Stamford Periodontal Disease

Periodontal disease (gum disease,pyorrhea) is an infection of the supporting structures of the teeth. Though it starts by affecting the gums, it eventually can result in the loss of the jaw bone that anchors teeth, and ultimately in tooth loss. Periodontal disease is actually responsible for 75% of adult tooth loss. The predisposition to develop gum disease is often, but not always, hereditary. It is the result of a bacterial infection which progresses along the tooth root. Signs of gum disease include red,swollen gums, bleeding when brushing, receding gums, bad breath, sore, tender, or itchy gums, shifting of teeth, and the formation of spaces between teeth. Often though,the gum appears normal and there are few symptoms that the disease is present. The infection is however chronic and ongoing. Though our body tries to keep the infection under control, it very often cannot win against the bacteria. The result is chronic and continued damage to the supporting structures of the teeth. In addition to bacteria, there are co-factors which can cause the bacteria to act more aggressively. These are poor oral hygiene, smoking, certain medications, hormone changes, pregnancy, stress, diet, age, and certain medical conditions. DIAGNOSIS The only way to accurately diagnose the presence of periodontal disease is through thorough examination by a dental professional. A small millimeter ruler is introduced between the gum and the root to detect the presence of pockets. These are gaps that form between the gum and the root and are the location where bacteria accumulate and harden. These eventually release toxins which lodge into the tooth root. Radiographs(xrays) are also used to assess actual damage which has occurred to the surrounding bone. In addition to the presence of pockets, recession of the gum around the root, bleeding and tooth mobility are also evaluated. CONSEQUENCES OF PERIODONTAL DISEASE Untreated periodontal disease can cause teeth to loosen, abscess, and can ultimately result in tooth loss. Teeth will then need to be replaced by bridges, dental implants, full dentures, or partial dentures. Recent research also has made connections between untreated periodontal diseaseand its contribution to poor overall health such as diabetes, heart attacks, strokes, respiratory disease, erectile dysfunction, pre-term childbirth, and pancreatic cancer. Additionally the bacteria of periodontal disease can be transmitted from parent to child and from spouse to spouse. These consequences are particularly serious for patients who are in higher risk categories. Patients who have a previous history of heart disease, high blood pressure, stroke, heart attacks, diabetes, respiratory disease, chronic stress, smoking , and pregnant women should be particularly concerned with having their disease treated. TREATMENT Treatment is usually performed comfortably with local anesthetic. For those patients who are fearful or nervous, we provide pre-treatment sedatives such as valium or xanax. Additionally, nitrous oxide(laughing gas) can be used for relaxation. In those patients who prefer to not be aware or remember their visits, we are able to provide conscious sedation(twilight sleep). Please rest assured that all of our treatment is performed in the gentlest, most caring manner possible. Non-Surgical Therapy: The soft bacteria, hard deposits, and root toxins can be comfortably removed using specialized instruments and ultrasound. The procedure is called scaling and root planing. It is quite different and more thorough and involved than the prophylaxis cleanings performed by the hygienist. In addition to mechanical removal of the causes of periodontal disease, it is often possible and necessary to provide additional therapy via the use of local antibiotic or systemic medications: - Arestin(minocycline) is an antibiotic which is professionally delivered directly to the infection in the pocket. - Periostat(low dose doxycycline) is a systemic medication which can control tissue destruction. - Chlorhexidine is a rinse which helps to control the formation of new plaque above the gumline. Surgical therapy -Flap Surgery: Surgery may be necessary if inflammation and pockets persist after non-surgical therapy. The gum is gently lifted away from the teeth, remaining deposits are removed, and bone loss issues are addressed. The gum is then returned against the roots and dissolving sutures are used to hold it in place. -Bone Grafts: If the bone loss is severe, procedures are available to graft or regenerate lost structure. Natural or synthetic bone can be used in a grafting technique. Additionally , in a procedure called guided tissue regeneration, a small piece of mesh like material is inserted between the gum and bone to help the body deposit its own bone to the area. -Gum grafting: Sometimes the gum recedes around roots leaving unsightly, sensitive root surfaces. In some cases gum tissue can be placed in these areas to either cover the root or to increase the amount of gum tissue and prevent further recession. Though traditionally gum grafts have been taken from one area of the patient's mouth and transferred to the area of recession, new material advances now allow the use of donor material which makes treatment much easier and much more comfortable for our patients. -Crown lengthening: Sometimes there is an extensive area of decay or a fracture of the tooth below the gum line. To avoid extraction, a crown lengthening procedure can be performed. The gum is gently moved away from the tooth and the gum is lowered to expose more tooth. In this manner, more tooth structure is provided enabling the placement of a crown by our general dentists. -Cosmetic Procedures- When a patient looks at their smile, the front teeth can appear uneven or short. Gum recontouring or crown lengthening procedures can be performed to lengthen the teeth or make the gum line more even. Often this is done in conjunction with the placement of veneers or new crowns, but it can sometimes also be performed on natural teeth. Proper tooth length and a pleasing , even gum line can provide the proper setting for a cosmetic smile makeover. PREVENTION The key to success in periodontal treatment is prevention. Even though gum disease can be treated and the mouth can be returned to a state of health, there is no cure. The bacteria which cause the original problem are always present in the mouth. In addition to excellent home care, prevention through periodontal maintenance(cleaning) is essential. We will be happy to guide you in selecting a proper maintenance interval to help control your periodontal problems and maintain good oral health. Contact us today to learn more about Periodontal Disease and your treatment options.