Periodontal Disease

Periodontal treatment methods depend upon the type and severity of the disease. Your dentist or hygienist will use pocket depths, amount of bleeding, inflammation, tooth mobility, etc., to make a diagnosis that will fall into a category below:

Gingivitis
Gingivitis is the first stage of periodontal disease. Plaque and its toxin by-products irritate the gums, making them tender, inflamed, and likely to bleed. Healthy tissue does not bleed.

Periodontitis
Plaque hardens into calculus (tartar). As calculus and plaque continue to build up, the gums begin to separate from the teeth and attachment of the teeth to the gums is decreased. Deeper pockets form between the gums and teeth and become filled with more plaque and toxins. The gums become very irritated, inflamed, and bleed easily. Slight to moderate bone loss may be present.

Advanced Periodontitis
The teeth lose more support as the gums, bone, and periodontal ligament continue to be destroyed. Unless treated, the affected teeth will become very loose and may be lost. Generalized moderate to severe bone loss may be present. Periodontal disease can never be cured fully, only maintained. That is why it must be treated completely and monitored vigilantly.

Periodontal treatment methods depend upon the type and severity of the disease. Your dentist and dental hygienist will evaluate for periodontal disease and recommend the appropriate treatment.

Periodontal disease progresses as the sulcus (pocket or space) between the tooth and gums gets filled with bacteria, plaque, and tartar, causing irritation to the surrounding tissues. When these irritants remain in the pocket space, they can cause damage to the gums and eventually, the bone that supports the teeth!

If the disease is caught in the early stages of gingivitis, and no damage has been done, one to two regular cleanings will be recommended. You will also be given instructions on improving your daily oral hygiene habits and having regular dental cleanings.

If the disease has progressed to more advanced stages, a special periodontal cleaning called scaling and root planning (deep cleaning) will be recommended. It is usually done one or two quadrants of the mouth at a time while the area is numb. In this procedure, tartar, plaque, and toxins are removed from above and below the gum line (scaling) and rough spots on root surfaces are made smooth (planning). All of the pockets are irrigated with a prescription strength antimicrobial rinse. This procedure helps gum tissue to heal and pockets to shrink. Medications, special medicated mouth rinses, and an electric tooth brush may be recommended to help control infection and healing.

If deeper pockets are present (6mm or deeper), Dr. Fleming will recommend the placement of Arestin®. Arestin® is an antibiotic that is placed directly into the pocket next to the tooth ensuring that new colonies of bacteria cannot form at the base of the pocket. Arestin® is used with scaling and root planning to allow maximum heating for areas that are not treated as well with scaling and root planning alone. Ask Dr. Fleming about the great results he has seen.

If the pockets do not heal after scaling and root planning, periodontal surgery may be needed to reduce pocket depths, making teeth easier to clean. Your dentist may also recommend that you see a Periodontist (specialist of the gums and supporting bone).

If a pocket is of a certain depth a localized antibiotic powder may be recommended for that site to aid in healing. This ensures that even the deepest pockets can be bacteria free to give them the best chance of healing.