Bacteria found in plaque produces toxins or poisons that irritate the gums, which may cause them to turn red, swell and bleed easily. If this irritation is prolonged, the gums separate from the teeth, causing pockets (spaces) to form. As periodontal diseases progress, the supporting gum tissue and bone that holds teeth in place deteriorate. If left untreated, this leads to tooth loss.
The current, state of the art approach to periodontal disease involves a four-pronged approach:
- Elimination of the bacteria that is causing the gum disease Removal of the bacteria under the gumline is the key to successful periodontal treatment. There are a variety of new techniques that make it easier for us to remove these harmful bacteria. How aggressive we get depends of the strategic importance of the tooth and the depth to with the bacteria has penetrated. Shallow pockets – When the pockets are relatively shallow we can usually get to and remove the debris without disturbing the gum at all. This “deep cleaning” is done in the office using local anesthetic. Deeper pockets – In pockets of moderate depths it is often difficult to completely remove all bacteria. Antibiotics taken by mouth don’t help since the antibiotic cannot get from the bloodstream into the tooth pocket. However, new antibiotic delivery systems allow us to place antibiotics directly into the infected pockets, reducing or eliminating the need for more aggressive treatment. Also, we have recently introduced laser therapy to disinfect and reduce pockets. There have been some reports of bone regeneration with laser therapy. Patients typically go about their normal activities immediately after these types of procedures. In areas of extreme inflammation the gum will shrink once the infection is eliminated. This shrinkage can lead to a change in contour of the gum and sometimes to a temporary increase in sensitivity to hot or cold.
- Making you more resistant to gum breakdown. We will identify and work with you to modify any factors that may be enhancing the development of gum inflammation in your case. There also is emerging technology that allows patients to boost their response to the bacteria. The therapy involves a low dose of Doxycycline taken in 3-month intervals. At such a low dose the medication has no antibiotic effect. It does, however, make your gum and bone tissues more resistant to attack and breakdown by the bacteria. We will certainly consider if this therapy will be beneficial in the management of disease in your case.
- Rebuilding any bone destruction that has occurred around strategically important teeth. Technology exists which allows the bone that has been lost to gum disease to be rebuilt. These techniques are used around strategically important teeth for which repair of the bone is essential for continued function. Powdered bone graft material can be packed into a pocket which then encourages your own bone cells to lay down new bone and repair the pocketing. This is usually performed by one of our skilled periodontal specialists.
- Reducing the likelihood for reinfection (and disease recurrence). Once the bacteria are removed and the infection is stopped, we will design a plan that will allow you to keep things health and lessen the likelihood for future reinfect