FAQs
What is Periodontal Disease?
Periodontal (gum) diseases, including gingivitis and periodontitis, are serious infections that, left untreated, can lead to tooth loss. The word periodontal literally means “around the tooth.” Periodontal disease is a chronic bacterial infection that affects the gums and bone supporting the teeth.
Periodontal disease can affect one tooth or many teeth. It begins when the bacteria in plaque (the sticky, colorless film that constantly forms on your teeth) causes the gums to become inflamed.
In the mildest form of the disease, gingivitis, the gums redden, swell and bleed easily. There is usually little or no discomfort. Gingivitis is often caused by inadequate oral hygiene. Gingivitis is reversible with professional treatment and good oral home care.
Untreated gingivitis can advance to periodontitis. With time, plaque can spread and grow below the gum line. Toxins produced by the bacteria in plaque irritate the gums. The toxins stimulate a chronic inflammatory response in which the body in essence turns on itself, and the tissues and bone that support the teeth are broken down and destroyed. Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. Often, this destructive process has very mild symptoms. Eventually, teeth can become loose and may have to be removed.
Causes of Periodontal Disease
The main cause of periodontal disease is bacterial plaque, a sticky, colorless film that constantly forms on your teeth. However, factors like the following also affect the health of your gums.
Smoking/Tobacco Use
As you probably already know, tobacco use is linked with many serious illnesses such as cancer, lung disease and heart disease, as well as numerous other health problems. What you may not know is that tobacco users also are at increased risk for periodontal disease. In fact, recent studies have shown that tobacco use may be one of the most significant risk factors in the development and progression of periodontal disease.
Genetics
Research proves that up to 30% of the population may be genetically susceptible to gum disease. Despite aggressive oral care habits, these people may be six times more likely to develop periodontal disease. Identifying these people with a genetic test before they even show signs of the disease and getting them into early interventive treatment may help them keep their teeth for a lifetime.
Pregnancy and Puberty
As a woman, you know that your health needs are unique. You know that brushing and flossing daily, a healthy diet, and regular exercise are all important to help you stay in shape. You also know that at specific times in your life, you need to take extra care of yourself. Times when you mature and change, for example, puberty or menopause, and times when you have special health needs, such as menstruation or pregnancy. During these particular times, your body experiences hormonal changes. These changes can affect many of the tissues in your body, including your gums. Your gums can become sensitive, and at times react strongly to the hormonal fluctuations. This may make you more susceptible to gum disease. Additionally, recent studies suggest that pregnant women with gum disease are seven times more likely to deliver preterm, low birth weight babies.
Stress
As you probably already know, stress is linked to many serious conditions such as hypertension, cancer, and numerous other health problems. What you may not know is that stress also is a risk factor for periodontal disease. Research demonstrates that stress can make it more difficult for the body to fight off infection, including periodontal diseases.
Medications
Some drugs, such as oral contraceptives, anti-depressants, and certain heart medicines, can affect your oral health. Just as you notify your pharmacist and other health care providers of all medicines you are taking and any changes in your overall health, you should also inform your dental care provider.
Clenching or Grinding Your Teeth
Has anyone ever told you that you grind your teeth at night? Is your jaw sore from clenching your teeth when you’re taking a test or solving a problem at work? Clenching or grinding your teeth can put excess force on the supporting tissues of the teeth and could speed up the rate at which these periodontal tissues are destroyed.
Diabetes
Diabetes is a disease that causes altered levels of sugar in the blood. Diabetes develops from either a deficiency in insulin production (a hormone that is the key component in the body’s ability to use blood sugars) or the body’s inability to use insulin correctly. According to the American Diabetes Association, approximately 16 million Americans have diabetes; however, more than half have not been diagnosed with this disease. If you are diabetic, you are at higher risk for developing infections, including periodontal diseases. These infections can impair the ability to process and/or utilize insulin, which may cause your diabetes to be more difficult to control and your infection to be more severe than a non-diabetic.
Poor Nutrition
As you may already know, a diet low in important nutrients can compromise the body’s immune system and make it harder for the body to fight off infection. Because periodontal disease is a serious infection, poor nutrition can worsen the condition of your gums.
Other Systemic Diseases
Diseases that interfere with the body’s immune system may worsen the condition of the gums.
