What is periodontal disease?
Periodontal disease is an illness that affects the gums and the bone around the teeth. It is caused by harmful bacteria that accumulate around the teeth, resulting in buildup of a soft film on the teeth called plaque. If not removed the plaque hardens to tartar, and the bacterial buildup causes the gums to break down, bleed, and detach from the teeth, creating spaces called "pockets". Pockets unfortunately allow more bacteria to accumulate. This buildup can eventually lead to the deterioration of the bone that secures the teeth in place. Periodontal disease can cause you to lose your teeth. It has also been linked to a variety of other health problems, including heart disease and diabetes.
How serious is it?
Well it's important to understand that periodontal disease is quite common. Over 50% of the US population is estimated to have it, although the severe cases are only about 10%. It ranges in severity from gingivitis, which is limited to inflammation of the gums, to aggressive periodontal disease, in which the deterioration of gums and bone is rapid despite the patient's otherwise good health. Chronic periodontal disease is progressive and causes damage more slowly. Gingivitis is easily reversible with improved hygiene, but left unchecked it can lead to full blown periodontal disease, which should not be taken lightly.
Why is it called a disease?
Periodontal disease is caused by microorganisms that invade the body. It is not an injury and is not injury related.
Is it contagious?
How do you get periodontal disease?
Typically, when you fail to keep your teeth sufficiently clean by routine daily brushing and flossing, harmful bacteria begin to proliferate around the base of the teeth. That sets in motion the process I described above - increasing bacterial infection, deterioration of the gums and bone, and eventual loss of teeth.
Is it curable?
The good news is that yes, periodontal disease is curable. A variety of therapies are available, including treatment with drugs that kill the harmful bacteria, scaling and root planning ("deep cleaning"), periodontal surgery, and more advanced techniques such as Laser surgery and Perioscopy. More importantly, periodontal disease is preventable and controllable, primarily through the adoption of healthy habits. Keep your teeth clean, and have routine checkups, and you probably won't ever experience it.
Can you get it again?
Periodontal disease may return, mostly depending on the way you take care of your oral health. Consistent daily habits of thorough teeth cleaning, along with periodic visits for periodontal cleanings and examinations, are highly effective at preventing its recurrence.
How do you know you have periodontal disease?
The first signs are typically bleeding of the gums when you brush your teeth. There should be no bleeding when you brush or floss, even though some people may believe that's "normal".
You can sometimes see tartar accumulating on your teeth. It is yellowish and very hard, and sticks to your teeth like plaster.
Bleeding gums and visible tartar are most likely accompanied by the deterioration of the gums that form "pockets". You can't see them, but to understand pockets, visualize a well-fitting turtleneck sweater. The neck is snug against your skin. That is how healthy gums fit around your teeth.
However as the sweater wears, the neck may become baggy and form pockets of space around your neck, allowing you to even put your finger in between. Similarly, unhealthy gums do not adhere to the teeth, and they also form pockets. Dr. Gutt can actually insert a probe into the pockets to measure the size of the space.
Pockets are a sure sign that you have periodontal disease. However if you're attentive to the early signs, you can probably arrest the disease before pockets form.
How do you prevent periodontal disease?
Preventing periodontal disease is a matter of adopting healthy habits. First and foremost, you must clean your teeth thoroughly and often. A toothbrush and dental floss are highly effective at removing plaque, which is a soft film that is generated by bacteria in your mouth. Removing the plaque stops the process of bacterial buildup that leads to disease.
You daily oral hygiene should be followed up with periodontal examinations and periodontal cleaning, to ensure that no unhealthy conditions are allowed to develop.
How is periodontal disease treated?
Mild cases of periodontal disease, including gingivitis, are treated with regular cleaning and dental checkups.
More severe cases generally require professional attention, including:
Please visit the Treatment Options section of this site for details on these procedures.
- Deep cleaning (scaling and root planning)
- Periodontal surgery
- LANAP Laser surgery
- Antibiotic therapy
What happens in periodontal surgery?
Surgery is used to reach areas of the teeth that cannot be seen or reached during regular professional teeth cleaning sessions. It allows for deep cleaning of the root surface, removal of diseased tissue, and restoration of the bones, gum, and tissues supporting the teeth. Surgical procedures vary, but the conventional procedure is like this:
- Dr. Gutt lifts ("flaps") the gums away from the tooth and surrounding bone.
- The diseased root surfaces are scraped to remove deposits.
- Natural or synthetic body tissues are grafted into place to regenerate lost gum, bone and connective tissue.
What is LANAP laser therapy?
LANAP is an advanced form of periodontal surgery that uses a slender, probe-like tool containing a tiny fiber to conduct light energy to a pinpoint location under the control of the doctor. The probe is gently inserted underneath the gum line, and the laser energy is pulsed into the infected area. The laser is sensitive to differences in the infected tissue and the non-infected tissue, so it only destroys the infection, leaving healthy gum and bone intact. LANAP laser surgery enables complete removal of the harmful bacteria and tartar buildup beneath the gum line with no scalpels and no sutures, for a much more comfortable patient experience and much shorter post-operative recovery times.
How does it compare to periodontal surgery?
LANAP achieves the equal or better results in comparison to conventional periodontal surgery. The big difference of the laser technique is that it eliminates the bacteria and tartar below the gum line without cutting the gums to expose the roots of the teeth. The major advantages of LANAP laser treatment are that it is more comfortable for the patient, requires less anesthesia, and results in faster recuperation time. It is an alternative treatment that is suitable for most patients.
What is Perioscopy?
Positioned between conventional scaling and root planing and periodontal surgery, Perioscopy is a therapy that can offer patients a less invasive alternative treatment approach for some non-responsive periodontal problems.
Perioscopy uses a tiny fiber-optic camera similar to an endoscope to enable Dr. Gutt to see tartar and disease below the gum line. Then miniature , diamond-tipped instruments are used to remove the tartar below the gum line without damaging any gum tissue or teeth roots. Gums heal naturally and tissue regeneration may occur if regenerative proteins are used in conjunction with Perioscopy.
How does it compare to periodontal surgery?
Perioscopy is an excellent alternative to conventional periodontal surgery. It eliminates periodontal disease in areas underneath the gums with the same success rate. However, not all patients are good candidates for this approach. The extent of the periodontal disease and the physical condition of the gums and bone are just two of the factors that must be assessed before choosing Perioscopy.
Does treatment for periodontal disease cause a lot of pain?
We are always careful to manage pain with any periodontal procedure. During treatments, we do so with a variety of anesthetics that eliminate pain altogether, which is of course a necessary step in surgery. Pain is effectively minimized in the recovery period with commonly available over-the-counter pain killers and stronger prescription medications as needed.
The non-invasive treatments, LANAP laser surgery and Perioscopy, cause minimal discomfort both during and after treatment, and as a result require less pain management.
How long does it take to recuperate?
That is a big variable of course, but the typical recovery time from treatment for chronic periodontal disease is measured in weeks, not months.