Gum Disease

Periodontal (Gum) Therapy

Gum disease is a bacterial infection that “unzips” your gums from the roots of your teeth. As the result, food and bacteria collect in the pockets between the teeth, allowing the infection to eat away the supporting bone tissue. Think it’s not your problem? Gum disease is the leading cause of tooth loss for adults over the age of 25.

Characteristics of Gum Disease:

  • Bleeding, sore, or red gums
  • Changes in bite
  • Spaces between teeth
  • Loose teeth
  • Teeth that appear longer due to gum recession
  • Bad breath

The Cause of Gum Disease

Periodontal disease results from poor oral hygiene and can be easily prevented with daily brushing and flossing. Plaque (a sticky, white film of bacteria) that remains on the teeth hardens into tartar and creates a sandpaper-like surface on the roots of teeth. This process leads to periodontal disease, which is very difficult to stop once it begins. In fact, there is no cure for advanced stage gum disease, and we can only treat the symptoms and keep it from spreading.

Symptoms & Screening

Since symptoms of gum disease are mild, many patients don’t notice a problem until it’s too late. Your dentist can screen for periodontal disease using a dental probe and X-rays during your regular checkup. Probing measures pocket depth and X-rays show the condition of the surrounding bone. Make sure you ask your dentist if he or she performs a periodontal analysis, as statistics show that 80% of dentists do not.

At our office, we offer non-surgical treatment for mild cases of gum disease, including:

  • Debridement – The first phase of treatment, debridement uses a combination of water and high-frequency vibrations to dislodge excessive amounts of plaque and tartar from the teeth. This may require local anesthesia if the patient is very sensitive.
  • Scaling and Root Planing (SRP) – The most common and conservative type of treatment, SRP involves removing plaque and calculus from below the gum line, as well as smoothing root surfaces so supporting tissues can reattach to the tooth surface. SRP may take 1 to 4 appointments, or more. For your comfort, we typically use general anesthesia.
  • Targeted Antibiotic Therapy – This advanced technique involves strategic placement of antibiotics. Unlike traditional oral antibiotics, this therapy will not affect your entire system, which is preferable in most cases. At Fountain View, we use Arestin prescription antibiotic therapy.

More Information:

Periodontal Disease affects the tissues surrounding and supporting your teeth. Dentists diagnose periodontal disease by measuring the tissues around the teeth with a “probe” and by using radiographs to detect bone loss around your teeth. The probe is used to measure for “pockets” that occur when the gums unzip from the roots of your teeth. Any pocket that is 4mm or greater is considered unhealthy. Harmful bacteria are the cause of periodontitis, but contributing risk factors includes smoking, poorly controlled diabetes, genetic susceptibility, diet, and poor oral hygiene.

DIAGNOSIS of periodontal disease is broken down into two levels: gingivitis or periodontitis, each with subcategories, (i.e. mild, moderate, and severe). Gingivitis is reversible and does not cause damage to the bone. Gums are red and swollen, but no pockets exists over 3mm. Periodontitis occurs after prolonged infection, causing harmful detachment of the gums from the roots as a result of what Dr. Harden terms a “bacterial knife.” Gums are red and swollen, and pockets are 4mm and above. As the pockets get deeper, the bone level is more damaged, the teeth begin to loosen, and the diagnosis advances from mild to moderate to severe.

TREATMENT is performed by a doctor or hygienist to disrupt the bacteria below the gumline. Patients call this a “cleaning,” but technically cleanings have different names based upon the level of disease. A “cleaning” is what we consider a routine six month visit which concludes with a rubber cup polish. Cleanings or prophys are preventive care and apply to healthy gums and gingivitis. As periodontal disease progresses to a level of mild or moderate periodontitis, and the bone is infected, a “non-surgical” treatment is utilized, called (a) Debridement and/or (b) Scaling & Root Planing (“SRP”) and (c) Antibiotic Therapy. Treatment of more severe periodontitis, involving 7mm pockets or greater and significant bone loss, requires actual gum surgery to gain access to these deep problem areas in order to see and remove the bacteria off the roots.

Non-Surgical Treatment
(a) Debridement is the technical name for an advanced cleaning that involves the removal of excessive amounts of plaque and tartar from your teeth, which builds up because a person hasn’t visited a dentist in several years. This may require local anesthesia if the patient is very sensitive. Debridement is done with a combination of hand instruments and an ultrasonic device. This device uses water and high-frequency vibrations to dislodge plaque and tartar from the teeth. Debridement is usually the first phase of comprehensive periodontal treatment. After completing the debridement, your dentist will re-evaluate your teeth to determine the appropriate course of therapy, which may involve scaling and root planing or periodontal surgery.

(b) Scaling and Root Planing (SRP) is the most common type and conservative form of treatment for periodontal (gum) disease, because it is non-surgical. Based upon the infection, this advanced cleaning may take one to four or more appointments. Scaling is a type of cleaning that removes plaque and calculus from the teeth at and slightly below the gumline. Root planing smoothes root surfaces, so the supportive tissues can better reattach to the tooth surface. Local anesthesia is often used for patient comfort.

(c) Targeted Antibiotic Therapy for gum disease is an advanced new technique that involves strategic placement of antibiotics into the infected area (i.e. gum pocket) where bacteria reside. This is alternative to systemic ingestion of antibiotics, which affects your entire system, and therefore revolutionizes the benefits of antibiotics because it is site specific. Fountain View Dentistry has chosen ARESTIN®, a prescription antibiotic specifically approved by the Food and Drug Administration (FDA), to reduce and eliminate harmful bacteria that cause periodontal disease.

Dr. Scott Harden