Types of Periodontal Disease
There are many forms of periodontal disease. The most common ones include the following.
Gingivitis
Gingivitis is the mildest form of periodontal disease. It causes the gums to become red, swollen, and bleed easily. There is usually little or no discomfort at this stage. Gingivitis is reversible with professional treatment and good at home oral care.
Aggressive Periodontitis
A form of periodontitis that occurs in patients who are otherwise clinically healthy. Common features include rapid attachment loss and bone destruction and familial aggregation.
Chronic Periodontitis
A form of periodontal disease resulting in inflammation within the supporting tissues of the teeth, progressive attachment and bone loss and is characterized by pocket formation and/or recession of the gingiva. It is recognized as the most frequently occurring form of periodontitis. It is prevalent in adults, but can occur at any age. Progression of attachment loss usually occurs slowly, but periods of rapid progression can occur.
Periodontitis as a Manifestation of Systemic Diseases
Periodontititis, often with onset at a young age, associated with one of several systemic diseases, such as diabetes.
Treatment of Periodontal Disease
If you’re diagnosed with periodontal disease, Dr. Sam may recommend periodontal surgery. Periodontal surgery is necessary when your periodontist determines that the tissue around your teeth is unhealthy and cannot be repaired with non-surgical treatment. Following are the four types of surgical treatments most commonly prescribed:
* Pocket Reduction Procedures
* Regenerative Procedures
* Crown Lengthening
* Soft Tissue Grafts
If you’ve already lost a tooth to periodontal disease, you may be interested in dental implants – the permanent tooth replacement option.
What is Scaling and “root planning?”
Periodontal scaling & root planing is a conservative cleaning procedure meant to remove contamination and infection from beneath the gum. Scaling removes deposits of bacterial plaque, calculus, food debris, and pus that have accumulated in the infect pocket due to periodontitis. Root planing smoothes and cleans the root of the tooth so that the gum tissue may heal next to the tooth.
Scaling and root planing is usually performed in one section of the mouth at a time using local anesthesia for your comfort. This non-surgical treatment is often effective in allowing complete healing of early stages of periodontitis and may reduce the extent of surgical treatment needed when performed in more advanced stages of gum disease.
What is Conscious Sedation?
This type of sedation induces an altered state of consciousness that minimizes pain and discomfort through the use of pain relievers and sedatives. Patients, who receive conscious sedation usually are able to speak and respond to verbal cues throughout the procedure, communicating any discomfort they experience. A brief period of amnesia may erase any memory of the procedure.
Conscious sedation provides a safe and effective option for patients undergoing minor surgeries or diagnostic procedures. The number and type of procedures that can be performed using conscious sedation have increased significantly as a result of new technology and state of the art drugs.
Conscious sedation allows patients to recover quickly and resume normal daily activities in a short period of time.
Who Can Administer Conscious Sedation?
Conscious sedation is extremely safe when administered by qualified providers such as those on the staff at Premier Periodontics. Certified Registered Nurse Anesthetists (CRNAs), anesthesiologists, other physicians, dentists, and oral surgeons are qualified providers of conscious sedation. Specifically trained Registered Nurses may assist in the administration of conscious sedation.
Who Should Monitor Conscious Sedation?
Because patients can slip into a deep sleep, proper monitoring of conscious sedation is necessary. Dr. Sam and his staff monitor patient heart rate, blood pressure, breathing, oxygen level and alertness throughout and after the procedure. We remain with the patient at all times during the procedure.
What are the Side Effects of Conscious Sedation?
A brief period of amnesia after the procedure may follow the administration of conscious sedation. Occasional side effects may rarely include headache, hangover, nausea and vomiting or unpleasant memories of the surgical experience.
What Should Patients Expect Immediately Following the Surgical or Diagnostic Procedure?
Written post-operative care instructions should be followed. Patients should not drive a vehicle, operate dangerous equipment or make any important decisions for at least 24 hours after receiving conscious sedation. A follow-up phone call is made by the by our staff to check on the patient’s condition and answer any remaining questions.
Can you fix a “gummy” smile?
Periodontal procedures such as CROWN LENGTHENING are available to lay the groundwork for restorative and cosmetic dentistry and/or to improve the esthetics of your gum line.
