushing and flossing daily will prevent the harmful bacteria in plaque from proliferating and causing periodontal disease.
In healthy teeth, the groove (sulcus) between the gum and tooth is less than 3mm deep and can be fairly easily cleaned by flossing and brushing. In periodontal disease this groove deepens (to 4 mm or more) to form a pocket which collects more plaque bacteria. These bacteria, which are difficult to remove from the pocket by normal brushing and flossing, produce toxins which lead to the breakdown of the tissue and bone anchoring the teeth. Over time, the pocket deepens, the tooth becomes loose and will eventually fall out.
Fortunately, if diagnosed early, periodontal disease can be treated with regular scaling and rigorous oral hygiene. Often, it can be managed by your dentist and hygienist, but if the condition worsens you may be advised to see a periodontist.
Initially when you see the periodontist, you will have all the pockets around your teeth measured with a probe and a full set of x-rays done to assess any bone loss. Based on the findings the periodontist will propose a treatment plan that may include extracting any teeth beyond saving, and scaling and root planing the remaining teeth. Root planing removes all the plaque and calculus (tartar) from the pockets and root surface. This allows for reattachment of the gum to the healthy bone. This can result in gum shrinkage, with some sensitivity, increase in size of gaps between teeth and a temporary increase in mobility of teeth, but you get to keep your teeth.
Periodontal disease cannot be ’cured’ but with careful maintenance we can ensure the disease doesn’t get the chance to re-establish itself. This requires a real commitment from you.
We will teach you a thorough and effective way to clean your teeth every day. Two months after your initial treatment you will have a review where we look to see if the pockets show signs of healing and sometimes it may be necessary for further treatment in some areas, which we will then discuss. If everything is healing well, you will be asked to see the hygienist at regular intervals to scale and polish your teeth and check your cleaning regime.
This maintenance phase is the most important in ensuring the long-term success of your treatment. Smoking makes gum disease worse. The smoke encourages more bacterial plaque and the oxygen deprivation slows down any possible healing.