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Preventive, Cosmetic and Implant Dentistry

Prevention and treatment of periodontal disease, more commonly known as gum disease

Periodontal diseases are infections of the gums, which gradually destroy the support of your natural teeth. Our office employs several methods to aid in preventing, identifying and treating periodontal disease.
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Preventive, Cosmetic and Implant Dentistry

Prevention and treatment of periodontal disease, more commonly known as gum disease

Periodontal diseases are infections of the gums, which gradually destroy the support of your natural teeth. Our office employs several methods to aid in preventing, identifying and treating periodontal disease.
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An overview
of periodontal disease.

Periodontal diseases are mainly the result of infections and inflammation of the gums and bone that surround and support the teeth.
In its early stage, called gingivitis, the gums can become swollen and red, and they may bleed. In its more serious form, called periodontitis, the gums can pull away from the tooth, bone can be lost, and the teeth may loosen or even fall out. Periodontal disease is mostly seen in adults. Periodontal disease and tooth decay are the two biggest threats to dental health. Periodontal disease can also affect overall systemic health.

Causes of periodontal disease

Periodontitis is typically caused by poor dental hygiene. When you don’t brush your teeth and clean in hard-to-reach places in your mouth, the following happens: bacteria multiply and form plaque. If not removed, the plaque will form tartar which encourages more bacterial growth. Your body’s immune response to the bacteria causes inflammation in the gums. Over time, the attachment of the gum to the root of a tooth is disrupted, this can lead to pockets forming between the gum and root.

Other causes of periodontal disease include:

  • $Smoking, which is one of the biggest risk factors for periodontitis
  • $Type 2 diabetes
  • $Obesity
  • $Hormonal changes in women (such as when menstruation, pregnancy, or menopause occurs), which can make the gums more sensitive
  • $ Conditions that impact your immune system, like HIV or leukemia
  • $Medications that reduce the flow of saliva in your mouth
  • $Genetics
  • $ Poor nutrition, including a deficiency in vitamin C

Signs and Symptoms of periodontal disease

The symptoms depend on the stage of disease, but generally include:
  • $ Gums that bleed when you brush your teeth or floss
  • $Bad breath
  • $Changes in the position of your teeth or loose teeth
  • $Receding gums
  • $Red, tender, or swollen gums
  • $Buildup of plaque or tartar on your teeth
  • $Pain when chewing
  • $Tooth loss
  • $Foul taste in your mouth
  • $Inflammatory response throughout your body

How Periodontal Disease
can affect your overall systemic health

Several studies have shown a link between periodontal disease and other systemic diseases. While a causal relationship has not been conclusively established, research suggest that periodontal disease may contribute to the progression of other diseases.

Diabetes

People with diabetes are more likely to have periodontal disease than people without diabetes, probably because people with diabetes are more susceptible to contracting infections. In fact, periodontal disease is often considered a complication of diabetes. Those who don’t have their diabetes under control are especially at risk. Research has suggested that the relationship between diabetes and periodontal disease goes both ways: periodontal disease may also make it more difficult for people who have diabetes to control their blood sugar, increasing the risk for diabetic complications.

Heart Disease

Several studies have shown that periodontal disease may increase the risk of heart disease. Scientists believe that inflammation caused by periodontal disease may be responsible for the association. Periodontal disease can also exacerbate existing heart conditions. Patients at risk for infective endocarditis may require antibiotics prior to dental procedures. Your dentist and cardiologist will be able to determine if your heart condition requires use of antibiotics prior to dental procedures.

Respiratory Disease

Research has found that bacteria associated with periodontal disease can be aspirated into the lungs and contribute to respiratory diseases such as pneumonia.

Cancer

Researchers found that men with gum disease were 49% more likely to develop kidney cancer, 54% more likely to develop pancreatic cancer, and 30% more likely to develop blood cancers.

Alzheimer’s Disease

Studies have shown a connection between bacteria associated with periodontal disease and the progression of Alzheimer’s disease. Gum disease bacteria may be able to travel to the brain and contribute to the development of Alzheimer’s disease.

The role our office takes in diagnosing,
treating and preventing periodontal disease.

Gum disease is diagnosed and charted by your dental hygienist and doctor. When your hygienist performs your routine cleaning they will check for signs of periodontal disease such as bleeding from the gums. They will also perform what is called periodontal probing and charting. There is a natural pocket between your teeth and the surrounding gums, your hygienist will use a small ruler, called a periodontal probe to measure that pocket in millimeters. In checking the size of these pockets and charting the findings, we are able to evaluate your gum health. During this probing, you may hear your hygienist calling out numbers as she measures and charts your pockets. A normal, healthy pocket is a maximum of 3 millimeters deep, numbers such as four, five and six, along with bleeding from the gums, could be red flags. Pockets that are around 4 millimeters can indicate early stages of gum disease such as gingivitis, the higher the number the more advanced the periodontitis. It could mean that the gum tissue is either swollen or it could mean there is bone loss around the tooth causing a deeper pocket. Once a year, as part of your routine cleaning and exam, x-rays are also taken, which can aid in identifying and diagnosing periodontal disease.

