Periodontal disease, often called gum disease, affects the gums, teeth and jaw bone. There are several types of gum disease, and the milder forms can progress into the more serious forms if left untreated. There are several treatment options for periodontal disease, and they depend on the type and severity of the condition.
Classification
Periodontal disease has been classified into different types by the American Dental Association (ADA). Gingivitis is called Case Type I. It causes swollen and bleeding gums. Bad breath, or halitosis, is often present as well. A distinguishing feature of this class is that the damage is limited to the gum tissue at this stage.
Early periodontitis is called Class Type II. It exhibits the same symptoms as gingivitis, only more severe. The gums may begin to recede in this phase. The biggest indicator that the disease has progressed beyond gingivitis is that connective tissue damage and some jaw bone loss may also occur. Moderate periodontitis is called Class Type III, and it includes Class Type II's symptoms. In addition, there is more profound bone loss. Pockets or recesses may develop in the gums. Teeth can begin to shift due to bone loss and the degeneration of connective tissue. Advanced periodontitis is called Class Type IV. It includes the symptoms of Class Type III, and bone loss is more widespread. The gums will definitely bleed when probed. Shifting of teeth and even loss of teeth can occur at this stage.
Prevention/Solution
Preventing gum disease may be the best course to ensure that permanent damage isn't sustained by the gums or connective tissue. Proper oral hygiene is the first defense. Brushing at least twice a day, preferably after each meal, is a minimum standard. Flossing daily greatly reduces the amount of bacteria along the gum line, which is what causes inflammation and leads to gum disease. Professional cleanings twice a year can reduce the tartar or plaque that may have formed over time. A dentist can also let you know the condition of your gums and alert you of early signs of disease.
Deep Cleaning
To treat periodontal disease, the bacteria and plaque that resides below the gum line must be removed. To do this, a dentist or periodontist will need to perform a more invasive cleaning procedure. By doing a deep cleaning, the gums will be more likely to heal and reattach to the teeth. This makes it harder for bacteria to get beneath the gums and develop into gum disease again. There are two main types of deep cleaning procedures: root planing and scaling. Root planing removes spots of plaque and bacteria from below the gums. It also smoothes out the root of the tooth, which allows the gums to heal and reattach to the tooth more easily. Scaling is a procedure that removes toxins, plaque, tartar and dentin that is rough from around and under the gum line. If pockets or recesses have formed in the gums, they can also be cleaned out with scaling. Both root planing and scaling can be uncomfortable procedures, and the gums will experience swelling and bleeding as they heal after the cleanings. According to Dr. Jeffrey Wissot, "one common side effect of periodontal scaling is sensitivity to hot and cold, due to exposed roots after the gum shrinks. Conscientious oral hygiene, use of a desensitizing toothpaste and 'tincture of time' usually minimizes the sensitivity."
Flap Surgery
Sometimes dental professionals need to cut a flap in the gums then pull them away from the teeth so that they can remove all of the matter from beneath them. Hard plaque and deposits that form lower beneath the gums in more severe cases of periodontal disease may respond better to this treatment. The gums are then stitched back in place, and they will be able to firmly adhere to the teeth again.
Flap surgery is often used when root planing or scaling weren't effective at removing all of the debris below the gum line.
Antibiotics
Antibiotics can be used to treat periodontal disease as well. Oral and topical antibiotics can both be used to treat periodontal disease. Topical antibiotics can be in the form of gel, tiny capsules, a chip or strips. Antibiotics can be applied directly to the gums or under them. Antibiotics treat the bacterial infection that causes periodontal disease. They also offer protection for patients with heart disease who have dental surgery. The antibiotic acts to prevent infections in the cardiovascular systems. Antibiotics prevent further infection in the gums when applied directly to the affected areas. These topical treatments remain in the mouth for a period of time and release low doses of antibiotic over a period of time.
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