Periodontal Disease or Gum Disease Treatments
Gum Disease or Periodontal disease is accumulation of bacteria causing disease and breakdown in the gums, tissues, bones to breakdown support of the tooth structure and possibly cause to plaque to further deteriorate other systemic problems. Gum disease is actually an auto immune disease.
We naturally focus on a persons teeth when they smile, but healthy gums is also a must to project a healthy and youthful image.
What is Gum Disease?
Gum disease is NOT Synonymous with GINGIVITIS. Gingivitis is inflammation of the gums, without bone loss. Gingivitis is reversible, since there is no bone loss involved. When there is any bone loss it is classified as PERIODONTAL DISEASE. Periodontal Disease is classified into three (3) stages: Initial, Moderate and Advanced Periodontal Disease.
What is the cause of periodontal disease?
The cause of periodontitis or gum disease is accumulation of plaque and growth of bacteria, in which if it remains undisturbed, it grows exponentially, producing end product of acidity in which breaks down the periodontal (supporting structure of the teeth) structure.
Periodontal disease is caused by lack of proper oral hygiene maintenance, and it can advance further if the patient does not keep his or her periodontal maintenance appointment. Acidity in the mouth is also a major contributor to periodontal breakdown, and caries in the mouth. Genetics also plays a great role and the consistency of your saliva enzymes.
How do the dentist diagnose gum disease?
The most important way to diagnose Periodontal Disease is via complete dental X-Rays to diagnose any loss of BONE and of course periodontal examination and periodontal probing and pocket examination to determine the depth of the pockets.
The depth of pocket is critical, as to how much food, plaque and bacteria can grow, in that sulcus to cause further disease. Periodontal disease can be chronic in which there is no sign of pain, till it reveals itself to an abscess. Certain gum diseases can be classified as acute or painful, however most periodontal disease is a chronic condition with absence of pain.
How is periodontal disease classified?
Early Periodontal Disease– is the progression of gingival or gum inflammation, into the bone crest, revealing early bone loss, resulting in moderate pocket or sulcus formation of 4 to 6 mm.
Moderate Periodontal Disease– is more advanced stage of early gum disease, with increase destruction of the bone, and is associated with deeper pockets of 5 to 8 mm, there is tooth looseness or mobility of teeth associated with moderate periodontal disease.
Advanced periodontal Disease or Gum Disease- is associated with further progression of gum disease, with severe destruction of the bone, with increased pockets of 7 to 8 mm, revealing mobility and loose teeth, in addition of pus coming out of the gum pockets.
Can gum disease cause cavities, or loose teeth?
Periodontal disease or gum disease can cause vast number of problems such as (but not limited to) the following:
1- Root decay. A beautifully constructed crown, may need to be redone if the gum disease is not controlled, since the crown can not get cavity, nor the white fillings or inlays and onlays, but the root of the teeth due to deep pockets can get cavities or secondary caries, in which the crown, or the filling or the inlay needs to be redone.
2-Loss of bone can cause mobility of the roots, loose teeth, causing your teeth to shift and in some cases protrude forward.
3-Gum disease in most cases causes Halitosis or bad breath!
4-Can cause the foundation of your oral cavity to be compromised, and once the bone is gone, it does not grow back!
5- Can cause recessions of the gums, and exposure of the roots and cementum, in which the root can be sensitive, or is prone to get caries or abfraction due to normal brushing.
How many gum treatments exists?
Treatment for Early Periodontal Disease is usually Non surgical gum treatments , such as prophylaxis, root planning. and periodontal maintenance are indicated, surgical gum procedures such as gingevectomy, or gingival flap procedure surgery might also be indicated.
Treatment for Moderate Gum Disease is usually surgical and non surgical or the combination of both, such as scaling and root planning, gingevectomy, gingival flap surgery ( gum surgery), osseous or bone surgery, and possible guided tissue regeneration procedures.
Treatment for Advanced Periodontal Disease or Advanced Periodontitis, is all the nonsurgical treatments initially, to evaluate the progression of change and then surgical gum intervention, via gingevectomy, , gum curettage, gum flap surgery, osseous or bone surgery, guided tissue generation, and bone grafting.
Bad Breath or Halitosis, can be the domino effect of what periodontal diseases cause !
There is also acute Necrotizing Periodontal Disease “ANUG” which is a form of Disease that gets worse rapidly and can cause Pain, Bad Breath, Halitosis, a whitish film on the surface of the gum. People with these forms of Gum Disease may also develop fever or swollen glands.
The treatment for ANUG TYPICALLY INVOLVES:
- Complete Periodontal Evaluation including Dental X-Rays and Charting.
Scaling and Root Planning.
Full Mouth Antibiotic Debridement of the Gums.
Possible use of Antibiotics pills.
Chlorhexidine rinses prescribed by the Dentist.
Oral hygiene instruction and demonstration to the Patient.
Periodontal Disease is classified as a disease that can spread and destroy the Gums and Bone around the Teeth. In recent years we have linked Periodontal Disease to Systemic Ailment causing Heart Disease, Pulmonary Disease and the vast many other Systemic Problems.
