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Gum & Periodontitis
How do I know if I have gum disease? During an exam or a cleaning, we will measure the space between your tooth and your gums: under 3 mm is healthy, 4 mm and above is a sign of disease and infection.
How do I control my gum disease? Gum disease can't be cured, but it can be controlled. Our goal is for you to keep your teeth. We have the easy part, to remove the source of infection and promote healing. Your responsibility is to keep your teeth clean, and return for regular cleaning maintenance (usually every 3-4 months until your tissues become healthier). A basic cleaning will not remove the source of infection if you have spaces greater than 3 mm under your gums. This is when we will need to do a deeper cleaning (called scaling and root planing), and will clean the surfaces of the roots below your gums. Because this can be sensitive, we will numb these areas before we start. This can take several appointments to properly provide this deep cleaning treatment. If you have pockets 5 mm or greater, we will recommend placing medicine in these deeper areas after the deep cleaning is done. This will promote healing of the tissues, and usually shrinks those pockets to a healthier level. We will do everything we can to reduce the need for gum surgery by a specialist, yet despite our best attempts sometimes your body will not respond as well as it should. In this instance a periodontist will help you keep your gums healthy and maintain your teeth.
What kind of medicine do you use to help my gums heal? If you have pocket depths (the distance from the top to the bottom of your gums along side your teeth) between 5-8mm, you are an ideal candidate to receive either the Arestin treatment. The whole idea is simple: a small amount of medicine, having antibacterial properties is placed in the deepest pockets of your teeth after a deep cleaning by the hygienist. That's it! We will make a follow up appointment verify your improvements. This sure beats having to go to a specialist. This does not treat everything, because not all patients respond the same.
What is Periodontal Disease? The main cause of periodontal disease is bacteria in the form of a sticky, colorless plaque that constantly forms on your teeth; however, many other factors can cause periodontal (gum) disease or influence its progression. In its first stages, the disease is known as Gingivitis. Gingivitis is caused by the accumulation of bacterial plaque, resulting in inflammation of the gingiva. Spontaneous untreated healing rarely occurs.
According to a recent US government report, approximately 80 - 90% of all adults in the US have some degree of periodontal disease, and more than one third of the elderly population have at least one site with more than 6mm pockets. The prevalence of the disease increases steadily with age: 40% of persons who are aged 65 years and older with teeth, have at least 1 site with greater than 5 mm loss of attachment and 26% of adults have completely lost all of their teeth by age 65. Periodontal disease is especially prevalent in people who smoke , and it may be increased amongst those who abuse alcohol or are on an insufficient diet. Poor oral hygiene, certain medications, and specific illnesses such as diabetes and AIDS, also increase the risk of periodontitis.
In recent years, growing evidence supports the theory of a link between periodontal disease and other diseases like heart disease, stroke, uncontrolled diabetes, preterm births and respiratory disease. More research needs to be done to say definitively determine that people with periodontal disease are at higher risk for developing these diseases, but evidence does support the fact that there is an association between periodontitis and a large variety of systemic diseases.
Non-Surgical Treatments
The American Academy of Periodontology treatment guidelines stress that periodontal health should be achieved in the least invasive and most cost-effective manner. This is often accomplished through non-surgical periodontal treatment, including scaling and root planing (a careful cleaning of the root surfaces to remove plaque and calculus [tartar] from deep periodontal pockets and to smooth the tooth root to remove infection and bacterial toxins), followed by adjunctive therapy such as local delivery antimicrobials (Arestin). If you have pocket depths in the range of 5-8mm, you are an ideal candidate to receive the Arestin treatment.
Following the scaling and root planning, and placement of either the Arestin in the deeper pockets, the majority of patients will require ongoing maintenance therapy to sustain health. Non-surgical therapy does have its limitations, however, and when it does not achieve periodontal health, surgery may be indicated to restore periodontal anatomy damaged by periodontal diseases and to facilitate oral hygiene practices.
Where Do I Go For Information?
Arestin.com
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