According to a recent study by the CDC (Centre for Disease Control), almost half of the American population over the age of 30 are affected by gum disease, also known as periodontal disease or periodontitis. If left unchecked, periodontitis can become a debilitating condition and lead to loss of a tooth.
Gum diseases typically begin with mild inflammation of the gums, which is defined as gingivitis. The accumulation of plaque around the teeth that results due to inadequate oral hygiene is the primary cause of gingivitis. Red, inflamed gums that bleed easily are the most common signs of gingivitis. With regular brushing and flossing and a professional cleaning by the dentist, gingivitis can be easily treated.
Untreated gingivitis can progress to a more chronic and severe form of gum disease and lead to advanced periodontal disease. Advanced periodontitis occurs when the disease has reached the bone and other supporting structures around the tooth. While it is more challenging to treat, with the right kind of intervention, it is undoubtedly not an irreversible disease.
The first step towards treating any type of periodontal disease is to carry out conservative and non-invasive procedures to remove plaque and bacteria from the surfaces of the teeth and gums. This may include the following procedures:
The dentist or dental hygienist performs deep cleaning of the teeth and gums with the help of ultrasonic or hand instruments. Through a gentle scraping motion, the dentist can remove plaque and tartar deposits from the surfaces of the teeth and from beneath the gums.
The process of root planing is a lot like scaling but meant for the roots. The plaque and tartar deposits are cleaned from the root, and the surface is smoothed down to remove any roughness that may result in the accumulation of plaque and bacterial by-products. Such build-up on the root surface can result in inflammation and hinder the attachment of the gum to the tooth surface.
Administration of Antibiotics:
Most dentists also advise antibiotics along with the scaling and root planing procedure in patients suffering from advanced periodontal disease. Both topical or oral antibiotics may be prescribed to control infection in the oral tissues. Topical antibiotics can be placed into the pockets created around the tooth in chronic periodontal diseases; however, oral antibiotics are often necessary to eliminate the infection-causing bacteria.
In chronic and advanced cases of periodontitis, surgical intervention is often necessary for the complete resolution of the disease. These may include procedures like:
Also known as pocket reduction surgery, flap surgery is done by surgically lifting a section of diseased gum tissue for more effective cleaning of the root surface underneath. The flap of gum tissue is then sutured back into place, which after healing allows for easier cleaning of the area and reduction in the size of the pockets.
The recession of gums is a common consequence of Advanced periodontal disease. Chronically receding gums can be treated by surgically grafting a small piece of soft tissue from other areas in the mouth and attaching it to the affected site. Bone grafting is done in areas where periodontitis has resulted in bone loss. The grafted bone may be synthetic or natural and helps in reducing tooth mobility and also regrowth of natural bone.
This is a relatively new type of surgical treatment done for advanced cases of periodontitis. A small piece of biocompatible material is placed between the tooth and bone surface, which helps in regrowth of natural bone by preventing unwanted tissue from affecting the healing region.
Oral Care at Home
Apart from professional treatments, adequate maintenance of oral hygiene at home is an essential part of treating advanced periodontitis. This includes regular brushing and flossing and maintaining a balanced diet to ensure the health of the oral tissues.
Treatment of advanced periodontitis usually takes multiple sittings and is mostly done under local anesthesia to prevent pain and discomfort. It can occasionally take months for the gums to heal completely and reattach themselves to the healthy and clean surfaces of the teeth. Regular visits to the dentist are essential during the healing stage of advanced periodontitis for the necessary evaluation of the disease.