You may have wondered about procedures to improve a “gummy” smile because your teeth appear short. Your teeth may actually be the proper lengths, but they’re covered with too much gum tissue. To correct this, Dr. Sam can perform crown lengthening.
During this procedure, excess gum and bone tissue is reshaped to expose more of the natural tooth. This can be done to one tooth, to even your gum line, or to several teeth to expose a natural, broad smile.
Dr. Sam may also recommend crown lengthening to make a restorative or cosmetic dental procedure possible. Perhaps your tooth is decayed, broken below the gum line, or has insufficient tooth structure for a restoration, such as a crown or bridge. Crown lengthening adjusts the gum and bone level to expose more of the tooth so it can be restored.
Whether you have crown lengthening to improve function or esthetics, patients often receive the benefits of both: a beautiful new smile and improved periodontal health – your keys to smiling, eating and speaking with comfort and confidence.
What is Bone Grafting and Guided-Tissue Regeneration?
In the past, the treatment of periodontal (gum) disease was considered to be painful and disfiguring. For many years, the best way to achieve the ultimate goal of therapy (shallow, maintainable pockets) was to do resective surgical procedures that often resulted in the exposure of sensitive root surfaces and the appearance of “long” teeth.
Today, Dr. Sam is often able to restore or regenerate missing bone and attachment around teeth subjected to long-standing periodontal disease. In addition, if you have lost a tooth due to trauma or disease, we can restore or regenerate bone prior to the placement of bridges or implants.
Guided Tissue Regeneration (GTR) refers to procedures that attempt to regenerate lost periodontal structures (bone, periodontal ligament, and connective tissue attachment) that support our teeth. This is accomplished using biocompatible membranes, often in combination with bone grafts and/or tissue stimulating proteins.
Guided Bone Regeneration (GBR) refers to procedures that attempt to regenerate bone prior to the placement of bridges or, more commonly, implants. This is accomplished using bone grafts and biocompatible membranes that keep out tissue and allow the bone to grow.
What is a frenectomy?
A Frenectomy is the surgical removal of a frenum in the mouth. A frenum is a fold of tissue that passes from the movable lip or cheek to the gum. When a frenum is positioned in such a way as to interfere with the normal alignment of teeth or results in pulling away of the gum from the tooth surface causing recession, these are often removed using a surgical process known as a frenectomy.
What is a gingivectomy?
A gingivectomy is necessary when the gums have pulled away from the teeth or receded down the root, creating deep pockets. The pockets make it hard to clean away plaque. Gingivectomy is usually done before gum disease has damaged the bone supporting your teeth.
If you maintain good dental care after surgery, a gingivectomy is likely to help stop gum disease. Your gums should become pink and healthy again.
• Gingivectomy may help keep gum disease from further damaging your gum tissue, teeth, and bones by helping you to clean better around and between your teeth. If bones are damaged, it is more likely that you will lose your teeth.
• Gum disease usually will progress if you do not brush and floss regularly after surgery or if you continue to use tobacco.
• To promote healing, stop all use of tobacco because it decreases your ability to fight infection of your gums and delays healing.
• Regular follow-up with your dentist is important. If your gum disease gets worse, you may need a different type of surgery.
What is a Dental Implant?
Dental implants are a reliable solution
…if disease leads to tooth loss.
At any age, periodontitis, caries, or other diseases can cause tooth loss. Dental implants are then the ideal solution for your missing teeth.
…if an accident leaves you with missing teeth.
Whether in sports activities or daily life – a small accident can cause tooth loss. In this case, too, dental implants restore lost function and appearance.
…if teeth are congenitally missing.
For teeth that never grew at all, dental implants provide a solid foundation for replacement teeth.
How long do implants last?
Long-term studies confirm a success rate of over 95% after 10 years. Careful treatment planning, proper implant placement, regular follow-ups with your dentist, and good oral hygiene are all significant factors that influence the long-term success of your implant.
Are there age restrictions for receiving implants?
In principle, dental implants are suited for adult patients of almost any age. Implants are not for use on children and growing adolescents, as implants would interfere with growth of the jaw.
Advantages of Dental Implants Over Dentures or a Bridge
Every way you look at it, dental implants are a better solution to the problem of missing teeth.
