Periodontal Disease and Treatment
Periodontal disease is a very common disease and is often not detected by those affected, who don’t seek regular dental care, due to the fact that a lot of times there is no pain associated with the disease. Some symptoms may include bleeding gums, bad breath or bad taste, and in serious cases, loose teeth. Once this irreversible disease is detected, it is very important that it is not only treated, but maintained. Some factors that increase your chances of inheriting this disease may be health conditions such as diabetes and cardiovascular disease, or tobacco use. In turn, once you have periodontal disease, research has shown that it can exacerbate the above mentioned conditions, as well as lead to pre-term or low birth weight babies in pregnant women, or even pneumonia. Studies have shown that bacteria found in the oral cavity of some who have died from pneumonia matches the bacteria in their lungs, thus leading us to the conclusion that inhaling these harmful bacteria could have played a role in the pneumonia. Not only are periodontal infections the number one cause of adult tooth loss in the United States, but this common disease will also affect your overall health.
It is so important to see your dentist regularly, so that he or she can monitor the health of your gums. There is a space between your teeth and gums, kind of like the space between your finger and your fingernail. When a dentist or hygienist is checking you for periodontal disease, they will usually begin by measuring that space, or what we call a pocket, with a tiny probe, which is kind of like a little ruler, to see how deep it is. Each tooth will get six measurements. A healthy pocket reading is between 0mm and 3mm. If there are any 4mm, these are areas that need to be monitored and also probably need more oral hygiene attention. The dentist may recommend more frequent recalls at this point. Once a pocket is 5mm or greater, this is a sign that there is some periodontal infection and inflammation, and at this point, attention is required to halt the disease process. Bone loss seen on x-rays will also be considered when diagnosing periodontal disease.
Unfortunately, once it is determined that you do have this form of gum disease, it is not something that can be cured. Periodontal disease must be treated by a procedure called scaling and root planing, or what you may hear called a “deep cleaning”, and must be maintained at home by excellent oral hygiene practices and by having your teeth cleaned by a hygienist every three months, forever. It only takes three months for the bacteria to return. In severe cases, some teeth may need to be extracted, and/or you may be referred to a specialist.
When you see your hygienist for your regular cleaning, or as we call it, a prophy, every six months, this is considered a preventive procedure. Once you have periodontal disease, a preventive cleaning is no longer indicated and would actually be neglectful. A regular cleaning entails cleaning tarter and plaque from above the gum line and no deeper than 3 to 4mm below the gum line. If you have 5mm pockets, a regular cleaning will not reach the deposits and bacteria, which is why you need the deeper cleaning, called scaling and root planing. In most cases the patient will receive local anesthesia, or what you may call “Novocain”. The goal is to make you as comfortable as possible during this procedure. The hygienist will use special instruments to remove all of the bacteria, plaque, and tarter from your teeth, and then will give detailed home care instructions, which will show and explain how to brush, floss, and rinse properly. Usually, he or she will also irrigate or “flush out” your gums with a prescription strength mouthwash and may also place some antibiotics below the gum line. Most people have minimal discomfort following this procedure and only experience some soreness to the gums and tooth sensitivity, which in most cases, are temporary and last only a couple of days to a week. You will be instructed to return to the office in about a month for a reevaluation. This will include checking your gum measurements again, polishing, and reviewing homecare instructions. Homecare and maintenance are extremely important, but preventing this disease in the first place is ideal. You should be brushing your teeth two times a day for two minutes each time, flossing once per day, and rinsing with a mouthwash, such as Listerine. If you think you could have periodontal disease, you should see a dentist immediately, so they can get the condition under control before too much damage and infection occur.