According to reports by the CDC, 47.2% of adults above 30 years have a form of periodontal disease. The same report indicates that your chances of having periodontal disease increase with age since about 70.1% of adults aged 65 and over have periodontal disease. Interestingly, this disease is more prevalent in men than women. Periodontics provide the solution to these diseases.
It might not be very clear to know when to visit a general dentist or a periodontist. By the time you are through with this write-up, you will have a thorough understanding of this subject and what to expect when you visit our periodontist at La Puente Advanced Dentistry. It is amazing how versatile periodontics can be and the level of solutions it caHalitosisn offer. You will also understand the conditions that require periodontal care and the most common treatment options.
Understanding Periodontics
Periodontics is the branch of dentistry that involves the study, diagnosis, and treatment of the supporting structures of the teeth, including the periodontal membrane, alveolar bone, periodontal ligament, cementum, and gingiva. Since periodontics is a specialty field of dentistry, only dentists trained in periodontics can practice it.
It also requires ongoing education to stay abreast of the newest developments in the field. Treatment by a periodontist generally consists of non-surgical therapies and surgical therapy to help maintain the teeth. The goal of periodontics is to improve or maintain oral health by preventing or treating diseases of the supporting structures of the teeth.
What Conditions Do Periodontics Address?
A periodontist’s job is to prevent gum disease, diagnose illnesses that affect the gums and jawbone, and treat gingivitis, periodontitis, and bone loss. Gum disease is a progressive condition that causes tooth loss in adults in the developed world.
Periodontists can treat gum disease in many categories, from mild to advanced. The first step is addressing the infection at the root of the problem. This is accomplished by providing treatment for gum disease, cleaning teeth, and educating patients on proper oral hygiene.
The periodontist might recommend regular periodontal cleanings, at least four times annually. During these cleaning sessions, the practitioner will keenly assess the pocket depths to ensure they are healthy. The doctor might also incorporate X-rays, oral cancer screenings, examinations for tooth decay or existing restorations.
Here are some prevalent conditions that periodontists treat:
Gingivitis
You might have noticed a few red patches in the gums around your teeth. This is gingivitis, a common form of gum disease. Gingivitis causes inflammation and swelling at the base of the tooth. To avoid the nasty consequences of gingivitis, you need to take care of it quickly. If left untreated, this condition may escalate to more severe gum disease like periodontitis and ultimately tooth loss.
The mild inflammation from gingivitis is due to constant irritation of the gingiva caused by plaque and tartar on the teeth. With time, your gums may swell and bleed. You may also have dental caries. You can prevent and manage this disease by adopting proper oral hygiene practices, having frequent dental exams and routine dental clean-ups.
Mild Periodontal Disease
Mild periodontitis is the second stage of gum disease, also referred to as the “slight periodontal disease.” “Slight” means that the bacteria are still quite small, but the bones are being destroyed nonetheless. At this point, you can only manage but not reverse it. This is because, by this time, the bacteria are more aggressive, which leads to bone loss.
Moderate Periodontal Disease
When left untreated, mild periodontal disease can lead to all sorts of unpleasant symptoms like bleeding and pain around the teeth. As the infection progresses, in moderate periodontal disease, it could cause bone loss, looseness of your teeth, and inflammatory response in your entire body.
Advanced Periodontal Disease
In the advanced stages of periodontal disease, your tooth starts to lose its anchor from neighboring tissues. The gums, bones, and other tissues that support it are gradually lost. Severe pain while chewing, severe bad breath and a foul taste in your mouth are common symptoms of advanced periodontitis. You probably will lose your teeth.
When to See a Periodontist
You can either refer yourself to a periodontist or get a directive from a general dentist. If you are experiencing any of the following signs, do not hesitate to schedule a periodontist consultation:
- Bleeding while eating or brushing, especially unexplained, is a common side effect of a periodontal infection.
- Halitosis – A continuing bad breath that persists even with an excellent oral hygiene routine can indicate periodontitis, gingivitis, or the developing infection of the gum tissues.
- Loose teeth and gums – People with loose teeth and gums are at risk of a recession of their gums and bone loss. As this condition progresses, the teeth become more prone to falling out or becoming loose.
- Gangrene- Gangrene is tricky to identify on our own, but general dentists and periodontists can check for the presence of gangrene in the soft tissues, alveolar bone, and periodontal ligament.
- Related Medical Conditions- Periodontitis correlates with other health conditions, including heart disease, diabetes, osteopenia, and osteoporosis. When this bacteria is left untreated, it can affect other parts of the body.
Diagnosing Periodontal Disease
A periodontist will use a periodontal probe, a small instrument that gently measures the space between your tooth and your gums. Healthy pocket space is between three and five millimeters deep and does not bleed when touched. The probe indicates the severity of periodontal disease by measuring pockets that are more than three millimeters deep.
As the disease progresses, pockets tend to get deeper. Here are the parameters that will guide the diagnosis:
- Amount of bleeding
- Inflammation
- Tooth mobility
- Pocket depths
Based on these parameters, the periodontist can identify the stage of the periodontal disease and, as such, prescribe the best treatment plan.
