Professional diagnosis and the treatment and maintenance of Periodontal (Gum) disease
Clean teeth and good oral hygiene is not only important to keep your teeth clean and white, but for your general health as well, specifically to avoid problems such as gum disease, bone loss, bad breath and decay.
It is very important to keep your teeth clean to prevent gum disease. Dr Finkelstein confirms that gum disease is linked to heart disease such as strokes and heart attacks as well as other health issues such as diabetes, rheumatoid arthritis, low birth rate and pre term births.
What is Peridontal Disease?
Periodontal disease is a common and often, painful, inflammatory condition which affects the gums. It attacks the supporting and surrounding soft tissues of the tooth, and in the advanced stage, can even affect the jawbone.
Types of Periodontal Disease
Gingivitis is a bacterial infection of the gum tissue and is caused when plaque is allowed to build up on the teeth, and the toxins contained in the plaque produce a bacterial infection which results in irritation and inflammation of the gum tissues.
If left untreated, gingivitis can spread below the gum line and cause a chronic inflammatory condition which could cause the body to breakdown and destroy its own bone and soft tissue.
It is very important that people suffering from a lowered immunity for whatever reason seek treatment immediately for this condition.
Periodontal disease is a progressive condition that can eventually result in destruction of the connective tissue surrounding the teeth and the jawbone. Obviously if not, treated, this could result in the teeth becoming loose, shifting positions and could eventually lead in the teeth being lost.
Chronic Periodontitis is when the inflammation of the supporting tissue causes deep pockets and gum recession is usually visible, appearing as “tooth lengthening”. In actual fact this is the result of the gums (gingiva) shrinking and receding. This is the most common form of periodontal disease seen amongs adults.
Aggressive Periodontitis occurs in otherwise apparently healthy patients and is remarkable for the rapid loss of gum attachment and chronic bone destruction.
Necrotizing Periodontitis is usually found in people who are suffering from immunosuppression, HIV or malnutrition. Necrosis (or death of tissue) would occur in the gingival tissues such as Alveolar bone and periodontal ligaments.
Periodontitis can also be caused by medical conditions such as Diabetes, Cardiac Disease or Respiratory disease and can occur at an early age.
Causes of Gum Disease
- Poor dental hygiene Tobacco use
- Pregnancy and Menopause
- Chronic stress and poor diet
- Grinding of teeth
Symptoms of Gum Disease
Common signs and symptoms of gum problems are:
- Unexplained bleeding, often without pain, produced when brushing, flossing or eating food is the most common symptom.
- Swelling, redness and pain of the gums.
- Longer looking gums due to gum recession giving credence to the old expression “that one gets long in the tooth as one ages” The teeth appear longer and the smile appears “toothy”
- Bad smelling breath or “Halitosis” which is caused by food particles which have become trapped between the teeth or under the gum line in the deep pockets that occur. Halitosis can be due to food that we eat, smoking or other conditions but is often a good indicator of gum disease
- Loose teeth or inability to masticate food due to the loosening and misplacement of teeth due to detachment of the teeth from the jawbone because of the destructive effect of the Periodontitis on the ligaments and gum tissue.
- Pus can sometimes be observed oozing out from the pockets or spaces around the teeth. This is a sign of severe Periodontitis.
Diagnosis of Gum Disease
Periodontal Gum disease is easily diagnosed by a General Dentist or a Dental Hygienist during a normal dental examination, which should be part of your health routine every 6 months.
A periodontal probe is used very gently to assess the condition of each tooth. Surrounding each tooth is a pocket or sulcus , rather like a moat around a castle. If the gums are healthy this space measures only three millimeters or less. A deeper pocket and other signs of inflammation , such as bleeding, swelling or redness would indicate the presence of Periodontal gum disease.
There are 3 categories or stages of Peridontal disease:
Stage 1. Gingivitis “inflammation of the gum”
- The first stage of gum disease is caused by the build-up of plaque which produces toxins which irritate the gums making them tender red, and inflamed, There is often a little bleeding. This is usually noticed by the patients who report seeing blood on their toothbrushes.
Stage 2. Periodontitis “Inflammation around the tooth”
When the plaque hardens , it forms calculus (tartar) , which causes the gums to recede away from the teeth, causing spaces or pockets , These pockets become filled with food particles, bacteria and sometimes, pus.
The gums become very irritated, inflamed, and bleed easily. Some patients do report discomfort. Sometimes there is a slight to moderate amount of bone loss , which can be revealed by X-Ray.
Stage 3. Advanced Periodontitis
Because the gums, bone and periodontal ligaments holding the teeth in place are destroyed, they can no longer continue to support the teeth satisfactorily. Unless treated immediately, these affected teeth become very loose in their sockets and may be lost.
Moderate to severe bone loss is usually apparent on X-ray examination.
Treatment of Gum Disease
Initial diagnosis and treatment of this condition would be carried out in our office by Dr Michael Finkelstein and his team. Advanced cases would be referred to a Specialist Periodontist.
After a complete periodontal examination and X-Rays of the mouth and jaw, the following Prophylactic procedure would be put into place;
- Scaling and polish, with root planing.
- The calculus (tartar) surrounding the teeth, which produces the bacteria causing the infection, is removed. This is done gently either by using manual scalers or a water driven device.
- If there are “gum pockets” surrounding the teeth, these are assessed, measured and cleaned
- If necessary, antibiotics and a prescription mouthwash are prescribed to alleviate the symptoms.
- A simple but effective daily cleaning routine is explained to the patient, including the use of special tooth brushes, dental floss, piksters, and mouthwash .
- Tissue regeneration is used if gum tissue and bone have been destroyed. Grafting procedures can be used to encourage regrowth, this consists of inserting a membrane into the affected areas to accelerate the regeneneration process.
- Pocket Elimination Surgery or “flap surgery” can be performed to reduce the size of the space or pockets between the teeth and the gums. Surgery on the jawbone is another method which helps eliminate the indentations in the bone which may house the bacteria.
If unfortunately teeth have been lost due to periodontal disease, replacement teeth can be implanted into the jawbone in order to restore the functionality of the mouth. Tissue regeneration procedures to strengthen the jawbone may be necessary before the dental implant is placed. To read more about Dental Implants, please click here.
Gum Disease Maintenance
Periodontal Disease can be prevented and corrected by diligent maintenance both at home and through regular dental appointments. At home it is vital to:
- Control build-up of tartar through daily brushing and flossing
- Use the correct methods of cleaning – Dr Finekstein will assist you with teaching you the correct methods
- Use the correct aids such as toothbrushes, dental floss, mouth rinses – We can recommend the correct aids to assist maintenance
However it is important for the patient to have regular 6 monthly check ups and if necessary, Periodontal maintenance at least twice a year from your Dentist.
In addition to the Periodontal cleaning, your gum disease maintenance appointment will also include:
- Diagnostic X-rays for detection of decay, tumors, cysts, bone-loss and determination of tooth and tooth positions.
- Valuation of existing restorations
- Checking the surfaces of all the teeth for possible decay
- Oral Hygiene instructions and recommendations including the introduction to the latest methods and techniques, electric and other new toothbrushes, fluorides , rinses etc
- Removal of stains
It has to be stressed that good hygiene practices combined with regular gum disease maintenance and cleanings are essential for controlling periodontal disease and for maintaining perfect dental health.
Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.
Dr Michael Finkelstein BDS
For further information of gum disease or any of our other treatments such as Porcelain On-lays, Root Canals, Sleep Apnoea, Tooth Fillings, Wisdom Teeth Removal or Night Guards, please contact our friendly staff on 9262 7778.