Periodontal care is the treatment of periodontal disease, more commonly known as gum disease. The stages of gum disease include gingivitis, periodontitis and advanced periodontitis. Although gingivitis can be treated with a more rigorous oral healthcare routine, periodontitis requires periodontal maintenance care, such as deep cleanings, or surgical methods.
Periodontal disease is chronic and incurable, but it can be controlled with maintenance care.
First, your mouth will be numbed with a local anesthetic to keep you comfortable during your treatment. Deep cleanings may cause more sensitivity for patients than regular dental cleanings, but you’ll be comfortable throughout the procedure with local anesthetic.
In the next step of the process, your dentist will use special dental tools to “scale” tartar and plaque from between your teeth and below your gum line. The goal is to remove the harmful bacteria that causes gum disease.
Once your teeth and gums have been cleaned, your dentist will “plane” and smooth the roots of your teeth. This process eliminates the pockets and pits that form below the roots of your teeth which harbor bad bacteria.
The final step of your appointment is antibiotic treatment. Depending on your case, you may receive topical antibiotics that are applied to gums during treatment, an antibiotic rinse that you can use at home, or a prescription antibiotic taken orally.
The first step in treating gum disease is a deep cleaning, also known as “scaling and root planing.” This treatment is used to remove the bacteria, plaque, and tartar that cause gum disease.
Your dentist will clean deeply between your teeth and gums, and will also smooth out the roots of your teeth to remove “pockets” that harbor the bacteria that cause gum disease. The process is minimally-invasive, and is usually conducted under local anesthesia (a numbing agent).
Typically, half of your mouth will be cleaned during each appointment. Combined with antibiotic treatment, deep cleanings are usually enough to maintain most minor-to-moderate cases of gum disease.
This type of surgery is typically required for more advanced cases of gum disease that cannot be treated with deep cleaning alone. In this procedure, your dentist will surgically pull your gums away from your teeth and fold them back to gain direct access to the roots.
The area is cleaned and inflamed tissue is removed. The underlying bone structure may also be adjusted to eliminate bone defects, if necessary.
Then, your gums will be reattached using sutures and given time to heal. A periodontal dressing may also be applied to help the gums heal properly.
Soft tissue grafts, also known as “gum grafts,” are used to help restore your gums after severe gum recession caused by gum disease. In this procedure, soft tissue is removed from the roof of the mouth, and is then sutured into place around the teeth. The tissue heals and bonds with the existing gum tissue, restoring your gum line and resolving negative effects of gum recession, such as tooth sensitivity.
Bone grafting may be required if advanced periodontal disease has damaged your underlying jaw tissue. In this procedure, bone is taken from elsewhere in your body or from a donor, usually in the form of powder or small granules. Then, this bone matter is packed into the damaged bone area, and your natural bone heals around it, restoring your jaw.
Guided Tissue Regeneration (GTR) is typically used alongside gum flap surgery. When this procedure is used, a specialized membrane is placed between the gum tissue and the bone before the gums are stitched and re-attached.
This membrane stops soft tissue (gum tissue) from growing into the gap between the teeth and gums. As it slowly dissolves, slower-growing bone tissue will grow into the area instead, which allows the jaw bone to regenerate itself.
Perio maintenance appointments occur every 3 months to keep bacteria at bay.
Gum disease is commonly split into three different “stages.” The first stage is called “gingivitis.” In this stage of the disease, there is no permanent damage to your teeth or gums, and you can completely reverse and eliminate gum disease with proper care. Common symptoms of this include bleeding when brushing, inflamed and discolored gums, and halitosis (bad breath).
If left untreated, however, gingivitis will advance to the second stage of gum disease, known as “periodontitis.” This stage of gum disease is not reversible, but can be halted and controlled to keep your teeth and gums healthy with proper intervention. Symptoms usually include lengthening of the teeth (gum recession), sensitive or sore teeth and gums, excessive gum bleeding, and very swollen or puffy gums.
The final stage is “advanced periodontitis,” which causes permanent damage to your teeth, gums, and jaw bone. Common symptoms include pus forming between the teeth and gums, shifting of the teeth, changes in your bite, or the loosening of one or more teeth. Surgical intervention is usually necessary to treat this issue. In the most severe cases, your teeth may need to be extracted and replaced with false teeth like dentures or dental implants.
No. Gum disease is not contagious. It’s caused by bacteria that are present in all of our mouths. However, in a healthy mouth, these bacteria do not reproduce uncontrollably in a way that causes gum disease. Gum disease occurs when poor oral hygiene allows bacteria to reproduce, or if a patient is genetically predisposed to gum disease.
Gum disease is caused by bad bacteria flourishing in the mouth. This can happen because of poor oral hygiene. For instance, failing to brush and floss properly means that the bacteria that are present in your mouth will begin to reproduce and form plaque and tartar between your teeth and your gums. Over time, these bacteria begin to attack and infect your gum tissue. Eventually, this infection will cause permanent, irreversible damage to your oral health unless you maintain proper care.
It’s also possible that your genetics will influence the likelihood of gum disease. If you have gum disease, your doctor will be able to determine the cause and the best methods to protect against it.
Gum disease affects more than just your oral health. It can also contribute to inflammation in other parts of your body, and raise the risk of health problems like heart disease, atherosclerosis (narrowing of the arteries), and even stroke. For these reasons, it’s very important to get help for gum disease right away.
When caught early, gingivitis is entirely treatable and reversible.