Common Periodontal Procedures
There are various procedures that periodontists adopt in their treatment plans. They all depend on the type of disease and its severity. The procedures can either be non-surgical or surgical.
Non-Surgical Procedures
If the disease is still in its initial stages, gingivitis with no apparent damage, the doctor will recommend a single or several cleanings. The doctor will also give instructions on enhancing oral hygiene and schedule a regular dental cleaning.
Here is a look into non-surgical periodontal treatment plans:
Scaling and Root Planing
Scaling and root planing is when a doctor carefully cleans the teeth by removing plaque and calculus from deep pockets. Afterward, the doctor will smooth the root surfaces to remove bacterial toxins. Occasionally, the doctor will need to follow up with adjunctive therapy such as local antimicrobials, systemic antibiotics, and host modulation. All these will depend on the specific case.
This procedure is best for more advanced conditions. It helps in healing the gums and shrinking the pockets. Besides the antimicrobials, the periodontist may also recommend using special medicated mouth rinses and an electric toothbrush. All these measures help to control the infection and promote healing.
Periodontal Tray Delivery Systems
The Perio Tray is a mouth guard-like device made by taking the impression of the patient’s mouth that delivers medication below the gums, fighting infections. The dentist will send the measurements of your mouth to the lab with a mold of your mouth. The lab will use these measurements to create your tray. It’s easy to use: fill up the tray with meds and wear it for a few minutes a day.
The Perio Tray is a small, uniquely shaped tray that fits between teeth and gums, applying medication to infected gum tissue not reached by toothbrushes, dental floss, or mouthwashes.
The Perio Tray is a device applied to a patient’s gums so that it can deliver medication. The pressure of a seal prevents the medication from seeping into the mouth of the patient. This deepens the reach of the medication so that it can treat gum disease more effectively than any other non-invasive treatment.
The daily application of medication prevents bacterial infections and rebuilds gum tissue, which allows the mouth to heal. The frequency of using this tray varies from patient to patient. In most cases, doctors will recommend two to three tray applications daily for about 10-15 minutes. However, this need might vary with a patient’s need.
Surgical Procedures
If the non-surgical procedures fail to offer the relief required, the periodontist might opt for surgical treatment options. Here’s a look at some of the common surgical treatment options.
Gingivectomy
If your gum disease is severe, you may need to have a gingivectomy. This procedure removes diseased gum tissue and reshapes the loose, infected areas with healthy tissue. A gum specialist or oral surgeon often will perform this procedure.
This procedure usually happens before the gum disease has damaged the bone supporting your teeth. What happens during a gingivectomy? The periodontist will begin by using a local anesthetic to numb your gums. He may also use a laser to get rid of loose gum tissue.
After its removal, your doctor may put a temporary putty over your gum line to protect your gums as they heal. You can have soft foods and cool or slightly warm liquids for the next few days. As soon as the anesthetic wears off, you can resume your normal activities. You may heal completely in a few days or weeks.
After this treatment, the shape of your gums might change. With proper dental care after the gingivectomy, the gum disease is likely to stop and become pink and healthy once again.
Pocket Reduction Surgery (Osseous Surgery)
Pocket reduction surgery is a way to get rid of bacteria that have taken up residence in your gums. During the procedure, the periodontist cuts back your gums, removes bacteria, and repairs anything that’s damaged. The surgery is best for severe gum disease that antibiotics or root planing cannot treat.
Here’s an overview of all that you should expect during the surgery:
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The doctor will give you a local anesthetic to numb your gums.
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The periodontist will make a small cut along the gumline. Once they pull back the gums, they can remove bacteria from underneath.
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When they do the surgery to fix your broken jaw, they will shave off any irregularly shaped bone edges.
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If your bone is severely damaged, they may need to perform a periodontal regeneration technique. This might include grafting bone or using a regenerative membrane to help it heal.
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If your gums are sewn back together, they will cover them with a dressing to stop the bleeding.
Most people recover from pocket reduction surgery after a few days. The periodontist may give you particular recommendations, especially dietary changes you can adopt as you recover. This may include a prescription for painkillers.
Regenerative Procedures
A periodontist might recommend a regenerative procedure if a periodontal disease destroys the bone supporting your teeth. With these procedures, the periodontist can reverse the damage by recreating lost bone and tissue.
The first step of gum surgery is to remove the bacteria from the periodontal pocket by folding back the gum tissue. The second step is to place a membrane or bone graft to stimulate your body’s natural ability to regenerate bone and tissue.
Eliminating existing bacteria and repairing damage caused by periodontal disease is key to maintaining a healthy mouth. To do this, you need to maintain a daily oral hygiene routine and go in for professional maintenance care. This helps prevent periodontal disease from getting too deep and reduces the impact of other health problems.
