What is periodontal disease?

The word “periodontal” literally means “around the tooth.”  Periodontal or gum disease is a chronic bacterial infection wherein the soft and hard tissues surrounding the tooth are affected.  This is caused by plaque, a sticky, colorless film that adheres to the teeth.  The bacteria in plaque releases toxins or poisons that cause the gums to become inflamed, a condition now called gingivitis.  If left untreated, the toxins will continue to destroy the attachment fibers and bone supporting the teeth. This state is known as periodontitis.  At its worst, tooth loss is eventual.

Plaque constantly forms on the teeth.  Because it is soft, proper brushing and flossing can remove it.  However, if it is not eliminated, it hardens and becomes calculus.  At this point, professional cleaning is needed.  The rough and uneven surfaces of calculus create a niche for plaque, making it more difficult to clean, especially when it continues to develop below the gums.  Pockets or spaces between the tooth and the bone are then formed.

The first signs of periodontal disease are:

§  Bleeding

§  Redness and swelling

§  Bad breath

There are many forms of periodontal disease.  The most common are:

Ø  Gingivitis.  It is the inflammation of the gingiva or gums.  It is the mildest form of this disease, wherein the gums turn red, become swollen, and bleed easily.  Usually, there is little or no discomfort at this phase.  This condition is reversible with professional treatment and good oral hygiene.

Ø  Periodontitis.  It is the inflammation of the gums and bone supporting the teeth.  This occurs as a consequence of gingivitis that is left untreated. 

o   In its mild stages, the destruction of these tooth-supporting structures begins. 

o   In mid-stages, it continues to destroy bone and tissue. 

o   And in its advanced stages, extensive loss of soft and hard tissues occurs.  Often times, the tooth becomes mobile and may even result to its loss.

Daily brushing and flossing can help minimize calculus formation, but not totally prevent it.  Professional cleaning at least twice a year is necessary to remove calculus that toothbrush and floss were not able to.  If one has had periodontal disease, more frequent visits to a periodontist for maintenance is needed.

PERIODONTAL COSMETIC PROCEDURES  

Crown Lengthening Procedures for Gummy Smile or Uneven Gumline 

Some people smile with more of their gums showing.  One would think that they have short teeth but this is not always the case.  There is just too much gum tissue covering the teeth hiding the real size of the crown.

With crown lengthening procedures, the gums are recontoured to show the correct size and length of the teeth.  Following this procedure, placement of crowns or veneers can also help in enhancing one’s smile.

Root Coverage Procedures for Long Teeth and Exposed Roots 

As part of aging, we experience a certain degree of gum recession.  In some cases, however, it occurs much faster than normal, usually as a result of toothbrush abrasion or periodontal disease.  When this happens, teeth appear longer making us look older.  Also, root cavities and sensitivities are prone to developing.  Fortunately, soft tissue grafts and other root coverage procedures are available to prevent further recession, to protect roots from decay, and to restore a youthful smile.

Ridge Augmentation Procedures for Indentations in the Gums and Jawbone 

After a tooth has been extracted, the bone surrounding it recedes.  It then creates indentations in the ridge.  Aside from being unsightly, it makes it more difficult to recreate a natural looking replacement tooth.  This can be avoided with ridge preservation procedures.  Following tooth extraction, bone fillers will be placed inside the socket to prevent it from collapsing.  However, if a defect is already present, ridge augmentation procedures can restore the natural contours of the gums and jawbone.  

Dental Implants for Missing Teeth 

While conventional bridgeworks can replace missing teeth, they cause unnecessary damage to adjacent teeth.  This can be avoided with dental implants.

Dental implants are artificial tooth root replacements placed inside the jawbone to provide retention and support for crowns, bridges or removable dentures (dental prosthesis).  They look and feel like your natural teeth it will seem that you never lost your teeth.  

It is, however, important to stress that not all patients are good candidates for implants.  Proper assessment and treatment planning are key essentials to the success of implant placement.