Periodontal Therapy: A specialized form of dentistry that involves the diagnosis and treatment of periodontal disease that affect the gums and structures that support the teeth.
The Problem: Periodontal Disease
Periodontal Disease Treatment involves inflammation and infection that destroys the tissues that support the teeth, including the gums, the periodontal ligaments, and the tooth sockets (alveolar bone).
Otherwise known as gum disease or gingivitis, periodontal disease is caused by from the long-term effects of plaque deposits. Plaque is a major cause of tooth decay. If you do not remove plaque, it turns into a hard deposit called tartar that becomes trapped at the base of the tooth. Plaque and tartar irritate and inflame the gums. Bacteria and the toxins they produce cause the gums to become infected, swollen, and tender.
There are many causes and degrees of periodontal disease. Most common are the result of poor dental hygiene, including overly vigorous brushing or flossing of the teeth, can cause gingivitis. Misaligned teeth, rough edges of fillings, and ill-fitting or unclean mouth appliances (such as braces, dentures, bridges, and crowns) can irritate the gums and increase the risk of gingivitis or periodontal disease. Other causes include pregnancy, medications such as phenytoin and birth control pills, and poor eating habits.
The Periodontist has a variety of ways of determining the severity of periodontal disease, and the stage at which it has affected the patient’s mouth. Typically the patient has an understanding that periodontal disease may exists based on the symptoms they experience.
During a periodontal exam, your gums are checked for bleeding, swelling, and firmness. The teeth are checked for movement and sensitivity. Your bite is assessed. Full-mouth X-rays can help detect breakdown of bone surrounding your teeth.
The Periodontal Disease Treatment begins with non-surgical procedures. The removal of sub-gingival calculus (tartar) and biofilm deposits. Another procedure called scaling and root planing is the common first step in addressing periodontal problems, which seeks to remove calculus by mechanically scraping it from tooth surfaces. Occlusal adjustments can also help eliminate problems within the mouth, and therefore minimize the formation of bacteria that can result in periodontal disease.
Flap Surgery. Surgery might be necessary if inflammation and deep pockets remain following Periodontal Disease Treatment with deep cleaning and medications. A periodontist may perform flap surgery to remove tartar deposits in deep pockets or to reduce the periodontal pocket and make it easier to keep the area clean. This common surgery involves lifting back the gums and removing the tartar. The gums are then sutured back in place so that the tissue fits snugly around the tooth again. After surgery the gums will heal and fit more tightly around the tooth. This sometimes results in the teeth appearing longer.
Bone and Tissue Grafts. In addition to flap surgery for periodontal disease treatment, your periodontist or dentist may suggest procedures to help regenerate any bone or gum tissues lost to periodontitis. Bone grafting, in which natural or synthetic bone is placed in the area of bone loss, can help promote bone growth. A technique that can be used for periodontal disease with bone grafting is called guided tissue regeneration. In this procedure, a small piece of mesh-like material is inserted between the bone and gum tissue. This keeps the gum tissue from growing into the area where the bone should be, allowing the bone and connective tissue to regrow. In cases where gum tissue has been lost, your dentist or periodontist may suggest a soft tissue graft, in which synthetic material or tissue taken from another area of your mouth is used to cover exposed tooth roots.
The goal of periodontal disease treatment is to reduce inflammation, eliminate pockets if present, and address any underlying causes. All treatment options for periodontal disease will be discussed with the patient, which vary depending on the severity of the case.