Gum Disease and Periodontal Care

Did you know 80% of people have gum disease and is a major cause of tooth loss in adults?  Recognized as a progressive disorder, gum disease is triggered by many factors, like plaque buildup, tobacco use, certain medications, and stress, as well as systematic disease.  New research proves up to 30 percent of the population may be genetically susceptible to gum disease. In addition, gum disease has now been linked to a number of other diseases including cancer. For anyone sincerely concerned about their health gum disease should be considered a major threat.

Gum disease begins when the bacteria group in a sticky film called plaque which forms on the tooth surface.  This causes gum inflammation.  If the irritation is ignored, plaque  and infection will release toxins to break down the fibers that hold your gums to your teeth. This permits even more bacteria and toxins to be created and enter the body.  Plaque deposits harden into calculus or tartar, which is a rough, porous substance that cannot be removed by brushing. The most damaging of all is the tartar that develops below the gum line and lacerates the gums. Over time, this progression can lead to severe infection, inflammation, bone loss, gum recession, and finally tooth loss.

 A complete examination of the gums is a necessary part of your dental visits. In addition to checking for the signs shown below, a very slim instrument will be gently placed under the gums to measure any crevice that has formed. The instrument is called a periodontal probe. Normal crevices (pockets) are 1 to 2 mm. deep. When 3 mm. deep they are borderline. When at 4 mm. deep and above it is a sign of serious gum disease.    if bleeding is present with the probing that is an indication of an even more serious problem with significant infection.

Signs of Gum Disease include: Red, swollen or tender gums Bleeding gums in any amount. Gum recession, or gums pulling away from teeth. Loose or separating teeth. Pus between the gum and tooth. Persistent bad breath.  If you have noticed any of the above problems, please call us to schedule a consultation.  We can keep your teeth and gums healthy for a lifetime with the proper .

Types of Gum Disease and Treatments

 

Gingivitis: Gingivitis is a localized inflammation of the gums surrounding the teeth. Often seen as red bleeding gums, it is reversible with a thorough professional cleaning and good oral hygiene at home.The is no permanent damage to the bone or fibers supporting the teeth.

 Periodontitis: Periodontitis can range from mild to severe. The main difference between gingivitis and periodontitis is the later is accompanied by destruction of the bone or fibers that hold the teeth in place. The diagram above shows the difference between health and disease. Note how much lower the bone is in the area of infection. Also note how deep the crevice is allowing more plaque and accumulation of food. in addition the rough tarter lacerates the gums as you eat. Untreated the process will continue until so much bone is lost that the tooth becomes loose and is lost. With the heavy loss of bone the placement  of an implant restoration becomes much more difficult. Often a major surgical procedure is needed to transfer bone from another area of the body to the damaged areas of the jaw.

 

Treatments: We believe in Conservative treatment. In a healthy mouth a dental hygienist will remove plaque, any tartar and stain s that have accumulated on the   teeth. The teeth will be polished, and flossed. Difficult stains can be removed with an ultrasonic cleaner. Oral hygiene techniques will be review as we as a medical history update to see if special care is needed.

Where disease is present a more complete form of periodontal therapy will be needed. It is done by a specially trained dental hygienest or dentist.  This periodontal therapy is often called Scaling and Root Planing (SRP) or "deep cleaning" which is an inaccurate name for the treatment. With local anesthesia, very small instruments remove from the root surface the tartar and then the surfaces are smoothed. The bacteria and diseased tissue is peeled away, We strongly recommend that the area be flushed with an antiseptic to kill any remaining bacteria. While this sounds terrible and painful, it is NOT. Rarely have I ever seen a patient need more than a few Advil  to be comfortable. Please note: We do not recommend Laser gum therapy because It is nor as effective as traditional treatments in my opinion. While some improvements have been noted, it clearly is not the "gold standard" in periodontal disease care. While some will argue this, I mention to them the fact that to the best of my knowledge, no gum specialist that I am aware of uses laser therapy. Do your research on the internet on the subject before agreeing to Laser treatments.

 As a final resort, surgery of the gums can be used. Surgery will remove all diseased tissue and allow for the placement of materials that can restore lost bone. The surgery is done through very small openings and heals quickly. With today's advanced techniques, surgery is rarely needed. Today gum surgery has been simplifies and made much easier for the patient. Pain, healing time and complications are rare with todays techniques.

Therapeutic Oral Rinses:

Theraputic oral rinses can improve oral health in several ways. The most common use is to mask oral odors and freshen the breath. Usually available in your local pharmacy, therapeutic rinses can help with dry mouth, prevent decay desensatize gumline areas, and reduce reduce plaque and tartar build up. Inorder to be sold over-the -counter the FDA has required them to be at a very low strength.

Dentist can prescribe full prescription strength oral rinses that help reduce gum disease, provide relief from oral pain, lubricate oral tissues, and treat  certain oral infections. Therapeudic rinses are often prescribed for persons that are unable to adequately brush their teeth because of certain medical conditions.

• Flouride: Prescriptation strength flouride have been a great aid in situations where the teeth can not be well brushed. They are also effective at relieving sensativity.
• Anodynes: Anodynes sooth painful areas such as canker sore by medicating then and coating them with a thin film.
• Chlorhexadines: These agents have a strong anti bacteral affect and can be used as an additional treatment in gingivitis and periodontal disease.
• Cetalyperadium: This is an antiseptic that will reduce certain hard to control bacteria that live in areas of the mouth where there is no oxygen. It is also used in mouthwashes but is not very effective in that application.

Home Care:

 

At any age, you can begin the fight against plaque and keep your teeth and gums healthy. It's really quite easy.

Simply Follow this Routine: 

1. Brush your teeth twice a day with a soft-bristled toothbrush and fluoride toothpaste to remove food particles and plaque from the tooth surfaces. While you're at it, brush the top surface of your tongue to eliminate bad breath and bacteria buildup.
2. Clean between your teeth daily with floss or an inter-dental cleaner. Decay-causing bacteria can linger between teeth where toothbrush bristles can't reach. Flossing removes plaque and food particles from between the teeth and under the gum line.
3. Eat a balanced diet and limit between snacks. If a snack is needed, nutritious foods such as raw vegetables, plain yogurt, cheese, or a piece of fruit should be chosen.

We often work with or consult with Encino/Tarzana Dentists that specialize in gum disease. We can refer people to specialists in other areas of the San Fernando Valley in very advanced cases, but we believe in very Conservative Treatment.

 

"I was convinced I was going to lose all my teeth. I owe my gratitude to Dr. Melnick for the smile thought I would never have or keep for very long." Robin W. Cosmetician, Glendale