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Periodontal Disease – A Closer Look

Periodontal (gum) disease, including gingivitis and periodontitis, is a serious infection that, left untreated, can lead to tooth loss. The word “periodontal” literally means around the tooth. Periodontal disease is a chronic bacterial infection that affects the gums and bone supporting the teeth.


There are many forms of periodontal disease requiring treatment. The most common ones include the following.


Gingivitis is the mildest form of periodontal disease. It causes the gums to become red, swollen, and bleed easily. There is usually little or no discomfort at this stage. Gingivitis is reversible with professional treatment and good at home oral care. If gingivitis, the mildest form of periodontal disease, is left untreated, it can advance to periodontitis. In the mild stage, periodontal diseases begin to destroy the bone and tissue that support the teeth.


Moderate to advanced periodontitis develops if earlier forms of the disease like gingivitis and mild periodontitis are left untreated. This is the most advanced form of the disease in which extensive bone and tissue loss occurs.


Aggressive periodontitis can be localized or generalized and typically occurs in adolescents. It is characterized by the rapid loss of bone around permanent teeth, particularly the first molars and the lower front teeth. Pockets can form around the affected teeth, filling with infection. If not treated early, infection can lead to bone loss which may cause the teeth to become loose. Ironically, youngsters with aggressive periodontitis form very little dental plaque or tartar. Generalized aggressive periodontitis is often considered a disease of young adults, although it can begin around puberty.


Nonsurgical Gum Treatment: Microtherapy Procedures Microtherapy procedures bring an entirely new element to dental treatment. Through the use of high-powered magnification, special fiber-optic lighting, and novel micro-instruments, periodontal disease can now be treated with extraordinary comfort and effectiveness.

Due to the extremely small size of these instruments and the use of magnification, effective microtherapy treatment is rendered with minimal trauma to the oral tissues of the patient. Less intra-operative trauma results directly in less post-operative pain allowing for more comfort and a speedy recovery. 


Types of Microtherapy Procedures

Bacterial Culturing – A relatively new weapon used to identify the specific bacteria that are causing the disease in the patient’s mouth. The culture also helps us in choosing the right antibiotic, and treatment option for the patient. The culture is obtained by taking a very small sample of the bacteria around the diseased gums (very painless) and submitting it to a laboratory for analysis.


Subgingival Debridement (Scaling and Root planning) – A non-surgical microtherapy treatment which is basically a detailed cleaning of the bacterial build up (plaque, and tartar) on the teeth. With the advent of micro-ultrasonic tips the days of “scaling and scraping” are mostly over. This microtherapy treatment can now be done under local anesthesia with an ultrasonic (using sound waves) instrument very comfortably. This treatment is usually the first treatment we recommend for battling periodontal disease, and is sometimes the only treatment necessary.


Atridox – Atridox is a medicated gel that is gently squeezed under the diseased gums. Once in place the gel solidifies and slowly releases the antibiotic into the gum area for a period of ten days. Atridox is an excellent non-surgical microtherapy option for treating isolated diseased sites in the patient’s mouth.


Arestin – Arestin is a medicated powder (microspheres) that is gently inserted below the gum line, and allows for the slow release of antibiotic into the infected area.  Arestin is generally used in conjunction with scaling and root planing, and may need to be repeated.

Periostat– Periostat is an oral pill that the patients take to combat periodontal disease. The medication essentially block the effects of an enzyme in the body called collagenase, with the net effect of reducing bone-loss around teeth


Periodontal Microsurgery – Through the use of high-powered surgical telescopes, and fiber-optic lighting, we can now perform surgery with minimal tissue (and patient) trauma. Due to the small size of these new instruments effective treatment can be performed with far less surgical reflection (opening). The magnification also allows for far more precise closure of the surgical areas which makes the recovery from this form of microtherapy virtually painless.


You may not realize that persistent swollen, red or bleeding gums, tooth sensitivity, and bad breath are warning signs of periodontal disease. One must keep in mind however, that periodontal disease is usually painless.  Consulting a periodontist is often recommended by your dentist or dental hygienist, especially if signs of the development of periodontal disease are apparent. Still, you may make a personal decision to visit the periodontist in order to seek specific treatment and prevent such progression.


It is highly recommended that you consult a periodontist as soon as you experience any of the following symptoms in order to ensure the health of your teeth and gums:


  • Bleeding while consuming certain foods that are otherwise part of your normal diet or while brushing your teeth and gums are the most common indicators of periodontal disease.
  • Foul breath that persists even after daily oral hygiene is often a symptom of the development of periodontitis, gingivitis, or other infections of the gums.
  • A receding gum line and teeth that are loose both show signs of the disintegration of oral bones, and are predecessors to periodontal infections.  Teeth begin to appear longer.
  • The presence of pus in between the teeth and gums is a sign of infection of the gums.
  • Noticing a change in the way your teeth come together when you bite can be a sign of periodontal changes.
  • Individuals with specific health conditions including diabetes, osteoporosis, and heart disease have an increased vulnerability to developing periodontal disease.

To obtain the best results while brushing your teeth, hold your toothbrush at a 45 degree angle positioning the brush between the gums and the teeth. Using small, strokes, apply gentle pressure to the brush. Do not forget to brush the inside of the back teeth by stroking your brush in a vertical position. Also, it is essential to brush the gum tissues that surround the teeth.


Follow the same directions when brushing the biting surfaces of the teeth, manipulating the brush in order to cover all surfaces. Once finished, rinse your mouth thoroughly with water to extract possible plaque that remains on the teeth or gums.

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