The most common cause of periodontal and gum disease is plaque buildup, often the result of poor oral hygiene habits such as inadequate brushing, flossing, and rinsing. Plaque eventually leads to tartar, a substance that eats away enamel and causes inflammation and infection. Tartar can also reach below the gum line, making the teeth harder to clean and maintain.
Other common risk factors include diabetes, hormonal changes in girls and women, medications that decrease saliva flow, certain illnesses, and genetics. According to the CDC, signs or symptoms related to periodontal disease include:
An osseous procedure is a periodontal treatment that reduces or completely eliminates bacteria living in pockets underneath the gums. explains that during the procedure , a surgeon cuts back the patient’s gums, removes the bacteria, and repairs damaged bone. Hard tissue procedures primarily curb the progression of gum disease but can also involve treating the enamel, dentin, and cementum.
In both hard tissue and osseous procedures, the primary goal is to remove bacteria from the pockets to prevent the spread of infection and disease. With advancements in modern dental technology, these procedures can be done using a laser that burns bacteria without coming close to the nerves, roots, or bone. Once the gums are reattached and sewn, they naturally heal and cling onto the tooth, slightly tighter than they were before.
Typically, patients are screened for gum and periodontal disease during their routine check-ups. Dentists can identify and diagnose periodontal disease by checking for gum bleeding, swelling, firmness, and pocket depth (space between teeth and gum line). They also assess teeth movement, sensitivity, and proper alignment. If there are concerning symptoms, they may also examine the patient’s jawbone to detect any broken bones surrounding the teeth.
The three stages of periodontal disease are gingivitis, periodontitis, and advanced periodontitis. Gingivitis is the beginning stage and refers to inflammation of the gums. Treatments for gingivitis include a professional cleaning and special mouthwash that eliminates bacteria from the gums. Periodontitis, the second stage, occurs when bacteria or infection has spread beneath the gum line. This stage is also reversible and can be treated by professionally cleaning the pockets using a special tool. Advanced periodontitis, the final stage, refers to when the infection damages the underlying bone and surrounding tissues, causing tooth loss or severe shifting.
There are a variety of ways patients can prevent the development and progression of periodontal disease. First and foremost, practicing adequate oral hygiene habits is essential for proper oral care and function. The American Academy of Periodontology suggests doing the following to prevent periodontal disease:
Brushing after meals can help remove food debris and plaque trapped between the teeth and gums; especially if one thoroughly brushes the tongue.
Flossing at least once a day can help remove food particles and plaque between teeth and along the gum line that your toothbrush cannot quite reach.
Using a mouthwash helps reduce plaque and can remove remaining food particles that brushing and flossing missed.
Age, smoking, diet, and genetics can all increase the risk for periodontal disease. If at increased risk, be sure to talk with the dental professional.
Get an annual comprehensive periodontal evaluation (CPE) from a dental professional. A CPE looks at the teeth, plaque level, gums, bite, bone structure, and other risk factors for periodontal disease. Identifying symptoms of gum disease early is key to protecting the teeth and gums.
In severe cases and advanced stages, some patients may require periodontal surgery to effectively remove an infection. Periodontal surgery consists of a variety of treatments that target different regions of the mouth. Surgical procedures include flap surgery, bone grafting, guided tissue regeneration, or soft tissue grafts.
During periodontal surgery, a small cut or cuts are made in the gums, lifting back a section of tissue. This allows the periodontist to remove tartar, bacteria, and infection from the gum sockets and the teeth. The gums are then reattached to fit more securely on the teeth. The entire process takes about two hours and the recovery period can take up to two weeks.
During the consultation appointment, periodontists often review the patient’s health history and referral form to better understand their case. They will conduct their own examination and assessment which involves looking for indications of jaw dysfunction, gum recession, loss of bone, and/or periodontal disease. Using a periodontal probe, they will measure the pocket depths between the gums and teeth to determine whether a patient has the disease and what stage they are currently in.
Periodontists work primarily with the hard tissues of the mouth. They are also specially trained in oral surgical procedures, meaning they can perform tooth extractions, bone grafting, dental implant placement, and various cosmetic procedures.
Periodontal disease can be treated in a variety of ways depending on the patient’s case of level of severity. Non-surgical methods, such as scaling and planing or antibiotic therapy, can be done if the infection is caught in its early stages. In gum disease and periodontitis, periodontal surgery is often required to effectively remove the infection.
Although gum and periodontal disease are often the result of inadequate brushing and flossing, many genetic and environmental factors can also cause disease. Periodontitis and periodontal disease have been linked to systemic illnesses, including stroke, heart disease, diabetes, and certain types of cancer. A periodontist can help you understand your risk factors.
In the beginning stages, patients commonly experience swollen, bleeding gums, bad breath, and increased tooth sensitivity. In later stages, they may begin to notice loose or shifting teeth, and eventually, bone and tooth loss. It is important to seek a periodontist when first noticing early symptoms.
Bacterial plaque is a sticky film consisting of bacteria that coats teeth and can lead to tooth decay without proper oral hygiene.
Alveolar bone loss occurs when the bone containing the tooth sockets in the mouth decreases due to infection or resorption.
Calculus, also known as tartar, refers to the hardened dental plaque that forms on teeth due to a lack of proper oral hygiene.
A comprehensive periodontal evaluation is an effective and professional method for examining a patient’s teeth, plaque, gums, bite, bone structure and any potential risk factors to one’s oral health.
A dental prophylaxis is a thorough cleaning procedure that helps to prevent periodontal disease, gingivitis and the spread of plaque on the teeth.
Gingival flap surgery is a procedure in which the periodontist separates the gums from the teeth temporarily to reach the root of the tooth and nearby bone.
An inflammatory disease can result from oral inflammation and can lead to other disorders such as a heart attack, stroke, diabetes, kidney disease, sleep apnea and more.
A necrotizing periodontal disease is a disease that involves the necrosis of gingival tissues and lesions forming in the mouth.
Peri-Implantitis refers to the inflammation of the soft and hard gum tissue that surrounds a dental implant and can be a result of losing supporting bone.
A periapical abscess is an abscess that forms from inflammation containing pus in the tissue surrounding the tooth.
A periodontal ligament is a tissue that connects the tooth to the bone and is destroyed by advanced periodontal disease.
Periodontal pockets form when disease destroys surrounding bone and tissue, resulting in pockets that can create space for bacteria to live in.
Periodontitis is a lethal gum infection that results from poor oral hygiene, damaging soft tissue and destroying the bones that support the teeth.
The periodontium is the tissue that surrounds and supports the teeth, gums, periodontal ligament and bone.
Regenerative procedures can include services such as bone grafting that replaces missing bone in the jaw with bone from the patient, a donor or a substitute material.
Root scaling and planing is a non-surgical procedure that involves removing plaque and calculus from the pockets around the root before smoothing the surfaces of the root to help everything heal.
During a root scaling procedure to remove tartar from the surface of the teeth, a professional will also use root surface debridement to ensure the teeth are clean.
