Treating Periodontal Conditions
We treat conditions that affect the tissues that anchor our teeth in our mouths. The roots of our teeth are attached to bone, which provides support, and are covered by our gum tissue, which provides protection. We perform procedures to restore health to the gums and/or bone.
Treatment and Control of Gum Infections (Periodontal Disease)
Periodontal (gum) disease is an infection that affects the structures that hold our teeth firmly in place. It is usually not a painful condition and rarely gives any indication of its presence until the loss of attachment between the gum and the tooth is at least moderately advanced. This does not mean that there is any mystery surrounding the cause of the disease. We know it is caused by bacteria, just like many other infections that affect us humans.
|This demonstrates a healthy tooth with bone support covering the entire root and shallow (1-3 mm) probing depths between the tooth and gums||This demonstrates a tooth with periodontal disease. There has been loss of bony attachment along the tooth root and we are able to insert the probe more than 5 mm under the gum line. (This is called a pocket)|
At this point in time there is no definitive cure for periodontal disease. Treatment is centered around controlling the causative factors and preventing further deterioration of the supporting structures. Treatment may be conservative (non-surgical) or surgical.
Conservative therapy consists of root planing and curettage, a process of meticulously cleaning the tooth root surfaces below the gum line to remove bacterial plaque, toxins, and calculus. This is not something an individual can do for themselves but is performed in the periodontal office. In addition to this thorough cleaning, it is the individual’s responsibility to control the disease by removing the bacteria regularly on a daily basis and returning to the dental office for Supportive Periodontal Therapy (SPT) on a regular basis. Research has consistently shown that regular SPT in combination with effective homecare shifts the bacterial population under the gums from those associated with gum disease to those that are associated with health.
Adjunctive therapy may be performed along with conservative therapy. This consists of the local application of medicaments (antibiotics, antiseptics) directly to the root surface.
Gum tissue can recede, or move down, to expose the root of your tooth. This recession can occur for a variety of reasons, including aggressive tooth brushing and periodontal disease.
Soft tissue grafts can be used to stop further gum recession, root sensitivity and decay and to improve the esthetics of your gum line. Gum tissue taken from your palate or specially screened donor tissue is used to cover the exposed root.
Regeneration is a surgical procedure that aims to reverse some of the damage of periodontal disease by stimulating your body to regenerate some of the bone and attachment lost in the disease process.
This is a minor surgical procedure and is performed with local anesthesia. The gum tissue around the defect is folded back and the disease-causing bacteria are removed. We use a protein, amelogenin, to stimulate your body’s natural ability to regenerate bone and tissue. The periodontist will determine if your defect is likely to respond to this treatment.
|Gum tissue around the defect, in this case between the roots of a lower molar, is folded back
|The disease causing bacteria are removed|
|The proteins and bone products are applied to the defect||The gum tissue is replaced and sutured. The body begins healing and regenerating the lost attachment|
|Before: the dark area between the roots indicates bone loss. It is impossible for this person to access this area to perform daily bacterial plaque removal to prevent further destruction and periodontal infection.||After: The bony defect has been filled with new bone and new attachment from bone to tooth has formed. The bacteria that cause periodontal disease can no longer grow down between the roots and the tooth now has a favorable prognosis.|
Results will vary with the individual.