Does the gum grow back?
In most cases gum does not grow back, due to lack of bone supporting the gums. If you have black triangles between your teeth due to loss of gums (no Paplillae), then the only way to hide the dark spaces is with restorative material such as dental bonding or dental veneers.
It is of utmost importance to control the Periodontal Disease before starting “Cosmetic Dentistry or Restorative Dentistry Procedures” says Dr. Anthony Mobasser.
More than 75 percent of adults over 35, and 30 percent of the entire population suffer from some sort of periodontal disease. While heredity may be part of your problem, there can be other contributing factors. These include:
- Tobacco use
- Systemic disease
- The fluctuating hormonal levels of puberty, pregnancy or menopause
- Know that wisdom teeth that are partially impacted third molars can cause pain due to gum pocket being infected
Gingivitis is the earliest stage of gum disease. It is readily identifiable by red and swollen gums that bleed easily. Inflammation is caused by the bacteria in plaque that attacks all our teeth, as well.
Fortunately the treatment for gingivitis are : professional prophylaxis, full mouth scaling, root planning (deep cleaning, in conjunction with anti microbial medicament) in combination with careful oral hygiene practices such as regular brushing, flossing, mouth rinses and brushing your tongue which can reduce your propensity for gingivitis.
If periodontal disease is left untreated, you may face more serious problems. At this point, only professional dental treatment can help.
Should a problem be detected during your regular check, top cosmetic dentist Dr. Mobasser can help design the appropriate treatments.
What medications are generally prescribed for gum disease?
Depending on the condition of your mouth, Dr Mobasser may prescribe products such as antibiotics, peridex, peroxyl, prevident 5000 plus, clinpro 5000,or Mi paste plus, cervitec plus to aid fight the bacteria till your next periodontal maintenance visit.
A vital portion of such treatments includes a routine cleaning to remove the hard calcium deposits that form over time. Cleaning also will remove any plaque and tartar deposits built up at the gum line. Removing these deposits also will sooth root surfaces, preventing future bacterial deposits leading to Halitosis.
Remember, healthy gums and teeth mean a healthy smile that radiates the you within.
Visit our dental offices in Los Angeles or Beverly Hills for regular professional cleanings and checkups.
Should I floss first or Brush first?
Research has shown that by flossing first and then brushing teeth, less bacteria present, so we highly recommend flossing first then brushing. Flossing will help clean 2 surfaces out of 5 surface in each tooth that needs to be cleaned to avoid cavities between teeth and causing gum (periodontal) pockets. It is vital flossing be done since most gum disease and cavities start from between teeth.
Brushing cleans the 3 other surfaces of the 5 surface that needs to be cleaned. Those surfaces is outer or cheek side, the inside, which is palatal or lingual and the top of the tooth, which there are crevices and valleys, in which bacteria attack the tooth from the top of the teeth.
How long does healing take in cosmetic gum contouring?
The healing time for gum contouring depending on the extent of gum contouring and whether bone contouring is required also! Usually for gum contouring the length of time for healing is 2 weeks to 2 months if bone is involved more time is required up to 4 months. It is best to ask the surgeon or the periodontist prior. It is not recommended to have tooth bonding and porcelain veneers, or any dental restorative treatment done at the same time of the surgery, but it is advisable to wait for complete healing of the gums prior to do any dental restoration.
How to treat recessions, and exposed roots?
Generally 3 options are available: restorative, closed surgical procedure or gum surgery.
Dental bonding vs gum grating vs pinhole technique:
First you need to find out why there is a recession, to get to root cause of problem, it can be bone loss, bite and occlusion, and many other factors….. Once the recession is diagnosed, it can be treated via gum grafting, to eliminate sensitivity, or better yet you can use pinhole technique ( newer gum grafting technique), in which the gum is pulled down vs grafting in which the dentist cuts gum from palate or other recipient site to graft it in the area of the recession.
If you do not want surgery then dental bond can be an alternative, it is done in one visit, conservatively, and you will be done. The technique for dental bond to the root is technique sensitive, so the root does not look over-contoured and the root is sealed completely with no leakage of bacteria!
According to ADA ( american dental association) the dental bond can last 3 to 10 years! However the good dentist need to check your occlusion also, to make sure your bite particularly in the area of recession is balanced.
Dental bond is a great technique to conservatively restore the root area, however the expert dentist must look at the cosmetic aspect of the treatment to make sure the tooth will not look much longer. Of course the best treatment for recession with sensitivity is gum grafting surgery to cover the root, but majority of patients do not want to go through surgical intervention and discomfort to treat the recessed area. The next best thing to do is to have dental bonding and sealing the root.
Now days there is even pink dental composite to bond to your root area which mimics gums, the color might not be exact but it does help in areas that would show elongated length of the tooth in the Aesthetic zone ( where teeth show in your SMILE).
Synopsis: Dental bonding restoration due to gum recession