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Periodontology
What is periodontal
disease ?
The word "periodontitis" literally means "inflammation around the
tooth". Periodontal diseases are bacterial gum infections that
destroy the attachment fibres and supporting bone that hold your
teeth in your mouth.
The toxins are
penetrating the tissue and as soon as they entering the gum the body
defense cells are trying to fight the foreign invading material and
are forming an inflammation. This will then cause the gum to detach
from the tooth thus causing a gap that is called a Pocket. Pockets
in the range of 1-3mm may be normal. 4-5mm pockets usually need the
attention of a hygienist and as the pockets progress, the
consultation of a periodontist is required for evaluation of the
severity of the disease with possible surgical intervention. Many
people over the age of 35 develop periodontal diseases (80% of
population). Periodontal diseases are painless until at their
advanced stages. If left untreated, periodontal diseases can result
in tissue and bone destruction and eventually tooth loss. In fact
periodontal diseasses are the leading cause of adult tooth loss. The
following are the most common symptoms of periodontal diseases:
- Bleeding gum during brushing or flossing;
- Persistent bad breath;
- Red, swollen or tender gum;
- Pus between the teeth and gums (leaving a bad taste);
- Gum recess;
- A change in the way your teeth fit together when you bite;
- Loose or separating tooth.
If you have any of the
above symptoms, you should see a periodontist for a complete
periodontal evaluation and proper treatment.
Periodontal treatment
Because gum disease is usually painless, however, you may not know
you have it. Gum disease is caused by plaque, a sticky film of
bacteria that constantly forms on the teeth. These bacteria create
toxins that can damage the gums.
In the early stage of gum disease, called gingivitis, the gums can
become red, swollen and bleed easily. At this stage, the disease is
still reversible and can usually be eliminated by daily brushing and
flossing.
In the more advanced stages of gum disease, called periodontitis,
the gums and bone that support the teeth can become seriously
damaged. The teeth can become loose, fall out or have to be removed
by a dentist.
Non-surgical periodontal treatment
Scaling and Root Planing: Manually or by means of ultrasonic
instrument removing the plaque and tartar from the root surfaces of
your teeth below the gum line.
Scaling:
Scaling is a procedure to remove contamination toxins,
micro-organisms, plaque, tartar, cementum, dentin that is rough
and/or permeated by calculus from around, below and under the gum
line.
This procedure is done:
With our ultrasonic instrument that both scales and medicates your
gum tissue.
To control the growth of harmful bacteria.
Helps gums or pocket wall reattach firmly to the spotlessly clean
root surface to help prevent tooth loss.
- Prevent further bleeding of the gums.
- Reduces gum swelling
- Reduces discomfort.
- Decreases tooth sensitivity due to gum recession.
- Prevents bone loss.
- Prevents tooth loss due to gum disease.
 Root
Planing:
Root planing involves scraping and smoothing the root surfaces of
your teeth with thin curettes so gum tissue can more firmly reattach
to roots that are clean and smooth to prevent tooth loss and
sensitivity problems. Because this procedure goes deeper than a
regular cleaning your mouth may be numbed. The cleaning may take two
visits to complete.
Antibiotics:
Because bacteria cause periodontitis antibiotics may be prescribed
as pills or as an Antibiotic fiber. The fibers are used in
conjunction with scaling and root planing. They are placed directly
into the pockets and are removed within 7-10 days later.
Antibacterial mouth rinses may also be recommended to help plaque
control.
Bite correction:
An imbalanced bite may accelerate bone destruction. Your teeth may
be adjusted for proper and better function. A Bite-guard (removable
retainer fitting over teeth) may be required to protect teeth
surfaces and relax tense muscles.
Splinting:
This technique attaches weak teeth together, combining them into a
stronger single unit, making them more stable and offering more
comfortable chewing.
Surgical treatment
 Flap
Surgery: The periodontist separates the gum from the teeth
creating a "flap" and accesses the infected pocket. It aims to
reduce pocket depth and increase the ability to maintain the remnant
pockets clean.
In flap surgery, under local anesthesia, small incisions are made in
the gum, so that it can be lifted back to expose the tooth and bone.
The entire area is carefully cleaned. All tarter and infected
granulation tissue are removed and the bone is examined. Because
periodontal disease causes bone loss, often the bone will need to be
recontoured in order for the gum to heal properly. When the
procedure is done, the gums are sutured in to place on top the bone.
The entire procedure typically requires from 1 to 3 hours to perform
with only two quadrants of the mouth being address in a single
visit. The sutures will remain in place for approximately one week,
and you will likely be given a prescription for pain medication and
antibiotics.
Gingivectomy:
This procedure is performed when excess amounts of gum growth around
the teeth have occurred. This results in false pocket formation and
the inability to keep them clean.
Osseous (bone) surgery:
This procedure is done to smooth shallow craters and defects in the
bone due to mild or moderate bone loss. Guided Tissue Regeneration:
This procedure is done in combination with a surgical flap operation
where gum growth into a defect is barriered off to allow slower
growing bone, cementum and ligament cells to populate a bony defect.
Bone Grafts:
Tiny fragments of the patient's bone and synthetic bone are used to
fill a bony defect around the teeth. These grafts act as a scaffold
on or around which patients own bone is conducted or induced to
grow.
Soft Tissue Graft: In cases of gum recession a graft is usually
taken from the palate and transplanted onto the receding area to
reinforce the thin gum and to inhibit further gum recession.
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