What is a Periodontist and Periodontal Disease?
What is a Periodontist?
A Periodontist is a dental specialist trained to diagnose and treat diseases that affect the gums and the underlying bone. Periodontists have an additional three years of training after dental school to routinely perform surgical procedures in order to manage gum disease, receding gums, and defects in the bone around teeth and dental implants. They are also experts in the placement of dental implants and bone augmentation procedures.
What is Periodontal Disease?
Periodontal disease, or gum disease, is a chronic inflammatory condition that destroys the tissues (bone and gums) around your teeth.
Periodontal disease is a progressive condition that eventually leads to the destruction of the connective tissue and jawbone.
It is often preceded by gingivitis, a bacterial infection of the gum tissue caused by plaque toxins that irritate and inflame the gums. Once this infection colonizes in the gum pockets between the teeth, it becomes very difficult to treat and remove.
There may be few or no symptoms of periodontal disease, however, if left untreated, it can lead to shifting and loose teeth with eventual tooth loss.
Periodontal disease is the leading cause of tooth loss among adults in the developed world and should be treated promptly.
What causes periodontal disease?
There are genetic and environmental factors involved in the onset of periodontal disease. In many cases the risk of developing periodontitis can be significantly lowered by taking preventative measures.
Some of the most common causes of periodontal disease include:
Poor oral hygiene - When bacteria and tartar are not removed, the gums and bone around the teeth become affected by toxins that can cause gingivitis or periodontitis, which can lead to tooth loss. Preventing dental disease starts at home with good oral hygiene and a balanced diet. Regular dental visits, which include exams, cleanings, and x-rays, are also essential. A combination of excellent home care and professional dental care will help preserve the teeth and supporting bony structures.
Tobacco use – Research has indicated that smoking and tobacco use is one of the most significant factors in the development and progression of gum disease. Smokers have slower recovery and healing rates and are far more likely to suffer from tartar build-up on teeth, deep pockets in the gingival tissue, and significant bone loss.
Genetic predisposition –As much as 30 percent of the population may have a strong genetic predisposition to gum disease and are six times more likely to develop periodontal disease than people with no genetic predisposition, regardless of their oral hygiene routine. Genetic tests can determine susceptibility and early intervention can be performed to keep the oral cavity healthy.
Pregnancy and menopause – During pregnancy and menopause, regular brushing and flossing is critical. Hormonal changes can cause gum tissues to become more sensitive, rendering them more susceptible to gum disease.
Chronic stress and poor diet – Stress lowers the ability of the immune system to fight off disease, which can make bacterial infections more likely. Poor diet or malnutrition can also lower the body’s ability to fight periodontal infections.
Diabetes and underlying medical issues – Many medical conditions can intensify or accelerate the onset and progression of gum disease. For example, diabetes hinders the body’s ability to fight infection. Studies have shown that people with diabetes can reduce their risk of developing gum disease through good disease management. Furthermore, controlling periodontal disease can help improve diabetic control.
Grinding teeth – Tooth clenching or grinding can significantly damage gum tissue. Grinding can be associated with a “bad bite,” or misalignment of the teeth or stress. If a person is already suffering from gum disease, the additional destruction of gingival tissue due to grinding can accelerate the progression of the disease.
Medication – Several drugs, including oral contraceptive pills, heart medicines, anti-depressants, and steroids, affect the overall condition of teeth and gums.
What are the symptoms of periodontal disease?
-Bleeding when you brush
-Pus
-Swollen, painful gums
-Bad breath or a bad taste in your mouth
-Recession or longer teeth
-Loose teeth that may shift in position
-Spaces between teeth
-There are often no signs or symptoms of periodontal disease
How is periodontal disease diagnosed?
A periodontist will use a special probe to measure the depth of the pockets around your teeth. X-rays often reveal the amount of bone loss around your teeth.
How is periodontal disease treated?
The first steps in treating periodontal disease are scaling and root planing, which involve careful cleaning of root surfaces to remove plaque and tartar from the pockets. Local anesthetic (freezing) is often used to make the procedure more comfortable. Several treatments are usually needed for results to be seen.
After a period of healing, your periodontist will re-evaluate your condition by re-measuring the pockets to see if there has been any improvement.
After scaling and root planing, many patients do not require further active treatment and their condition can be maintained with professional cleanings every three months. It is very important to get regular cleanings to help maintain your teeth.
In some cases, the pockets are too deep and cannot effectively be cleaned or maintained in a state of health without surgery.
What is the purpose of periodontal surgery?
Surgery will help prolong the lifespan of your teeth.
Periodontal surgery is performed to allow access to the roots of your teeth so they can be effectively cleaned. Studies have shown that it is almost impossible to properly clean deep pockets without surgery.
Surgery reshapes the tissues around your teeth to create an anatomy that is easily maintained. This is called pocket reduction.
In some cases, lost tissue can be regenerated around your teeth. Grafting and regenerative materials such as Emdogain, Bone Ceramic, or Gem21 may be used in the affected areas to assist in regeneration.
What does periodontal surgery involve?
Pocket reduction surgery may be performed under local or general anesthetic depending on your preferences.
The gums will be gently pushed back from the teeth. Scaling and root planing will fully remove bacteria and tartar from the surface of the tooth root. The gum is then sutured with tiny stitches that are left in place for 5-10 days. The sutures usually dissolve on their own.
There will be a significant reduction in pocket depth and a vast improvement in the condition of the teeth and gums following the procedure.
The gums may be more sensitive immediately following the procedure.
Is there a need for ongoing care?
If you receive treatment or surgery for periodontal disease, it is important to continue with ongoing care. Gum disease can easily return if you do not take proper care of your teeth and gums.
It is very important to maintain daily home care, which includes brushing, flossing, and other techniques to remove plaque and bacteria. Regular cleaning visits are also essential to achieving and maintaining good oral health.
We may recommend the use of special mouth rinses or other oral cleaning aids that will help keep your teeth and gums healthy.
Quitting smoking will drastically improve the condition of your teeth.