J. Tabacca D.D.S., M.Sc.
Approximately 75% to 90% of the world's population has some form of periodontal diseases depending upon the information source. Periodontal diseases are caused by bacteria produced in the mouth. These bacteria, if left undisturbed, produce toxins that will ultimately destroy gingival (gum) and osseous (bone) tissues surrounding and supporting the teeth. By middle age, 3 out of 4 adults will be afflicted by some form of the disease; however, children can be affected also.
The most common form of periodontal diseases is gingivitis, which is the earliest stage of the bacterial infection and affects only the gum tissue. Treatment will reverse the course of the disease; but, if left untreated, it can lead to periodontitis which is a more advanced stage of the disease. Failure to treat can result in loss of teeth. This advanced form of the disease requires more extensive treatments.
Common warning signs include:
Pain is normally NOT a significant symptom until the disease process is very advanced
Bacteria, commonly referred to as dental plaque, is the primary cause of periodontal diseases. Other contributing factors may accelerate the process. These include:
Treatment of periodontal diseases vary according to the severity of the disease. Early disease (Gingivitis) can usually be treated non-surgically. This involves scaling and root planing (deep cleanings) to remove the bacterial toxins on the root surface. Typically local anesthesia (novocaine) is employed during this treatment. More advanced disease (Periodontitis) typically requires surgical intervention. Sedation and local anesthesia are used to ensure patients' comfort. Incisions are made into the gum tissues, the gum tissues are reflected away from the teeth (envision peeling a banana) to access the underlying bone. The bone must be scraped to remove bacterial toxins and byproducts. In some cases, with severe bone destruction, bone grafting techniques are employed to restore lost bone. The gum tissues are then placed back into position and sutured. The ultimate goal is to create an oral environment in which the bacteria can be successfully mechanically removed from the teeth and surrounding structures.
Prevention is the key to retaining your natural teeth for a lifetime.
Proper oral hygiene accompanied by proper diet and regular dental visits can prevent periodontal diseases. (Please refer to our section on hygiene instructions)
Antimicrobial therapy (antibiotics) are often times utilized as an adjunct to the mechanical therapy of deep cleanings and surgery. Antibiotics can be used topically or systemically to inhibit the growth of the bacterias that cause periodontal diseases. As a rule, antibiotics are not prescribed as the sole treatment for periodontal diseases. Since the bacteria are naturally produced in the oral environment, systemic antibiotics would have to be utilized on a daily basis to have a beneficial effect. Eventually resistant bacterial strains would emerge rendering the antibiotics ineffective.
There are also oral rinses, both over-the-counter and by prescription that can reduce the oral bacterial population. Unfortunately, their efficacy is limited to 50% of the bacterial popuation or less. Proper oral home care remains the primary focus for preventing periodontal diseases.
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