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Periodontal Disease

There are two ways to treat periodontal (gum) disease: surgically and non-surgically. A large majority of patients can be adequately treated non-surgically, if the disease is discovered and treated before it becomes too advanced. Because the only type of treatment performed in our City Center office is the non-surgical variety, the following information will deal exclusively with our approach to non-surgical periodontal treatment.

More than 75% of Americans over 30 will develop some form of gum disease at some point in their lives. However, with early detection and proper conservative treatment, almost all teeth can be saved.
Just as a sturdy home needs a firm foundation, so our teeth need solid support from the tissue that surrounds them. Any weakening of this supportive tissue is called perio ("around")- dontal ("tooth") disease.

Periodontal disease can be one of two types: gingivitis and periodontitis. The main difference between the two are that gingivitis involves only the gum tissue, and is reversible if treated promptly, while periodontitis includes destruction of bone tissue below the gum line, and its effects are usually irreversible.

Many factors can contribute to the development of periodontal disease, such as plaque, tartar, bacteria, heredity, diet, systemic conditions, and oral hygiene habits. One of the goals of our non-surgical treatment is to determine which of these factors are most important in your mouth, and how to control their effects. Your gum treatment program will be specially customized to fit particular needs present in your mouth.

Your non-surgical gum treatment program will consist of two types of appointments: active therapy appointments and a re-evaluation appointment.

It's great to see what regular flossing can do for your gums!
Active therapy appointments consist of measuring the gums to determine the extent of the disease, scaling and root planing of the teeth to promote healing, irrigation to fight unwanted bacteria, and home care instruction to equip you to restore and maintain health. The re-evaluation appointment, which should be scheduled about a month after the final active therapy appointment, is an opportunity to measure the amount of improvement obtained, evaluate any problem areas that remain, and discuss the best possible options for maintaining periodontal health in the years to come.

Following are some of the most common terms used in the treatment of periodontal disease, along with related explanations:

Plaque is a white soft film consisting of bacteria and food particles which accumulates on the teeth, especially near the gum line and in between the teeth. Proper brushing and flossing can keep plaque build-up to a minimum.

Tartar(calculus) is mineralized plaque. This is the yellowish-brown, hard substance that forms when calcium from the saliva attaches to the teeth. It cannot be removed by a toothbrush or floss, and normally requires the expertise of a dentist or dental hygienist for removal.

Pocket Depth is the small space in between each tooth and the gum tissue surrounding it. In a healthy mouth this space is usually 1-3 millimeters deep. Gum disease, however, can cause much deeper pockets to develop. In general, the deeper the pockets, the more advanced is the gum disease, and the harder it is to keep the teeth clean. A primary goal of our non-surgical gum treatment program is to shrink these pockets to a depth which can be more easily kept clean in the future.

Bone Loss is the loosening of the teeth which occurs in advanced periodontal disease and is a direct result of the loss of the bone tissue which surrounds the teeth. The best way to diagnose the amount of bone that has been lost is through the use of x-rays.

Root Planning is the cleaning and smoothing of the roots of the teeth, usually accomplished below the gum line. There are two major purposes for this procedure - to remove harmful plaque and calculus deposits, and to make the roots of your teeth smooth so that they will be easier to keep clean in the future.

Ultrasonic Instruments have been used for more than two decades, and only recently have they improved to the point of becoming an almost indispensable part of non-surgical gum treatment. Previously their effectiveness was limited to use above the gum line, but new slimmer instruments now allow for their use several millimeters below the gum line. There are two big advantages to ultrasonic instrumentation: its ability to disrupt harmful bacteria from under the gum line, and (best of all!) the increase in comfort that the patient now enjoys.

Irrigation Studies have shown that certain types of bacteria are found in large numbers in mouths suffering from periodontal disease. Irrigation is the method by which a special medication is squirted below the gum line in order to attack and to flush out as many of these harmful bacteria as possible.

Home Care is an indispensable facet of any successful gum treatment. Our non-surgical gum treatment program is truly a team effort. Our job is to get your teeth as clean and as free of harmful bacteria as they can be. Your job is to maintain that state of cleanliness as thoroughly as possible, and to allow us to periodically remove any plaque or calculus you miss, which will be accomplished at your periodic check-up appointments.

There are a wide variety of home care aids available to help you in cleaning your teeth. For you to attempt to use them all would be impractical. Therefore, as treatment progresses we will make specific recommendations concerning which two or three home care aids should give you the best results. You will also receive instruction on proper ways to use these various devices.

Arestin is a special antibiotic that can be placed under the gums in areas of advanced periodontal disease. The antibiotic helps decrease the number of harmful bacteria that are responsible for bone loss and gum inflammation.

In conclusion we hope that this information has been helpful in understanding what good oral health is all about. If you have any questions, please let us know. Gum disease is responsible for more tooth loss in America than cavities, accidents, and all other causes combined. The more you understand about gum disease, the less likely you are to become one of the 35 million people in America who must sleep with their teeth in a glass. Contact our City Center office in Newport News, VA for more information.