Gingivitis is the earliest, most common form of gum disease. There is usually no pain or discomfort associated with it; in fact, 75 percent of adults in the U.S. have gingivitis, and many aren't even aware of it.
Luckily, the effects of gingivitis are reversible, but this isn't the case if it goes untreated. Gingivitis can be the gateway to periodontal disease, a much more serious condition that can lead to irreversible bone loss and ultimately, tooth loss.
Plaque is the culprit
The main cause of both gingivitis and periodontal disease is the accumulation of plaque, the sticky film of food and bacteria that forms constantly on your teeth. You must remove all of the plaque each day, or it builds up and mineralizes to become tartar. Bacteria that thrive in tartar produce toxins; it's these toxins, combined with your body's reaction to them that destroy bone around your teeth. Once bone has been lost, it never grows back.
When too much bone is lost, there's little support for the teeth. They get loose and have to be removed. That's why it's vital that we treat gingivitis early, before it can progress and cause irreversible damage.
The symptoms of gingivitis
Though most people aren't aware that they have gingivitis, the warning signs are redness where the gums meet the teeth, swollen gums, bleeding when brushing and flossing, and persistent bad breath.
To determine whether or not you have gingivitis, we'll perform a thorough examination. We'll look for any changes in the shape, color or contour of your gums, and we'll determine if any bleeding occurs when we gently probe them.
Treating gingivitis
If we determine that you do have gingivitis, treatment will always include a professional cleaning, which removes plaque from teeth. We’ll also get you started on an effective, consistent homecare regime, and a revisit schedule. In some cases, additional steps are required, which could include using a disclosing solution to determine where the plaque is, a review of the proper use of floss as well as a manual or electric toothbrush, and using an antibacterial rinse to help kill destructive bacteria.
Periodontal Disease
Periodontal disease is an infection of the teeth, gums, and the bone that surrounds the teeth. Most people who have periodontal disease aren't even aware of it, because it's rarely painful, especially in the early stages.
What causes periodontal disease?
The main cause of periodontal disease is the accumulation of plaque. Plaque is the sticky film of food and bacteria that forms constantly on your teeth. If all of the plaque isn't removed each day, it builds up and mineralizes to become tartar, also called calculus.
If tartar isn't removed, it begins to accumulate on the root surfaces. Bacteria that cause periodontal disease thrive in tartar. These bacteria produce toxins, and it's these toxins, combined with your body's response to them, that destroy bone around your teeth. Professional help is required to remove tartar, because there's no way to remove it at home. A toothbrush or floss won't even budge it.
What are the warning signs?
While many people with periodontal disease experience no symptoms, others do experience warning signs that include:
persistent bad breath
bleeding of the gums when brushing or flossing
soft, swollen, or tender gums
gums shrinking away from the teeth
loose teeth
changes in the spaces between teeth, which may reflect changes in the underlying bone
How do we diagnose periodontal disease?
Since you may have periodontal disease without experiencing symptoms, we perform a thorough examination using X-rays and a periodontal probe.
The crevice between a tooth and the surrounding gum is called a sulcus. A healthy sulcus is two to three millimeters deep. When plaque and tartar invade a sulcus and it becomes deeper than three millimeters, it is called a pocket. We measure the depth of all pockets using a periodontal probe. The measurement is from the bottom of the pocket, where the gum is attached to the tooth, to the top of the gums. In general, the deeper the pockets, the greater the extent of periodontal disease.
We also examine the color, shape, and overall condition of the gums. Bleeding is a sign of infection; healthy gums don't bleed. Healthy gums are firm and lightly stippled. In moderate cases of periodontal disease, we see swollen gums.
X-rays also tell us a lot about periodontal disease, because they allow us to monitor your bone levels. In a healthy mouth, the bone comes up high around the necks of the teeth, and the bone level is even throughout the mouth. With advanced periodontal disease, the bone levels are much lower and are uneven.
In short, we look for the following signs to diagnose periodontal disease:
probe readings greater than three millimeters,
bleeding upon probing,
swollen and red gums, especially between the teeth,
and bone loss or tartar buildup.
Ultrasonic Scaling
What is periodontal disease?
