Posts for tag: periodontal disease
After several treatment sessions your periodontal (gum) disease is under control. But, while we may have won this battle, the war rages on. To keep an infection from re-occurring we'll have to remain on guard.
Gum disease begins and thrives on a thin film of bacteria and food particles on tooth surfaces called plaque. The infection usually begins as gingivitis, which causes the gums to become red and swollen (inflamed). Untreated it can develop into periodontitis, a more advanced form that progresses deeper into the gum tissues resulting in bone loss.
To treat the disease, we must remove all the plaque and calculus (hardened plaque deposits) we can find no matter how deeply they've penetrated below the gum line. Since the deeper it extends the more likely surgical techniques may be necessary to consider, it's better to catch the disease in its earliest stages when plaque can be removed with hand instruments or ultrasonic equipment.
The appropriate treatment technique can effectively stop and even reverse gum disease's effects — but it won't change your susceptibility. Constant vigilance is the best way to significantly reduce your risk of another episode. In this case, our prevention goal is the same as in treatment: remove plaque.
It begins with you learning and applying effective brushing and flossing techniques, and being consistent with these habits every day. As your dentist, we play a role too: we may need to see you as often as every few weeks or quarter to perform meticulous cleaning above and below the gum line. We may also perform procedures on your gums to make it easier to maintain them and your teeth, including correcting root surface irregularities that can accumulate plaque.
Our aim is to reduce the chances of another infection as much as possible. "Fighting the good fight" calls for attention, diligence and effort — but the reward is continuing good health for your teeth and gums.
If you would like more information on continuing dental care after gum disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Periodontal Cleanings.”
That bit of gum bleeding after you brush, along with redness and swelling, are strong signs you have gingivitis, a form of periodontal (gum) disease. Without treatment, though, your gingivitis could turn into something much more painful and unsightly — a condition commonly known as “trench mouth.”
Properly known as Acute Necrotizing Ulcerative Gingivitis (ANUG), the more colorful name arose from its frequent occurrence among soldiers during World War I. Although not contagious, many soldiers contracted it due to a lack of means to properly clean their teeth and gums and the anxiety associated with war. Inadequate hygiene and high stress still contribute to its occurrence today, along with smoking, medications that dry the mouth and reduced disease resistance — all of which create a perfect environment for bacterial growth.
ANUG can arise suddenly and be very painful. The cells in the gum tissue begin to die (“necrotizing”) and become swollen (“ulcerative”), especially the small triangle of gum tissue between the teeth called the papillae, which can appear yellowish. Patients also encounter a characteristic foul breath and taste. Untreated, ANUG can damage tissue and contribute to future tooth loss.
Fortunately, antibiotics and other treatments are quite effective in eradicating bacteria that cause the disease, so if caught early it’s completely reversible. We start with a complete examination to confirm the diagnosis and rule out other possible causes.Â We then attempt to relieve the pain and inflammation with non-steroidal, anti-inflammatory drugs like aspirin or ibuprofen and begin antibiotic treatment, most notably Metronidazole or amoxicillin. We may also prescribe a mouthrinse containing chlorhexidine and mild salt water rinses to further reduce the symptoms.
We must also treat any underlying gingivitis that gave rise to the more acute disease. Our goal here is remove any bacterial plaque and calculus (hardened plaque deposits) that have built up on tooth surfaces, particularly below the gums. Only then can we fully bring the disease under control.
It’s also important you become more consistent and effective with daily brushing and flossing, quit smoking, reduce undue stress, and get better rest and nutrition. Establishing these new habits and lifestyle changes will help ensure you’ll never have to experience trench mouth again.
If you would like more information on ANUG and other periodontal gum conditions, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Painful Gums in Teens & Adults.”
Periodontal gum disease is a relentless enemy to dental health that destroys gum tissue and the teeth’s attachment to the jaw. As it ravages these tissues it often creates periodontal pockets, hidden spaces between the teeth and bone that fill with infectious bacteria capable of accelerating damage to teeth and gums.
The primary treatment goal for gum disease is to create an environment that is cleansable below the gum tissues, in order to remove as much bacterial plaque from the tooth, gum and root surfaces as possible. Periodontal pockets pose a challenge to this goal as they are extremely difficult to access using standard cleaning and root planing techniques the deeper they become. Cleaning and treating these deep pockets, however, is made easier with a procedure known as periodontal flap surgery.
This procedure is not a cure, but rather a way to access the interior of a periodontal pocket to remove infection and diseased tissue. In effect, we create an opening — like the hinged flap of a letter envelope — to gain entry into the affected pocket. Not only does this opening enable us to clean out infection within the pocket, but it can also facilitate cleaning the tooth’s root surfaces.
It also provides an opening for us to insert grafting materials to regenerate lost bone and tissue. It’s nearly impossible for this tissue regeneration to occur if bacterial infection and inflammation persist in the affected area. Periodontal flap surgery provides us the critical access we need to effectively remove these contaminants that stymie healthy growth.
This procedure is normally performed with local anesthesia and usually results in little bleeding and minimal post-operative effects. Once we have finished any procedures to clean the pocket and other affected tissues, or installed grafts for future bone and tissue growth, we would then seal the flap back against the tooth using sutures and gentle pressure to promote blood clotting around the edges. We might also install a moldable dressing that re-secures the edges of the flap to their proper position and prevents food debris from interfering with healing.
Periodontal flap surgery is the result of years of research to find the best techniques for treating gum disease. It’s one of many weapons in our arsenal for winning the war against decay and gum disease, and helping you realize a healthier dental future.
If you would like more information on periodontal flap surgery, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Periodontal Flap Surgery.”