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Periodontal Disease

Periodontal diseases in it's most basic sense is an infection. For an infection to occur, three things are required: an infectious agent (bacteria), a susceptible host (the patient's mouth) and a method of transmission.

A great deal of time and money have been invested by researchers trying to understand what causes periodontitis and how we can prevent it. It's an important puzzle to solve because of the numbers! Periodontal disease is a widespread public health problem. Studies have shown that about 90 per cent of Americans will at some point of their lives become afflicted by this disease.

We have been able to isolate many of the bacteria which are responsible for the majority of the damage. We know how to eradicate them in almost all cases. We understand how the body's reaction to these bacteria can in fact accelerate the damage by releasing chemicals (inflammatory mediators) that destroy collagen and increase loss of bone. We also know how to bolster the body's resistance to this process. The hardest part is getting our patients to realize that they control the progress of their disease through their actions. The smoking patient will experience more episodes of disease recurrence following treatment as will the patient who refuses to floss. There are only a very few patients that will continue to lose bone and teeth no matter what treatment is done.

The typical classification of disease is based upon the severity of damage present.

The four stages of periodontal disease are:

I. Gingivitis--The gums are inflammed. They may be red, swollen and bleed with flossing. This is usually reversible with cleaning and thorough home hygiene.

II. Early Periodontitis--The infection is just beginning to destroy the bone that anchors your teeth. It can be arrested and controlled. Usually a deeper form of cleaning called root planing with thorough home hygiene is all that is needed

III. Moderate Periodontitis--The infection has caused significant supporting bone loss which is easily visible on a dental X Ray. It can be arrested and contained, however at this point, surgical therapy may be required.

IV. Advanced Periodontitis--Severe bone loss is noted. Some teeth may be loose already. This must be treated aggressively, or tooth loss will soon result. Your dentist may advise surgery or refer you to a periodontist.

In the pictures below, notice the accumulation of plaque and calculus around the teeth. As this occurs, the supporting bone for the teeth is damaged. In cases where significant damage has already occurred, looseness or "mobility" may be noted. The process must be stopped or tooth loss will occur.

Your examination will consist of a gentle measuring of the tissue around your teeth. A small rounded instrument with millimeter markings determines if your tissue may be inflamed from plaque and how far the damage has gone. A current set of dental X-rays may be obtained. Usually, that is all that is necessary for a complete diagnosis of the degree of your particular condition.

Treatment for Periodontits:

The type of treatment you will require varies from case to case. It depends on how far the damage extends into the bone.

The first phase of care is usually a thorough scaling to remove the calculus, or "tartar" below the gumline. The roots may have to be smoothed by root planing so that the gums can heal better. Next, you will be educated in how to clean your teeth at home properly to avoid damage caused by the redepositing of plaque on your teeth Home care must be performed daily. You will be shown how to do this and some products may be recommended to help you keep you mouth cleaner.

A remeasuring of your gums will take place after the doctor has determined that a significant length of time has passed to allow for adequate healing. A decision will be made as to whether any additional treatment is required. If you are ready to enter the mainenance phase of your treatment with periodic cleanings, they will be scheduled at an interval conducive to preventing any recurrence of periodontitis

. Periodontal therapy works! New equipment, techniques and anesthetics make this care more comfortable than ever. More effective medications are available to help keep you comfortable and we will tailor them to suit.

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