Periodontics

The term “periodontics” refers to the aspect of dentistry that pertains to the prevention, diagnosis and treatment of periodontal disease that affects the gums and jawbone. The gum tissues serve to surround and support the teeth and the underlying jawbone anchors teeth firmly in place.

Periodontics:

Reasons for periodontal treatment

Periodontal disease is a progressive condition which begins with mild gum inflammation called gingivitis. Periodontitis is the leading cause of tooth loss in adults living in the developed world, and should be taken very seriously. Periodontal disease is typically signified by red, swollen, painful, or bleeding gums, but in some cases has no noticeable symptoms.

Periodontal disease generally begins when the bacteria living in plaque cause an infection in the surrounding tissues of the teeth, causing them to become irritated and painful. Eventually, this chronic infection will; cause the bodies immune system to respond causing the jawbone to recede and the tooth to become loose. This disease is a chronic inflammatory disease that must be managed similar to that of: celiac disease, vasculitis, lupus, chronic obstructive pulmonary disease, irritable bowel disease, atherosclerosis, arthritis, and psoriasis. Periodontitis is multifactorial and requires bacterial assailants, systemic factors, and immune response to produce its effect.

There are several reasons why periodontal treatment may be necessary:

Moderate/advanced gum disease – This occurs when the gums are bleeding, swollen or red around most teeth and the alveolar bone has started to recede.

Localized gum recession – The infection which propagates moderate or advanced gum disease often begins in one area. Gum recession may also be caused due to over brushing with a hard bristle brush, or due to a tooth that is not positioned properly. Immediate treatment is required to prevent further spreading.

Before crown lengthening – The dentists may lengthen the crown of the tooth by removing surrounding soft tissue and bone to provide more tooth exposure for restoring a tooth.

Ridge augmentation – This procedure, often called “recontouring” may be required to correct an uneven gum line. Before embarking on treatment, a dentist needs to treat any bacterial infections and periodontitis.

In the case of mild/moderate periodontal problems, the focus of the periodontist will be on curing the underlying bacterial infection and then providing advice on the most appropriate home cleaning methods.

Sometimes a deep scaling is needed to remove the bacterial plaque and calculus (tartar) from the teeth and tissues. Where periodontal disease is advanced and the jawbone has regressed significantly, more intensive cleaning may be recommended and loose teeth that cannot be saved will be removed.

At Sacramento Comprehensive Family Dentistry we are trained in all aspects of dental implant procedures, which can restore functionality to the mouth when teeth have been affected by periodontitis.

Because periodontal disease is progressive, it is essential to remove the bacteria and calculus build up to halt the spread of the infection. Your dentist will be happy to advise you on effective cleaning methods and treatment options.

The most common periodontal conditions treated by the dentist are:

Gingivitis – This is the mild inflammation of the gums which may or may not be signified by pain and bleeding.

Mild/moderate periodontitis – When the pockets between the teeth and the soft tissues are measured to be between 4-6mm it is classified as moderate periodontitis (gum disease).

Advanced periodontitis – When the pockets between the teeth and the soft tissues in general exceed 6mm in depth, significant bone loss may occur; causing shifting or loss of teeth.

Missing teeth – When teeth are missing as a result of bone loss, the periodontist can implant prosthetic teeth. These teeth are anchored to the jawbone and restore functionality to the mouth.

Treatments Performed by a Dentist

The dentist is able to perform a wide range of treatments to halt the progression of gum disease, replace missing teeth and make the appearance of the smile more aesthetically pleasing.

Here are some of the treatments commonly performed:

    Implant placement – When a tooth or several teeth are missing, the dentist is able to create a natural-looking replacement by anchoring a prosthetic tooth to the jawbone.

    Osteoplasty (hard tissue recontouring) – Once periodontitis has been treated, the dentist can recontour the hard tissue to make the smile both natural-looking and aesthetically pleasing.

    Gingivoplasty (soft tissue recontouring) – As gums recede due to periodontitis, the teeth may appear longer; causing a “toothy” smile. The periodontist can remove tissues or straighten the gum line to make the teeth look more even.

    Bone grafting – Dental implants can only be positioned if there is sufficient bone to attach the prosthetic tooth to. If bone loss has occurred, bone grafting is an excellent way to add or “grow” bone so that an implant may be properly secured or the overlying tissue sits the proper place.

    Deep pocket cleanings – As gingivitis and periodontitis progress, it becomes more difficult to cleanse the pockets between the soft tissues and the teeth. The dentist can scale and root plane the teeth (sometimes under local anesthetic) to remove debris and infection-causing bacteria.

    Crown lengthening – In order to expose more of the natural tooth, the dentist can remove some of the surrounding gingival tissue.