Periodontitis or gum disease is very common. It is widely regarded as the second most common disease worldwide, after dental decay. In the United States periodontal disease has a prevalence of 30-50% of the population, but only about 10% have severe forms.
Scaling and Root Planing, (otherwise known as conventional periodontal therapy, non-surgical periodontal therapy, or deep cleaning), removes or eliminates the agents from the teeth which cause inflammation such as dental plaque and calculus. The deep cleaning will help maintain a periodontium (the tissues that surround and support the teeth) that is free of disease.
What is Periodontal Disease or Gum Disease?
Plaque is a soft, sticky mixture of bacteria, waste products from bacteria, and some food debris. It irritates the gums, or gingiva, and causes inflammation over time. The longer plaque is left on the teeth, the harder it gets. After 24 hours, some plaque hardens into calculus, otherwise know as tarter. Calculus is mineralized plaque and does not come off with a toothbrush or dental floss anymore. It will have to be removed by a dental professional. The bacteria in plaque and calculus cause an ongoing state of inflammation called gingivitis. If left untreated, gingivitis can progress to a more serious disease called periodontitis.
The bone is alive, it has cells that build and break down bone. Usually, these cells work at the same speed, and keep each other in balance. Ongoing inflammation stimulate the cells that break down bone, which now start working faster than the cells that build bone. The net result is that bone is lost, and the loss of bone and attachment tissues is called periodontal disease.
Periodontal disease involves progressive loss of the bone around the teeth, and if left untreated, can lead to the loosening and subsequent loss of teeth. Periodontitis is caused by microorganisms that adhere to and grow on the tooth’s surfaces. A diagnosis of periodontal disease is established by a dental professional inspecting the soft gum tissues around the teeth with a dental probe and by evaluating the patient’s X-rays to determine the amount of bone loss around the teeth.
What are the symptoms of Periodontal Disease?
In the early stages, periodontitis has very few symptoms and in many individuals the disease has progressed significantly before they seek treatment. Symptoms may include the following:
- Redness or bleeding of gums while brushing teeth, using dental floss or biting into hard food (e.g. apples). This may occur even in gingivitis, where there is no attachment loss.
- Gum swelling.
- Spitting out blood after brushing teeth.
- Bad breath and a persistent metallic taste in the mouth.
- Gingival recession, resulting in apparent lengthening of teeth.
- Deep pockets between the teeth and the gums (pockets are sites where the attachment has been gradually destroyed.)
- Loose teeth, in the later stages.
Patients should realize that the gingival inflammation and bone destruction are largely painless. Hence, people may wrongly assume that painless bleeding after teeth cleaning is insignificant, although this may be a symptom of progressing periodontitis in that patient.
What can I do to prevent gum disease?
In order to prevent periodontal disease a patient must have good oral homecare. See section on Detailed Homecare Instructions.
Treatment overview for periodontal disease
The first step in the treatment of periodontitis involves non-surgical cleaning below the gum line with a procedure called scaling, root planning and debridement often referred to as “deep cleaning”. This procedure may be performed using a number of dental tools, including ultrasonic instruments and hand instruments, such as periodontal scalers and curettes.
Dr. Knight recommends the use of our DEKA CO2 laser to treat periodontal disease after the initial scaling, root planning, and debridement. Laser therapy allows your dental hygienist to use the laser to eliminate the periodontitis causing bacteria. One to two follow-up visits 7-10 days apart are recommended to prevent the bacteria from growing back. This treatment has been proven to encourage new bone and tissue growth.
For these procedures to be considered effective, the patient must be able to be maintained at a level of periodontal health that will prevent re-infection with periodontal pathogens. This requires optimal home care and ongoing periodontal maintenance therapy, usually every 3 to 4 months, to sustain health. Smoking is another factor that increases the occurrence of periodontitis, directly or indirectly, and may interfere with or adversely affect its treatment.
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Some of the information was taken from Wikipedia