The Stages of Periodontal Disease
Periodontal Disease Overview
Commonly referred to as gum disease, periodontal disease is an infection of the gums caused by a buildup of plaque which, if not treated, can create toxins that damage the important structures that support your teeth. Periodontal disease forms just below the gum line and creates small pockets that separate the gums from the teeth. It has two stages: gingivitis and periodontitis.
In the very early stages – when it is gingivitis – you may just need a professional periodontal maintenance from your dental team. They can also give you some great advice and tips on how you can keep your teeth and gums healthy.
This is inflammation of the gums, when they become red and swollen and bleed easily. At this stage, the disease is treatable and can usually be eliminated by daily brushing and flossing and professional dental care.
If left untreated, gingivitis will advance into periodontitis, and the gums and bone that support the teeth will become seriously and irreversibly damaged. Progressive periodontal disease can cause teeth to become loose, painful, infected and may require that they be removed.
Periodontal Disease Frequently Asked Questions
What are the symptoms of Periodontal Disease?
- Red, swollen, tender gums
- Gums that bleed when brushing and flossing
- Pus between your teeth and gums
- Permanent teeth that appear longer or become loose or separate
- Large spaces that form between the teeth
- Gums that begin to pull away from the teeth
- Chronic bad breath or bad taste
- Any change in the way your teeth fit together when you bite
- Any change in the fit of partial dentures
What are the risk factors of Periodontal Disease?
- Smoking or using chewing tobacco
- Not brushing your teeth and flossing regularly
- Health conditions such as Diabetes, Heart Disease, or Osteoporosis
- Certain types of medication such as steroids, anti-epilepsy drugs, cancer therapy drugs, calcium channel blockers, and oral contraceptives
- Several of your family members having periodontal disease, as it can, in some cases, be genetic
- Bridges that no longer fit properly
- Crooked teeth
- Old fillings
How can you prevent Periodontal Disease?
- Brush and floss regularly
- Eat a balanced diet
- Avoid tobacco use
- Schedule regular periodontal visits
How do you treat Periodontal Disease?
- Phase I: Non-surgical treatment
- Phase II: Periodontal surgery
- Periodontal maintenance therapy coordinated with your dentist
Non-Surgical Treatment (Phase I)
The first line of defense against the presence of periodontal disease is a unique type of cleaning called “scaling and root planing.” During this procedure, hand instruments and/or an ultrasonic cleaning device are used to remove bacterial plaque and calculus from your teeth where regular cleaning devices can’t reach: under the gum line on the tooth root surface. Then, the rough surfaces of the tooth root are smoothed out (planed). This provides a healthy, clean surface that makes it easier for the gum tissue to reattach to the tooth.
If your periodontal disease is professionally treated before it becomes too severe, scaling and root planing may be the only treatment you need. However, continuous professional and home care is essential. If you don’t maintain quality home care, it’s quite likely that you’ll develop periodontal disease again.
Surgical Treatment Options (Phase II)
If the tissue or bone surrounding your teeth is too damaged to be repaired with non-surgical treatment, several surgical procedures are available to correct the severe damage and restore a healthy smile. We will recommend the procedure that is best suited to restore the health of your teeth and gums. Following is a list of common types of periodontal surgery.
Pocket Depth Reduction
In a healthy mouth, the teeth are firmly surrounded by gum tissue and securely supported by the bones of the jaw. Periodontal disease damages these tissues and bones, leaving open spaces around the teeth that we call pockets. The larger these pockets are, the easier it is for bacteria to collect inside them, leading to more and more damage over time. Eventually, the supportive structure degrades to the point that the tooth either falls out or needs to be removed.
During pocket reduction procedures (also known as “flap surgery”), we fold back the gum tissue and remove the bacteria hiding underneath as well as the hardened bacterial plaque and calculus that have formed. We may also remove any tissue that is too damaged to survive. We then suture the healthy tissue back into place. Now that the tooth and root are free of bacterial plaque and calculus, and the pockets have been reduced, the gums can reattach to the teeth.
When the bone and tissue supporting the teeth have been lost due to severe gum disease, we can restore these areas with a regeneration procedure. During this process, we begin by folding back the gum tissue and removing the bacterial plaque and calculus. Depending on your situation, we may then perform a bone graft to stimulate new bone growth, or we may place a special kind of protein that stimulates tissue growth to repair the areas that have been destroyed by the disease.
A frequent symptom of periodontal disease is gum recession (also called gingival recession). As the gums recede, more of the tooth root is revealed. This can make teeth appear longer and can also create sensitivity to hot or cold liquids. The exposed tooth root is also susceptible to decay which can result in loss of the tooth.
During a soft-tissue graft, tissue from the top of your mouth or another source is sutured to the recessed area, covering the roots and restoring the gum line to its original, healthy location. This procedure can also be performed for cosmetic reasons.
Practicing good oral hygiene means maintaining your smile by visiting your periodontist regularly and taking care of your teeth and gums between checkups. At Dr. Sims, we care about your life outside of our chair and want to make sure that your teeth stay healthy for life. We’ll work with you and your dentist to provide complete dental care and show you how to maintain your smile at home with the right dental products for you and your family.
Routine periodontal maintenance is an important part of maintaining your oral health. During your periodontal maintenance visit Dr. Sims and your hygienist will:
- Check for any problems that you may not see or feel
- Look for cavities or any other signs of tooth decay
- Examine your gums for gingivitis and signs of periodontal disease
- Provide a thorough periodontal cleaning and polish
Alternately visiting Dr. Sims and your dentist every three months gives you the chance to talk with your doctor and receive answers for any questions you may have about your oral health. Checkups are also a great way for you to find out about new treatments that may benefit your smile and boost your confidence.