Periodontal Disease

Periodontal Disease

Periodontal disease is a group of conditions affecting the tissues that support the teeth.  This group includes gingivitis, periodontitis and gum recession among many other conditions.   Gingivitis is a reversible inflammatory condition of the gums.  If left untreated, gingivitis could progress into periodontitis.  Periodontitis is characterized by loss of the bone supporting the teeth in addition to swollen and bleeding gums. The crevice between the gums and the teeth deepens as bone loss progresses.  This leads to the development of “deep pockets”.  These deep pockets between the gums and the teeth act as a reservoir of periodontal disease-causing bacteria.  Because of this, they are difficult keep clean.  As bone loss around the teeth progresses, the teeth become loose, and more susceptible to infections.  Eventually the teeth will fall out.  Periodontitis is the most common reason for tooth loss in adults.

Periodontal DiseaseSource: American Academy of Periodontology (perio.org)

Periodontitis is caused by plaque, the sticky colonies of bacteria that cover teeth. If plaque is not removed, it hardens and becomes tartar. Plaque and tartar deposits under the gum line lead to further bone loss around the teeth.  This may not be noticeable since the gums stay in the same position, while the underlying bone supporting the teeth-erodes away.   Development and progression of periodontitis is also affected by genetics, behavior and medical conditions.  Peridontitis is affected by genetic susceptibility, smoking and the presence of other systemic conditions, such as diabetes.

New evidence suggests that the presence of periodontal disease also has an effect on our general health. The chronic inflammatory response, triggered by the periodontal disease-causing bacteria, is believed to play a role in the development of heart disease among many other conditions.

Curettage

The main objective of curettage is to remove plaque and tartar deposits from the root surfaces and establish shallow “pockets”. This allows the health of the gums and teeth to be maintained.

This can be accomplished in one of three ways:

Scaling and root planing: Tartar deposits are removed from the root surfaces under the gum line.

Open curettage: The gum tissue is reflected away from the teeth to facilitate access for the removal of inflamed tissue surrounding the tooth and removal of tartar deposits on the root surface. Irregularities in the bone, caused by the progression of the periodontal disease, are corrected and finally the gums are repositioned back against the teeth.

Regenerative treatment: Sometimes it possible to regenerate some of the bone that has been lost around a tooth due to periodontal disease.

After a through assessment of the gums, the periodontist will be able to advise you which procedure is best suited to your condition. Once the periodontal disease is brought under control, most patients will require ongoing maintenance therapy. During the maintenance therapy, you will be seen periodically (3-4 times a year) for cleaning and periodontal assessment. Often these appointments will be alternating with your general dentist.

LANAP

Laser Treatment for Gum Disease (LANAP):  NOT RECOMMENDED  Capital Periodontics is continuously incorporating new technology that is beneficial to our patients.  We understand that many patients have heard about laser treatment in dentistry from advertisements. In deciding treatment protocol, we refer to American Academy of Periodontology and current publications.  We do not allow industry, with their mass advertising, to dictate our treatment protocol.  For this reason, we do not offer laser in our office.   The Academy of Periodontology’s statement regarding Laser Treatment for Gum Disease is, “Current controlled studies have shown that similar results have been found with the laser compared to specific other treatment options, including scaling and root planing alone. Scaling and root planing is a traditional non-surgical therapy used to treat periodontal diseases.” and, “At this time, there is insufficient evidence to suggest that any specific laser wavelength is superior to the traditional treatment methods of the common periodontal diseases, such as periodontitis.”  Scaling and Root Planing at a periodontal office can be performed at a fraction of the price and offers similar results.

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