Periodontal disease is a leading cause of tooth loss, pain and discomfort from abscesses and may be associated with other health problems like pre-term low birth weight babies, and chronic diseases like heart disease and diabetes.
Periodontal disease begins and progresses as the sulcus (pocket or space) between the tooth and gums gets filled with bacteria, plaque, and tartar, causing irritation to the surrounding tissues. When these irritants remain in the pocket space, they can cause damage to the gums (gingivitis) and eventually to the bone that supports the teeth (periodontal disease).
Periodontal diseases are recognized by Dr. Archibald and his team by collecting and examining several important diagnostic qualities. First we are able to visually recognized signs of periodontal disease through a thorough examination of your teeth and gums. Secondly, we use digital x-rays to examine the bone height and health around your teeth. Finally, we use a small, blunt instrument, to measure the space between your teeth and gums. Imagine a turtle neck sweater with the sweater being your gums and your head and neck being your tooth. When this space is large initially or increases between appointments it often tells us that periodontal disease is present and therapeutic rather than preventive treatment is indicated.
Other risk factors, besides inadequate home care for periodontal disease include:
- Smoking and tobacco use
- Certain medications
- Clenching or Grinding your teeth
- Other systemic diseases, like diabetes, cardiovascular disease and autoimmune diseases
- Poor nutrition and obesity
Gingivitis is characterized by gums that appear enlarged, puffy, red/darker and may bleed easily when brushing and flossing. Gingivitis is usually caused by inadequate oral hygiene and infrequent professional cleanings. Other contributing factors to gingivitis include diabetes, pregnancy, stress, hormonal fluctuations and certain medications. Gingivitis can typically be reversed with a professional dental cleaning followed by diligent and effective homecare habits and regular dental health visits for professional preventive cleanings, usually every 4-6 months.
Untreated gingivitis can advance to periodontitis. With time, plaque can spread and grow below the gum line. Toxins produced by the bacteria in plaque irritate the gums. The toxins stimulate a chronic inflammatory response in which the body in essence turns on itself, and the tissues and bone that support the teeth are broken down and destroyed. Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. This can cause teeth to become mobile and uncomfortable to chew with. It can also make the teeth appear longer and develop spaces between the teeth that retain food and make it more difficult to clean. Often, this destructive process has very mild symptoms. Eventually, loose teeth have no other options and may have to be removed.
If the disease has progressed to more advanced stages, a special periodontal cleaning called scaling and root planning (deep cleaning) will be recommended. It is usually done one quadrant of the mouth at a time. This conservative, non-surgical technique can be comfortably performed in our office with local anesthetic. In this procedure, tartar, plaque, and toxins are removed from above and below the gum line (scaling) and rough spots on root surfaces are made smooth (planning). This procedure helps gum tissue to heal and pockets to shrink. Medications, special medicated mouth rinses, and an electric tooth brush may be recommended to help control infection and healing.
Periodontal maintenance is an extension of active periodontal therapy initiated by scaling and root planning. It continues at varying intervals for the life of your teeth. Usually we will ask you to return every 3 months for the first year for maintenance visits.
At these maintenance appointments, the pocket depths around your teeth will be carefully re-checked to ensure that they are improving in health and are free of signs of inflammation. Plaque and calculus that is difficult for you to remove on a daily basis will be removed from above and below the gum line. Your teeth will be polished and you will have an opportunity to discuss your oral hygiene efforts and receive products and recommendations from Dr. Archibald and his team.
The goals of periodontal maintenance are:
- Minimize the recurrence and progression of periodontal disease in patients who have been previously treated for gingivitis or periodontal disease.
- Consistently reinforce and support you in your efforts to maintain your teeth in a healthy oral environment.
- Consistently improve quality of life by minimizing chronic infection and inflammation with the potentially adverse effects it can have on your general health and its associations with chronic diseases like cardiovascular disease and diabetes.