Periodontal disease, an infection of the teeth, gums, and bone that surrounds the teeth, is the number-one cause of adult tooth loss. It begins when plaque, a sticky film of food and bacteria, builds up on your teeth. If plaque isn't removed, it hardens into calculus, also called tartar. The buildup of plaque and tartar dramatically increases the number of harmful bacteria in your mouth and can result in deepening spaces between the teeth and gums, called pockets. Bacteria trigger the body's immune system to produce enzymes. These enzymes destroy the bone surrounding the teeth, which ultimately leads to tooth loss.
What is a ultrasonic scaler?
To fight periodontal disease, we need to reduce plaque, tartar, and the number of bacteria in the pockets in your mouth. One device we use to remove calculus from teeth is an ultrasonic sealer. It consists of a wand with a small scaling tip that produces a soft ultrasonic vibration. The small, quick vibrations in combination with a water flow give us a whole new level of effectiveness in calculus removal. The benefits of ultrasonic scaling include:
Increased efficiency of calculus removal
Less need for hand scaling of stubborn deposits
More comfortable access to the root surfaces, thanks to the small tip
Ultrasonic scaling removes calculus and reduces the number of harmful bacteria below the gum line. It is an important tool in the prevention and treatment of periodontal disease.
Scaling & Root Planing
Routine cleanings in our office remove plaque and tartar that exist on your teeth above the gum line, but sometimes, especially if you don't floss regularly, plaque, tartar and bacterial toxins can develop below the gum line. The goal of scaling and root planing is to remove this source of periodontal infection from below the gum line on the surfaces of the roots.
The procedure
Normally, we'll spread scaling and root planing over several appointments. This will maximize your comfort and allows us to check on the healing and help you fine-tune your homecare efforts.
To keep you comfortable, we may give you local anesthetic before the procedure begins. Then we'll use either a small scaling instrument or an ultrasonic sealer to carefully and meticulously remove plaque and tartar from the top of your tooth all the way down to the bottom of the pocket.
Then, we'll plane — or smooth — the root surfaces so your gums can heal and reattach to your teeth. If it appears to be necessary, an antibiotic or alternative medication will be placed in the pocket after it's been scaled and planed to control infection and promote healing. Oral antibiotics might also be prescribed to further combat the infection. Once the source of infection has been removed, your gums will begin to heal, and will once again tighten around your teeth.
Maintaining periodontal health
Homecare is the key to continuing the healing process. Since brushing and flossing only removes plaque about three millimeters below the gum line, you'll need special tools to clean the affected areas. As part of your treatment, we'll provide you with the tools and techniques you'll need to thoroughly clean and maintain these areas.
Arestin
What is periodontal disease?
One-third of the American population is affected by periodontal disease, a chronic bacterial infection of the gums, teeth, and bone that surrounds the teeth. Periodontal disease occurs when bacteria build up on your teeth and gums, causing your gums to become red and swollen.
Left untreated, this inflammation eventually results in damage to the ligaments and bone that hold your teeth in place. This damage causes pockets to form around your teeth. As the disease progresses and the pockets deepen, your teeth can become loose and fall out. Periodontal disease may also exacerbate other serious health problems, such as cardiovascular disease, osteoporosis, and diabetes.
Arestin can help
Fortunately, we now have a new, effective treatment that helps us control periodontal disease and its destructive effects. Its called Arestin, and ifs used in conjunction with scaling and root planing to reduce the number of harmful bacteria in your periodontal pockets and restore the area to health.
Arestin is an antibiotic in powder form. We painlessly insert the powder into your periodontal pockets, where it combines with moisture in your mouth and adheres immediately to the infected gum tissue. The individual powder particles, called microspheres, release a controlled, steady flow of the active ingredient minocycline, a potent antibiotic. This sustained-release process allows Arestin to fight your periodontal infection for at least 21 days.
When used together with scaling and root planing, Arestin significantly reduces the depth of the infected pockets and helps to prevent the progression of periodontal disease. Arestin has also been shown to be effective even in the most difficult-to-treat cases of periodontal disease, such as those experienced by smokers or patients with cardiovascular disease. However, Arestin's active ingredient is in the tetracycline family of antibiotics, so we won't use it to treat your infection if you are allergic to tetracycline, or if you're pregnant or nursing.
Periodontal disease is chronic, which means it can persist for a long time and may never be cured. It’s vital that we treat it aggressively to keep it under control. Arestin is an important part of your overall periodontal therapy program, which we have designed to prevent further destruction of bone and connective tissue, and to restore health to your gums