* Esthetic Dental implants look and feel like your own teeth! Since dental implants integrate into the structure of your bone, they prevent the bone loss and gum recession that often accompany bridgework and dentures. No one will ever know that you have a replacement tooth.
* Tooth-saving Dental implants don’t sacrifice the quality of your adjacent teeth like a bridge does because neighboring teeth are not altered to support the implant. More of your own teeth are left untouched, a significant long-term benefit to your oral health!
* Confidence Dental implants will allow you to once again speak and eat with comfort and confidence! They are secure and offer freedom from the irksome clicks and wobbles of dentures. They’ll allow you to say goodbye to worries about misplaced dentures and messy pastes and glues.
* Reliable The success rate of dental implants is highly predictable. They are considered an excellent option for tooth replacement.
A dental implant is an artificial tooth root that a periodontist places into your jaw to hold a replacement tooth or bridge. Dental implants are an ideal option for people in good general oral health who have lost a tooth or teeth due to periodontal disease, an injury, or some other reason.
While high-tech in nature, dental implants are actually more tooth-saving than traditional bridgework, since implants do not rely on neighboring teeth for support.
Dental implants are so natural-looking and feeling, you may forget you ever lost a tooth.You know that your confidence about your teeth affects how you feel about yourself, both personally and professionally. Perhaps you hide your smile because of spaces from missing teeth. Maybe your dentures don’t feel secure. Perhaps you have difficulty chewing. If you are missing one or more teeth and would like to smile, speak and eat again with comfort and confidence, there is good news! Dental implants are teeth that can look and feel just like your own! Under proper conditions, such as placement by a periodontist and diligent patient maintenance, implants can last a lifetime. Long-term studies continue to show improving success rates for implants.
What Dental Implants Can Do…
* Replace one or more teeth without affecting bordering teeth.
* Support a bridge and eliminate the need for a removable partial denture.
* Provide support for a denture, making it more secure and comfortable.
Are You a Candidate for Dental Implants?
The ideal candidate for a dental implant is in good general and oral health. Adequate bone in your jaw is needed to support the implant, and the best candidates have healthy gum tissues that are free of periodontal disease.
Dental implants are intimately connected with the gum tissues and underlying bone in the mouth. As a skilled periodontist Dr. Sam specializes in precisely these areas. Not only does he have experience working with other dental professionals, he also has the special knowledge, training and facilities that you need to have teeth that look and feel just like your own.
What is an Occlusal Procedure?
This procedure makes corrections to the bite associated with loose, shifting teeth or teeth that are biting too hard. Balancing and evenly distributing the biting and chewing forces on a tooth reduces the looseness and relieves excessive pressures on the supporting gum and bone structures.
What is an Osseous Procedure?
Osseous surgery is designed to modify and reshape deformities in the alveolar bone surrounding the teeth. It is a common requirement in effective treatment of more involved periodontal diseases. In some instances, the bony support of the tooth assumes an unusual configuration as a result of uneven progression of the disease. When this occurs, modification of the altered bone support may be indicated.
This surgical procedure is used to smooth/correct defects and irregularities in the bone surrounding the diseased teeth with the ultimate goal of reducing or eliminating the periodontal pockets.
What is a tissue grafting procedure?
This procedure is designed to replace or enhance the amount of gum supporting a tooth. Coverage of root surfaces exposed due to previous recession is also possible to achieve. These procedures are performed when there is inadequate gum remaining to help support a tooth or excessive recession has occurred exposing the root of the tooth.
There are basically TWO types of Gum Grafts (Free gingival grafts):
Sub-marginal Graft
This type of graft is the most predictable and is not meant to cover the root surface that has been exposed. It is meant to be placed at the current gum margin and to protect the underlying bone with a layer of tougher keratinized gum tissue that has been transplanted from another site. (usually the roof of the mouth).
Root Coverage:
This type of gum graft is designed to cover the root surface. It is not as predictable as the sub-marginal graft and is meant to be placed in areas that are highly visible such as the upper front teeth. This type of graft can be performed in several ways and may sometimes take two surgical steps.
The most common method is a Connective Tissue Graft. The gum is taken from the palatal sub-mucosal tissue and then placed directly over the root; there tends to be more discomfort post-surgically. Recently, there has been developed synthetic tissue without the need for a donor area (palate); this makes the procedure much more pleasant, but again is not fully predictable.