Gum disease is the silent killer of your teeth. Unfortunately it causes no pain till the very advanced stages when the teeth become loose and the gums abscess. Furthermore, gum disease has been strongly linked to heart disease, poor control of blood sugar for diabetics, premature or low birth weight babies and a host of other systemic conditions.
At Lifetime Smiles, we are dedicated to your dental and general health. Many people ignore the signs and symptoms of gum disease because it is a slow progression and patients get used to the bleeding gums etc.
It is important to have a thorough evaluation of your gums. The periodontal evaluation is done through probing of pocket depths. Deep pockets allow for bacteria to hide in the dark wet crevice and proliferate. The longer the bacteria and their toxins are allowed to stay in your pockets the more destruction they cause. The heavy tartar or calculus may be seen radiographically and felt by your dental professional in your gum pockets. When gum disease is diagnosed, it is important to address it immediately.
The biofilm or plaque that adheres to your teeth usually creeps around the gum line. As time progresses, if the bacteria are not removed, the gums swell. This condition known as gingivitis is the first stage of gum disease. The inflammation or puffiness around the gums cause the gums to pull away from the teeth thus breaking the protective seal. This allows the bacteria to travel below your gums where it is harder to reach and form a hard deposit called tartar. The root surfaces of teeth have no enamel which is smooth in nature but are rather covered by what we call cementum. As the name implies, cementum is like cement and is porous and allows the bacteria to lodge to these surfaces very readily. The tartar or calculus that sticks to root surface of your teeth acts as a splinter and the bone surrounding your teeth wants to get away from it. This bone loss is irreversible and the goal of periodontal therapy is to halt the disease and stop it from further destruction. Bone loss in moderate to advanced stages of gum disease can be seen radiographically.
When diagnosed with periodontal disease, we recommend deep cleaning also known as scaling and root planning. The goal of this therapy is to remove these toxins from your gum pockets so that your gums can reattach to your teeth and the pocket depths can be reduced. This procedure is usually performed in two visits with local anesthesia to ensure your comfort.
Another procedures on the forefront of treating periodontal disease is laser soft tissue therapy. After the calculus and toxins are removed, the laser removes the inflamed tissue so that it attaches back to your teeth in a healthy manner. For more information on soft tissue lasers read our blog on laser gum therapy.
Furthermore, in the age of modern dentistry we are able to sample your saliva and perform DNA testing to see which bacteria are the culprits and address them with systemic antibiotics specific to those bacteria. We all have bacteria in our mouths but fortunately Oral DNA Genetic Testing can detect when these bacteria are above threshold meaning your body can no longer keep them in check. It allows us to be more specific in our treatment protocol and individualize it to your needs.
Another treatment option for the deep pockets is the placement of Arestin into the infected pockets. The advantage of Arestin is that it is a local antibiotic right at the sight of the infection rather than systemic. It is a Tetracycline based antibiotic therefore it is contraindicated in patients with tetracycline allergy. Furthermore if there are a lot of teeth that have deep pockets it may get more costly and may make more sense to perform Oral DNA genetic testing and use a specific antibiotic to the bacteria that are in your mouth.
Once diagnosed with gum disease, the commitment is life long. A general dental hygiene appointment is not the recommended treatment for maintaing gum disease. Most dentists call the post therapy stage of periodontal disease periodontal maintenance. Periodontal maintenance is not the same as a general dental hygiene appointment. Once diagnosed with gum disease, your dental hygienist has to go deeper within each pocket to disrupt the bacterial biofilm and break up their colonization. This is more skilled and strenuous than a regular hygiene visit.
Following your specific periodontal therapy, your gums will be on their way to healing, will turn into a pink color and your mouth will feel much better. Your body will thank you for not making it fight this chronic asymptomatic infection. After all if you brush your hair and your scalp bleeds, you wouldn’t think that is normal. Bleeding gums are not normal either!
Home care is of utmost importance with maintenance of periodontal disease. You are an active member in controlling this silent killer. Brushing and flossing twice a day, using an electric toothbrush, scraping your tongue along with 3 month maintenance appointments will ensure your success.
For more information call our Escondido, CA dental office and be sure to take advantage of our new patient promotions.
To your health,
Dr. Rabee McDonald