Madison Family Dental

What is Periodontal Disease?

Periodontal disease, or gum disease (e.g. gingivitis and periodontitis), are serious infections that left untreated, can lead to tooth loss. Periodontal disease is a chronic, bacterial infection that affects the gums and bone that support the teeth. It begins when bacterial plaque (the sticky, colorless film that constantly forms on your teeth) causes the gums to become inflamed.

Gingivitis is the mildest form of periodontal disease. It causes the gums to become red, swollen and bleed easily. There is usually little or no discomfort at this stage. Gingivitis is often caused by inadequate oral hygiene. Gingivitis is reversible with professional treatment and good oral care at home.

Untreated gingivitis can advance to periodontitis. With time plaque can spread and grow below the gum line. Toxins produced by the bacteria in the plaque irritate the gums. The toxins stimulate a chronic, inflammatory response in which the body, in essence, turns on itself and the tissues and bone that support the teeth are destroyed. The gums then separate from the teeth, forming pockets that become infected. As the disease advances, the pockets get deeper and more tissue and bone is destroyed. Unfortunately this destructive process has very mild symptoms and people are not aware until the disease is very advanced. Eventually teeth become loose and may have to be removed.

An Illustrated View

The diagram and clinical photos show a progression (starting left to right) of good oral health, to gingivitis, to periodontitis, to advanced periodontitis.

Periodontal Disease FAQ

Why is the health of my mouth so important to the rest of my body?

The health of the mouth is integral to overall health. The mouth is connected to the body by the bloodstream and the digestive system. Recent evidence suggests that periodontal disease is associated with many health conditions. For example heart attacks and strokes are more common when gum disease is present. Gum disease also complicates blood sugar management for the diabetic, and high blood sugar worsens gum disease.

The hormonal changes during pregnancy increase the risk for gum disease and its severity if gum disease is already present. Furthermore, gum disease increases the risk that your infant will be premature with low birth weight, which is a very serious condition.

What can I do to prevent gum disease?

-Brushing and flossing every day is a very important behavior to prevent decay and gum disease

-Eating a balanced diet for good oral and general health

-Preventing adverse consequences from smoking; smoking is a risk factor for gum disease, oral cancer, and many other diseases

-Visiting your dentist on a regular basis for early detection and treatment of oral diseases; professional cleanings are the only way to remove tartar, which traps bacteria along and below the gum line

What are my treatment options?

Periodontal diseases can often be treated successfully. Treatment has benefits: increase the chance of keeping your natural teeth; decrease the chance of developing serious health problems that are associated with periodontal disease.

What are my non-surgical treatment options?

The first step in periodontal treatment usually involves a non-surgical treatment called scaling and root planing. It is a careful cleaning of the root surfaces to remove plaque and calculus (tartar) from deep periodontal pockets and to smooth the tooth root to remove bacterial toxins. Many patients do not require any further active treatment, however they will require ongoing maintenance therapy in order to sustain health. Nonsurgical therapy does have its limitations; when periodontal health is not achieved, surgery may be indicated.

What are my surgical treatment options?

When periodontal pockets do not heal after scaling and root planning, surgery may be needed to reduce the pocket depth, remove the inflamed tissues, and reduce the damage to the bone around the teeth. Surgery allows access to hard-to-reach areas where plaque and calculus have accumulated. Eliminating this bacteria and regenerating bone and tissue help to reduce pockets and repair the damage caused by the chronic inflammation of periodontal disease.

The damage that periodontal disease causes to the bone may require additional procedures to regenerate lost bone and tissue. Bone surgery, including bone grafts, are used to rebuild or reshape bone destroyed by the periodontal disease. Membranes and tissue-stimulating proteins may also be used to encourage your body to repair and regenerate new bone and tissue.

Soft tissue grafts can be used to cover roots or develop gum tissue where excessive gingival recession has occurred. Gum tissue is taken from your palate or another donor source to cover the exposed root surface. This procedure can be used to prevent further recession, to even your gum line, and reduce to sensitivity.