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Posts for tag: periodontal disease

By Sean M. Flynn, DMD, LLC
April 22, 2018
Category: Oral Health
GetaDentalExamasSoonasPossibleifyouSuspectGumDisease

If you suspect you have periodontal (gum) disease, it's important to get a correct diagnosis and begin treatment as soon as possible. The sooner you begin treatment the better the long-term outcome.

Gum disease is a bacterial infection that's most often triggered by plaque, a thin film of food particles on tooth surfaces. Plaque buildup most often occurs when a person doesn't practice effective oral hygiene: daily brushing and flossing and professional cleanings at least twice a year.

The most common type of gum disease, gingivitis, can begin within days of not brushing and flossing. It won't always show itself, but you can have symptoms like swollen, red or bleeding gums, as well as bad taste and breath. You could also develop painful abscesses, which are localized pockets of infection within the gums.

If we don't stop the disease it will eventually weaken the gum attachment to the teeth, bone loss will occur and form deep pockets of infection between the teeth and bone. There's only one way to stop it: remove the offending plaque from all tooth surfaces, particularly below the gum line.

We usually remove plaque and calculus (hardened plaque deposits) manually with special hand instruments called scalers. If the plaque and calculus have extended deeper, we may need to perform another procedure called root planing in which we shave or “plane” the plaque and calculus (tartar) from the root surfaces.

In many cases of early gum disease, your family dentist can perform plaque removal. If, however, your gum disease is more extensive, they may refer you to a periodontist, a specialist in the treatment and care of gums. Periodontists are trained and experienced in treating a full range of gum infections with advanced techniques, including gum surgery.

You can also see a periodontist on your own for treatment or for a second opinion — you don't necessarily need a referral order. If you have a systemic disease like diabetes it's highly advisable you see a periodontist first if you suspect gum disease.

If you think you might have gum disease, don't wait: the longer you do the more advanced and destructive the disease can become. Getting an early start on treatment is the best way to keep the treatment simple and keep gum disease from causing major harm to your teeth and gums.

If you would like more information on the diagnosis and treatment of 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 “When to See a Periodontist.”

LasersCouldOneDaybeCommonplaceforTreatingGumDisease

There are a variety of methods for treating periodontal (gum) disease depending on its severity — from routine office cleanings to periodontal surgery. But the goal behind all of them remains the same: remove bacterial plaque and calculus (tartar), the root cause for gum disease, from all tooth and gum surfaces.

The traditional method for doing this is called scaling in which we use special hand instruments (scalers) to mechanically remove plaque and calculus. Scaling and a similar procedure called root planing (the root surfaces are “planed” smooth of plaque to aid tissue reattachment) require quite a bit of skill and experience. They're also time-consuming: full treatment can take several sessions, depending on how extensive the infection has spread.

In recent years, we've also seen a new method emerge for removing plaque: lasers. Commonly used in other aspects of healthcare, lasers utilize a focused beam of light to destroy and remove diseased or unhealthy tissue while, according to studies and firsthand accounts, minimizing healthy tissue destruction to a better degree than traditional techniques. Procedure and healing times are likewise reduced.

Because of these beneficial characteristics, we are seeing their use in gum disease treatment, especially for removing diseased and inflamed tissues below the gum line and decreasing sub-gingival (“below the gums”) bacteria.

Dentists who have used lasers in this way do report less tissue damage, bleeding and post-treatment discomfort than traditional treatments. But because research is just beginning, there's not enough evidence to say laser treatment is preferably better than conventional treatment for gum disease.

At this point, lasers can be an effective addition to conventional gum disease treatment for certain people, especially those in the early stages of the disease. As we continue to study this technology, though, the day may come when lasers are the preferred way to stop gum disease from ruining your dental health.

If you would like more information on treating 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 “Lasers Versus Traditional Cleanings for Treating Gum Disease.”

StayAheadofGumDiseaseRe-InfectionwithPeriodontalMaintenance

If you've undergone treatment for periodontal (gum) disease, you know how involved it can be. After several sessions of plaque and calculus (hardened plaque deposits) removal, your swollen, red gums finally begin to regain their healthy pink color.

But with gum disease, the battle may be over but not necessarily the war. If we don't remain vigilant, there's a high chance you'll experience a re-infection.

That's why periodontal maintenance (PM) is so important for gum disease patients after treatment. Plaque, the thin film of bacteria and food particles responsible for the infection, can grow again on your tooth surfaces as it did before. You'll have to practice diligent, daily brushing and flossing to curb that development.

But it's also important to keep up regular dental visits for advanced cleaning to remove hard to reach plaque and calculus. For most people that's usually twice a year, but for gum disease patients it could be up to four times a year, especially just after treatment. And there's more to these visits than cleaning.

Since our goal is to reduce the chances of re-infection as much as possible, we'll thoroughly examine your teeth, gums and any implants for signs of disease (we'll also include an oral cancer screening). We want to assess the health of your teeth and gums and to see how well you're doing hygiene-wise with plaque control.

If we find signs of gum disease, we'll discuss this with you and schedule a new round of treatment. The sooner we initiate treatment, the better your outcome. In some cases, we may perform procedures that make it easier to access and clean areas where plaque tends to build up.

Overall, we want to prevent the occurrence of any future disease and treat it as soon as possible if it re-occurs. Keeping up diligent PM will help ensure your gums continue to stay healthy.

If you would like more information on after care following periodontal (gum) disease, please contact us or schedule an appointment for a consultation.

By Sean M. Flynn, DMD, LLC
November 15, 2016
Category: Oral Health
AvoidBoneLossaroundToothRootsthroughRegularDentalCare

Periodontal (gum) disease is a serious matter. Not only can it wreak havoc with your gums, it could also cause bone loss in the jaw that supports your teeth.

Gum disease is a bacterial infection that originates from a thin film of food particles on tooth surfaces called plaque. If you're not diligent about removing plaque through daily brushing and flossing, it can become a feeding ground for certain strains of bacteria that trigger gum infections. Left untreated, the disease can advance deeply into the teeth's supporting structures.

We're particularly concerned about furcations, the specific locations where multiple roots of a tooth fork or separate. When these locations become infected we call it a furcation involvement or invasion. The bone along the furcation will begin to deteriorate and dissolve, following a progression of stages (or classes) we can measure by probing the gum tissue or through x-ray evaluation:

  • Class I: the furcation feels like a groove, but without any noticeable bone loss;
  • Class II: a depression of about two or more millimeters develops indicating definite bone loss;
  • Class III:  bone loss now extends from one side of the root to the other, also known as “through and through.”

Treating furcation involvements can prove challenging because the infection is usually well below the gum line (sub-gingival). As with all gum disease treatment, our primary approach is to remove all plaque and calculus (hardened plaque deposits) where we find it, including around the roots. We typically use specially shaped instruments to clean the root surfaces. We can also employ an ultrasonic device that loosens plaque and calculus with high-frequency vibrations and flushed away with water.

Sometimes, we may need to surgically access involved furcations to clean them and stimulate bone growth with grafting. We can also use surgery to make the areas easier to clean — both for you and for us during your regular office cleanings — to prevent reoccurrences of infection.

Of course, preventing gum disease in the first place is your best defense against oral problems like furcation bone loss. Be sure you brush and floss every day, and visit us for thorough cleanings at least twice a year (unless we recommend more). This will help make sure not only your gums, but the bone that supports your teeth stays healthy.

If you would like more information on treating periodontal (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 “What are Furcations?

WinningtheWaronGumDiseaseRequiresPost-TreatmentVigilance

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.”