Periodontal diseases are a group of diseases that affect the tissues that support and anchor the teeth. Left untreated, periodontal disease results in the destruction of the gums, the part of the jaws where the teeth arise, and the outer layer of the tooth root.
Periodontal disease is usually seen as a chronic inflammatory disease. An acute infection of the periodontal tissue may occur. The tissues that are involved in periodontal diseases are the gums, which include the gingiva, periodontal ligament, cementum, and alveolar bone. The gingiva is a pink-colored mucus membrane that covers parts of the teeth and the alveolar bone. The periodontal ligament is the main part of the gums. The cementum is a calcified structure that covers the lower parts of the teeth. The alveolar bone is a set of ridges from the jaw bones (maxillary and mandible) in which the teeth are embedded. The main area involved in periodontal disease is the gingival sulcus, a pocket between the teeth and the gums.
Gingivitis is an inflammation of the outermost soft tissue of the gums. The gingivae become red and inflamed, loose their normal shape, and bleed easily. Gingivitis may remain a chronic disease for years without affecting other periodontal tissues.
Adult periodontitis is the most serious form of the periodontal diseases. It involves the gingiva, periodontal ligament, and alveolar bone. A deep periodontal pocket forms between the teeth, the cementum, and the gums. Plaque, calculus, and debris from food and other sources collect in the pocket. Without treatment, the periodontal ligament can be destroyed and resorption of the alveolar bone occurs. This allows the teeth to move more freely and eventually results in the loss of teeth. Most cases of adult periodontitis are chronic, but some cases occur in episodes or periods of tissue destruction.
“Scaling and root planing” are usually the first non-surgical steps involved in treating perio disease. This will remove plaque and tartar deposits and helps gum tissue heal. Medications might be recommended to help control infection and pain, or to aid in healing.
At the next visit, we will check the pocket depth to determine the effect of scaling and planing. Many patients need nothing further at this point, beyond regular preventive care. If the periodontal pockets are deep and the supporting bone is lost, surgery may be necessary to help prevent tooth loss.
When periodontal pockets don’t heal after scaling and planing, surgery may be needed to better remove the inflamed tissues and reduce damage to the bone. As the pockets enlarge, they provide a greater place for bacteria to live and attack the bone and tissue. Surgery allows the dentist to access hard-to-reach areas under the gum and along the roots where tartar and plaque have accumulated.
Once your periodontal surgery is completed, we will want to see you at regular intervals.
You don’t have to lose your teeth to periodontal diseases. Brush, clean between your teeth, eat a balanced diet, avoid tobacco and schedule regular dental visits for a lifetime of happy smiles.
© 2019 Mark R. Hanselman, D.D.S.