Gum Disease Therapy

What is gum or periodontal disease?

Gum or periodontal diseases are gum infections, which gradually destroy the bone and soft tissue or gum support of your natural teeth.   These diseases are the most common diseases known to mankind. 75% of all adults have had it or will have it at some time.  

If left unchecked and untreated, periodontal disease will lead to tooth loss and adversely affect your smile.

Our office is committed to preventing, identifying, and minimizing  this destructive disease among our patients. We demonstrate our commitment by providing our patients with a thorough understanding of the disease process, progression, treatment options, expected results, alternatives, and a dedicated and individualized patient self-care program.

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What causes periodontal (gum) disease?

Dental plaque is the primary cause of both tooth decay and gum disease in genetically susceptible individuals.

Plaque is a colorless film, which constantly forms and sticks to your teeth  at the gum line.  The bacteria  in plaque produces toxins or poisons that irritate the gums, which may cause them to turn red, swell and bleed easily. If this irritation is prolonged, the gums separate from the teeth, causing pockets (spaces) to form. As periodontal diseases progress, the supporting gum tissue and bone that holds teeth in place deteriorate. If left untreated, this leads to tooth loss.   If not carefully removed by daily brushing and flossing and regular periodontal maintenance visits for oral hygiene, plaque hardens into a rough, porous substance known as calculus (or tartar).

Periodontal diseases can be accelerated by a number of different factors.   Factors affecting the health of your gums include:
•Tobacco Usage
•Diabetes
•Stress
•Clenching and grinding teeth
•Medication
•Poor nutrition
•Heredity
•Daily Oral Hygiene

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Preventing gum disease

Adults past the age of 35 lose more teeth to gum diseases than cavities.  Three out of four adults are affected at some time in their life.  The best way to prevent gum disease is effective daily brushing and flossing as well as regular professional examinations and cleanings. Unfortunately, even with the most diligent home dental care, people still can develop some form of periodontal disease. Once this disease starts, professional intervention is necessary to prevent its progress.

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How do you treat periodontal disease?

There are numerous disease entities requiring different treatment approaches.

Many times, the early stages of periodontal disease are best treated with non-surgical periodontal therapy. Even in severe cases, non-surgical periodontal therapy often precedes surgical therapy. This is done to improve the overall tissue quality prior to surgery and also to help limit the areas requiring surgery.

  • Scaling may be the initial stage of treatment, usually a thorough cleaning to remove plaque and tartar deposits beneath the gum line.  This allows Dr. Chan, Rhona, or Cyndi to more accurately access the depth of the disease progression.
  • Root Planing is the removal of bacteria, toxins, calculus, and diseased deposits from the root surfaces of the teeth that have been affected by bone loss, periodontal disease or infection.  The tooth roots are planed to smooth the root surface allowing the gum tissue to heal and reattach to the tooth.  Signs and symptoms indicating root planning may include any or all of the following:  bleeding upon flossing, swollen or puffy gums, sensitive teeth/gums, bad breath, gum coloration other than pink, recession, loose teeth, changing bite, root exposure, increasing spaces between teeth, and pockets 4mm or deeper. Root planing is commonly performed using a local anesthetic.
  • Adjunct Therapy may include antibiotics, irrigation with anti-microbials (chemical agents or mouth rinses), or antibiotics..  These may be recommended to help control the growth of bacteria that create toxins and cause periodontitis. In some cases, antibiotic fibers may be placed in the periodontal pockets after scaling and root planing to control infection and encourage normal healing.
  • Referral or Surgical Therapy When deep pockets between the teeth and gums are present, it is difficult to thoroughly remove plaque and tartar. Hence, it is difficult for patients to keep these pockets clean and free of periodontal disease. As a result, surgery may be needed to restore periodontal health.

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How do you maintain or control periodontial disease long term?

Periodontal Maintenance are procedures instituted following periodontal therapy which continues at varying intervals, determined by the clinical evaluation of the dentist/hygienist, for the life of the teeth or any implant and includes the removal of plaque and calculus from crowns and root surfaces, including site specific scaling and root planning.

A periodontal maintenance procedure is not the same treatment as a regular prophylaxis or cleaning even though a hygienist may perform both services because of the skill and knowledge needed to address the specific specialized needs of the periodontal patient.

As in many other chronic conditions, successful long term control of periodontal disease and prevention of tooth loss and supportive tissues depend on continual and most often life-time maintenance, including 2, 3, or 4 month intervals between appointments.

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Why might a bite–adjustment be recommended?

Bite Adjustment  A bite is considered to be healthy when all or most of the teeth are present and not destroyed by daily chewing function.  It is destructive when teeth show wear, looseness or when TMJ (jaw joint) damage is seen. Bite therapy helps restore a bite that can function without damage and destruction. The therapy may include:

  • Reshaping the biting surfaces of the teeth and eliminating spots of excessive pressures where the teeth are brought into contact. This is done by carefully dividing bite pressures evenly across all of the teeth.
  • Bite splint therapy using a custom fitted and adjusted plastic bite guard to decrease excessive pressure on the teeth during the day, night or both.
  • Braces, to reposition mal-aligned or drifted teeth.
  • Replacement of old, worn out or damaged fillings.
  • Reconstruction of badly worn and damaged teeth.

A bite adjustment may be recommended for those with periodontal considerations to minimize chronic problem areas.

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Patient’s role In periodontal treatment

No matter how successful the periodontal treatment has been, ultimately you are most important in maintaining periodontal health. For maximum results, the patient must accept this role as a “co-therapist”. You must take “ownership” in achieving long-term success.

The first responsibility is to eliminate factors that increase susceptibility to periodontal disease. Some of these include smoking, diabetes and excessive use of alcohol.

Secondly, it is important to maintain daily plaque control. This is achieved through brushing and using other homecare aids such as floss, interdental brushes and rubber tips. Most periodontal disease begins between the teeth, therefore, we will recommend hygiene aids for your oral hygiene routine.

Lastly, you are responsible for scheduling regular periodontal maintenance. The frequency of these visits will be determined by Dr. Chan, the hygienist, and/or the periodontist based on the level of your periodontal health. Most patients with moderate to advanced cases or patients who may be susceptible to periodontal disease should have periodontal maintenance appointments every three to four months for their lifetime. Maintaining this schedule is very important to controlling periodontal disease.

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Periodontal disease and tobacco

You are probably familiar with the links between tobacco use and lung disease, cancer and heart disease.

Current studies have now also linked periodontal disease with tobacco usage. These cases may be even more severe than those of non-users of tobacco. There is a greater incidence of calculus formation on teeth, deeper pockets between gums and teeth as well as greater loss of the bone and fibers that hold teeth in your mouth. In addition, your chance of developing oral cancer increases with the use of smokeless tobacco.

Chemicals in tobacco such as nicotine and tar slow down healing and the predictability of success following periodontal treatment.

Problems caused by tobacco include: lung disease, heart disease, cancer, mouth sores, gum recession, loss of bone and teeth, bad breath, tooth staining, and less success with periodontal treatment and dental implants.

Quitting tobacco use will reduce the chance of developing the above problems and maximize the healing process.

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Diabetes and oral health

Individuals suffering from diabetes, especially uncontrolled diabetics, have a higher risk of developing bacterial infections of the mouth. These infections may impair your ability to process insulin, resulting in greater difficulty with controlling your diabetes. Periodontal diseases will be more severe than those of a non-diabetic and treatment more difficult. You can help resist periodontal infection by maintaining control of your blood sugar levels.
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