Should abnormal pocket depths, bleeding and noticeable x-ray findings be present, the doctor may recommend what is called scaling and root planing, or SRP. This is a process that takes place over 1-4 visits depending on the extensiveness of your disease and may require a local anesthetic. This deep cleaning has two parts. Scaling is when your dental professional removes all the plaque and tartar (hardened plaque) above and below the gumline, making sure to clean all the way down to the bottom of the pocket. They will then begin root planing, smoothing out your teeth roots to help your gums reattach to your teeth.

Depending on how comprehensive the periodontal disease is, it may also be recommended that a locally delivered antibiotic called Arestin be placed. Arestin consists of small spheres of minocycline, a derivative of tetracycline. The spheres, which look like a fine powder, are contained in a small blunt plastic needle, and are injected into the pocket. This requires no anesthesia. The spheres are bioadhesive, and stick to the pocket wall where they slowly release minocycline over a 14-21 day period. Because the spheres are also biodegradable they do not require removal. If an antibiotic can be delivered directly to the pocket, without the patient having to take systemic doses, there are far fewer side effects, and fewer chances of resistant bacteria forming. In addition, with direct local delivery, the concentration of the antibiotic at the diseased site can be 100 times greater than taking the medication orally.

Should the doctor find that your periodontal disease is too extensive, they may refer you to a periodontist. This is an oral health professional that specializes in gum health.

If this all seems a bit overwhelming, keep in mind that the first step in avoiding periodontal disease is prevention. While prevention should begin at home with twice daily brushing and flossing, our office also plays a significant role. Depending on how quickly your mouth develops plaque and tartar, your hygienist will recommend that you see us usually between two and four times a year for routine cleanings, x-rays and exams. Ensuring that you follow the recommendations means that any gum issues will be recognized and handled early on, so to hopefully avoid more in-depth treatment.

FAQs in regard to periodontal disease

FAQ

What are the stages of gum disease?

Periodontal disease is broken down into different stages, each of which is characterized by a set of symptoms that help the periodontist understand how far it has progressed. The three main stages of gum disease include:
Gingivitis – Early stage symptoms include inflammation of the gums, but the bone and connective tissue are not affected.
Periodontitis – Gums are irreversibly damaged, but further damage can be prevented.
Advanced periodontitis – Gums are destroyed, and teeth are beginning to shift or loosen
The more advanced periodontal disease becomes, the more complex the treatment will be to restore oral health.
FAQ

Is gingivitis reversible?

Gingivitis is the only stage of gum disease that can be reversed. By working closely with a dentist or periodontist, and following their instructions for a proper oral hygiene routine, most people can restore the health of their gums. When left untreated and the gum disease progresses, however, the gums become irreversibly damaged.
FAQ

How do you prevent gingivitis?

Gingivitis can be prevented by practicing proper oral hygiene. This means brushing twice a day and flossing once a day, or more if instructed by your periodontist. Regular professional teeth cleanings and bi-annual visits to the dentist are also essential for keeping your gums and teeth healthy.
FAQ

How can I take care of my gums?

Ensure that you are brushing and flossing at least twice a day. Ask the dentist or hygienist if a mouthwash is right for you. If you smoke, quit! Eat a balanced diet. Be aware of any bleeding or gum sensitivity when brushing and flossing. Be sure to see us at least twice a year for your preventative care- cleanings, x-rays and exams. Remember, the earlier periodontal disease is diagnosed, the easier it is to treat!
FAQ

I was told I need scaling and root planing, what can I expect?

As mentioned above, scaling and root planing, or SRP for short, includes two steps- the scaling which is the removal of the plaque and tartar below the gum line, and root planing where the dentist smooths out the roots of your tooth to aid in gum reattachment. Sometimes a local anesthetic is administered prior to this procedure. Afterwards, you may have pain for a day or two and teeth sensitivity for up to a week. Your gums also may be swollen, feel tender and bleed. To prevent infection, control pain or help you heal, your dentist may prescribe a pill or mouth rinse.
FAQ

Why do I need placement of a local antibiotic, can’t I just take a pill?

Because periodontal disease is an infection, it would seem logical that antibiotics would eliminate the problem. Unfortunately, when treating routine periodontal breakdown, the effects of antibiotics are short-lived. This is because the bacteria that cause the disease reform immediately after the oral antibiotics are discontinued. If an antibiotic can be delivered directly to the pocket, without the patient having to take systemic doses, there are far fewer side effects, and fewer chances of resistant bacteria forming. In addition, with direct local delivery, the concentration of the antibiotic at the diseased site can be 100 times greater than taking the medication orally.
FAQ

Can children develop gum disease?

While it’s more prevalent in adults, teens and younger kids are still at risk for gum disease. The most likely gum disease is gingivitis. The good news is that it’s very treatable. And that’s something worth smiling about.

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Contact

Dr. Gary Vander Vliet

Dr. K Dermoumi

Preventive, Cosmetic and Implant Dentistry

office@gvdental.com

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Call us

908-852-8858

Address

Hastings Commons, Building 2B;
486 Schooley’s Mountain Road;
Hackettstown, New Jersey 07840

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