After periodontal surgery, connective gingival, epithelial tissue, periodontal ligament cell, or bone might grow along the root surface. Periodontists use barriers as a means of guiding periodontal ligament cells to grow along the root surface to bring back lost tooth support. They also prevent the epithelial and gingival connective tissue cells from entering the space.
One way to regrow tissue in the mouth is to use a process called guided tissue regeneration. This works using resorbable barriers and calcium sulfate, resulting in gains in probing attachment and bone fill. Non-resorbable barriers may last longer, but they need to be removed at a later surgery. More and more people are using resorbable barriers, but these barriers may not be long enough for the bone to fill optimally.
Gum Graft Surgery
Gum graft surgery is a suitable option for correcting receding gums. With gum recession, the roots of your tooth are exposed, causing the likelihood of your teeth decaying or becoming hypersensitive and more prone to abrasion.
A gum graft is a quick procedure that your periodontist may perform to replace lost gum tissue. They remove a piece of tissue from the roof of your mouth or nearby healthy gum tissue and then attach it to the area of the gums that have worn away. The patient may leave as soon as the procedure is done.
A periodontist will suggest three different options to choose from, and they all depend on your specific need. The application of local anesthesia precedes surgical procedures.
Pedicle (lateral) graft: Your gum recession is restored with tissue from an area right next to the recession. This flap of tissue is used to cover the recession instead of taking it from another part of your mouth. This is the most successful type of graft because it leaves your gums healthy and doesn’t cut off blood flow in any part of your mouth. You need an adequate amount of gum tissue for this process to work, so it may not work for people with little gum tissue.
Free gingival graft: You will likely have this type of graft if you have thin gums and require additional tissue to prevent further recession. It involves the removal of a tiny piece of tissue from your mouth’s roof. The periodontist will stitch it in the region that needs the gum tissue.
Connective tissue graft: This is the most common type of gum grafting. The periodontist will gently open a flap in the roof of your mouth. After they remove connective tissue, they stitch it to the area that needs gum tissue.
Once the periodontist finishes the procedure, they’ll give you an antibacterial mouthwash. You will also receive instructions on how to take care of yourself until the graft completely heals. The healing will take about one to two weeks.
You only need to schedule an appointment with your periodontist a week after the procedure. This visit will help you keep tabs on your healing and determine the success of the graft. Based on how you take care of yourself during the recovery period, you should be able to brush and floss after two weeks.
Dental Implants
Dental implants are devices that replace the root of a missing tooth. In most cases, these implants are made of titanium. You can, therefore, not recognize them as foreign objects in your body.
They are surgically installed into the jawbone and allowed to fuse with the bone over a few months. When this “fake tooth root” has fully integrated with your jaw, it can support a replacement tooth or bridge. The process with which the dental implant and the jawbone fuse is called osseointegration.
Dental implants are ideal for a single, multiple or complete teeth replacement. The replacement serves to restore functionality and esthetics too. There are two types of implants:
Endosteal implants: This type of implant is the most common. It comes in many forms, including screws, cylinders, and blades implanted into the jawbone. These implants hold one or more false teeth. In most cases, these implants are used as a substitute for bridges or removable dentures.
Subperiosteal implants: The metal framework is placed on the top of your jaw, and posts are inserted through your gum to hold the prosthesis. This type of implant is used for patients who cannot wear conventional dentures and have little or no bone height.
Periodontal Plastic Surgery Procedures
If you desire to have a more comely smile, then a visit to a periodontist may work out the magic. Here are some instances when you can opt for a periodontal plastic surgery:
Uneven gum line: Have you been feeling self-conscious about the appearance of your teeth? If so, dental crown lengthening might be the solution. This procedure will make your smile look nicer with a few adjustments to your gum line. In this procedure, the periodontist removes excess gum tissue and sculpts the tooth to reveal just the right amount.
Exposed roots: Gum recession can wreak havoc on your teeth. Sometimes, the tooth root becomes exposed because of it. This recession can happen for a variety of reasons, including periodontal diseases.
Gum graft surgery and other procedures are designed to cover exposed roots, reducing future gum recession. They also protect the roots from decay.
Indented Gums and Jawbone: When you lose teeth, it can cause the jawbone to recede. This indention in the gums and bone where the tooth used to be is unnatural and results in a replacement tooth looking too long compared to the surrounding teeth.
Ridge augmentation fills the gap of a defect with natural-looking gum and jaw contours. The result will create a new tooth that looks natural, easy to clean, and beautiful.
Find a La Puente Periodontist Near Me
Proper dental care is crucial to your health as this can help prevent various complications arising from periodontal diseases. You don’t have to wait to have some symptoms to do this. Having a custom of having regular dental checkups can be an excellent start off.
The periodontist will assess your teeth and check for any unusual signs. If there is any concern, the periodontist will discuss it with you and viable treatment options. Other than this, he/she will give you general advice and instructions to enhance your dental health.
Getting services from a reputable and professional practitioner will make all the difference in your dental health. We at La Puente Advanced Dentistry are here to offer periodontal services to every person, regardless of age. You can reach us at 626-626-7075 to schedule a consultative session with us today.
