What is periodontal (gum) disease?
Periodontitis is an infection of the gum and bone tissue caused by bacteria that establishes below the gumline, creating a deeper pocket which is impossible for a patient to clean out with regular brushing and flossing. It is the most common cause of tooth loss in adults. This infection is exacerbated by conditions such as smoking, diabetes, genetics, osteoporosis, menopause, immunosuppression, xerostomia (dry mouth), medications, poor home care and irregular professional cleanings. Diagnosis is made with a periodontal probe which measures the depth of a pocket, which in health should be 3 millimeters (mm) or less. If the reading is 4 mm or more, you may have gum disease. Clinical signs such as bleeding, puffy gums and radiographs (x-rays) are also used to establish a diagnosis. Other conditions may mimick gum disease and create deeper pockets such as root fractures or root canal (nerve) infections.
How do you treat gum disease?
There are 2 major categories for treating gum disease, nonsurgical and surgical. Nonsurgical treatment includes scaling and root planing (deep cleanings), oral rinses, local antibiotics, systemic antibiotics (combined with bacterial DNA testing), and host modulation medications. Surgery involves incisions along the gumline to gain better access to the gum infection and regenerate lost bone when possible. Laser therapy offers a more minimally invasive approach to gum treatment. Nonsurgical treatment is more conservative and less expensive, however, surgery gives the surgeon increased access to remove infection from the root surface and can be more effective.
What is the relationship between oral health and overall health?
Bacteria from the mouth can travel through the bloodstream and cause inflammation or immune reactions in other parts of the body. Conversely, medical conditions that affect the body's defense system ( i.e. diabetes) can increase the risk of gum infection. Healthy gums are an important part of an overall healthy body.
When do I need to see a periodontist (gum specialist)?
a. If you notice red, swollen, bleeding gums, loose teeth, or bad breath.
b. If you notice receding gums or cold temperature sensitivity.
c. If you want to replace missing teeth with dental implants
d. If you see any unusual looking red/white lesions or non-healing ulcers in your mouth
e. If you have a dry, burning mouth
f. If you have been told by your general dentist to go see a gum specialist!
Why do I need to keep seeing the periodontist after treatment is completed?
We treat, not cure, gum disease. This means the bacteria can re-establish below the gumline and cause more infection, pocketing and bone loss We will alternate regular 3-4 month cleanings with your general dentist in order to keep a close watch for any return of the infection and remove bacteria and tartar before they slip below the gumline again. Studies have shown that patients who receive regular 3 month maintenance cleanings can be more stable with their gum health.
What dental products do you recommend?
Power toothbrushes have been shown to be more effective in plaque/bacterial removal than regular manual brushes. Many types of flosses can work well, but waxed floss and dental tapes might make it easier to slide between two teeth. Oral rinses that kill bacteria can be effective, especially when good brushing and flossing lightens the bacterial load first. Oral irrigators are a good adjunctive method of removing loose plaque and food debris. Interdental cleaning brushes can be more effective than flossing at removing food and debris between teeth, but you have to have enough room for them to fit. Any toothpaste with fluoride should be effective, just pick your favorite brand and select the type that fits your needs the most ( tartar-control. whitening, sensitivity protection, etc.).
What are dental implants?
Implants are titanium screws that are placed in the jaw bone to support crowns, bridges or dentures. Adjacent teeth do not have to be ground down, implants stand on their own foundation of bone. Implants must have adequate bone to support them, and bone augmentation procedures may be necessary to develop a site before an implant is placed. Implants have a high rate of success (>90%) in healthy individuals that properly care for and maintain them with good oral hygiene.
What can I do about receding gums?
Gum recession is usually caused by overzealous brushing on the gumline, resulting in root exposure, cold temperature sensitivity, inadequate thick tissue, and in severe cases may lead to gum disease and tooth loss. The treatment consists of a soft tissue graft to augment thicker tissue and cover parts of the exposed root. Grafts can reduce further gum recession, protect teeth from root decay, and improve overall gum health.
What is obstructive sleep apnea (OSA)?
OSA is one end of a breathing dysfunction continuum related to increasing airflow resistance. Lower levels of resistance cause the throat tissue to vibrate, resulting in snoring. As the resistance increases, it forces the person to work harder to breathe (upper airway resistance syndrome). Higher levels of resistance lead to partial or complete airway collapse resulting in decreased blood oxygen levels (obstructive sleep apnea).
What are symptoms of OSA?
Symptoms include snoring, daytime sleepiness, memory loss, diminished sex drive, personality changes, restless, non-restorative sleep, choking and/or gasping, esophageal reflux, nocturnal sweating and frequent nighttime bathroom stops. Snoring and OSA can be related to hypertension, cardiovascular disease, type 2 diabetes, asthma, Alzheimer's disease, fibromyalgia, headaches, sleep bruxism, and weight gain