Gum disease can be a deleterious dental condition that affects a majority of people with minimal early symptoms and can progress rapidly. The Centers for Disease Control and Prevention (CDC) have quantified almost half of the American population over the age of 30 to be at risk of or already battling advanced gum disease called periodontitis. Various treatment options are available for treating periodontitis, however, most relay an invasive approach due to the widespread damage caused by this disease.
Periodontitis: A brief overview
Periodontitis does not initially appear as it is. According to the American Dental Association (ADA), periodontitis presents as a minimally harmful gum disease called gingivitis. The three stages of gum disease are:
- Gingivitis: This is the earliest stage of gum disease characterized by bleeding and swollen gums. The NIDCR assures that this stage of gum disease can be easily reversed by proper oral prophylaxis.
- Mild to moderate periodontitis: Early bone loss and receding gums around the teeth may be reflective of this stage.
- Advanced periodontitis: Further deepening of the gum pockets and hefty deterioration of bone characterize this stage. Periodontal surgery is needed to restore the loosened tooth.
Chronic advanced periodontitis is highly destructive and affects 47.2% of adults over 30 in the United States. Surgical measures may be life-saving for this stage.
NON-SURGICAL TREATMENT OPTIONS
If periodontitis isn’t advanced, your first few steps in treating periodontitis are going to be as conservative as possible, including less-invasive, non-surgical options such as:
- Professional dental clean-up
A typical dental visit comprises of a thorough oral exam and corresponding clean-up. The dentist begins by removing tartar and plaque from above and below the gum line and teeth surfaces to minimize the risk of further gum disease. A regular dental clean-up every 6 months is highly recommended as an active prophylactic measure for gum disease.
- Teeth scaling and root planing
These are deep, non-surgical procedures, done under local anesthetic to remove tartar and plaque primarily from below the gum surfaces (subgingival calculus and plaque). It is done with either with a rotary ultrasonic scaler or a laser and is followed by a root planing whereby the roots are smoothened to demolish the “weak spots” where bacteria are more likely to adhere.
Topical or oral antibiotics are prescribed to help control the extent of bacterial infection. Topical antibiotics can include antimicrobial mouthwashes or gels. These gels containing antibiotics (like doxycycline) are placed in the gum pockets after deep cleaning. They are slow-release medications that cut down the expansion of pockets.
SURGICAL TREATMENT OPTIONS
If you have advanced periodontitis, the treatment approach may be much more invasive owing to the heavy tissue loss it may have incurred. The treatment options are usually corrective and surgical in nature, as listed by the American Academy of Periodontology (AAP) such as:
- Flap surgery
Also known as pocket reduction surgery is a surgical procedure that aims to reduce periodontal pocket size for better periodontitis prognosis. Your gums should ideally fit snugly around your teeth, but with the tartar and toxic bacterial by-products build-up in spaces between the teeth and gums, the sulcus area begins to widen. During this procedure, a section of the gums is lifted back to expose the roots for more effective scaling and root planing. After a thorough cleaning, the pulled-back gums are sutured back in place. This decreases the areas of harmful bacteria by reducing the space between the teeth and the gums.
- Bone grafting
Advanced periodontitis is characterized by immense degrees of bone loss surrounding your tooth root, due to the high bacterial infestation. In order to correct or restore lost bone, bone grafting can be performed. Bone grafting is a regenerative surgical procedure that involves using fragments of your own bone (autograft), synthetic bone, or donated bone (allograft) to replace the bone that has been destroyed by gum disease. The grafts act as a platform for the regrowth of natural bone (restoring stability to the tooth) and help prevent tooth loss by holding your tooth in place.
- Gum grafting
Exposed roots are a result of gum recession, a common sign of advanced periodontitis. Gum grafting helps repair receded gums and prevent additional gum recession and bone loss from taking place. This procedure involves taking a small amount of grafted tissue (usually from the roof of the mouth) and attaching it over the affected area to cover the roots that have been exposed as a result of gum recession. This helps reduce the gum recession and also gives the teeth a more esthetic look. This can be done for one or more teeth to even your gum line and to reduce tooth sensitivity caused by exposed roots.
- Guided tissue regeneration
This is an accompanying procedure mostly done alongside flap surgery. The goal of this surgery is to allow the regrowth of bone that has been destroyed by bacteria. Your periodontist places a special piece of mesh-like biocompatible fabric in between the remaining bone and your tooth. The material prevents the gum tissue from growing into the healing area, thereby allowing bone to grow back instead. The regrowth of the bone and connective tissue helps support and stabilize the weakened tooth and the harmful effects of gum disease can be well-reversed.
- Tissue-stimulating proteins
Another method of bone regeneration makes use of tissue-stimulating proteins in gel form. These proteins are the same proteins found in tooth enamel. When applied to the diseased tooth root, this gel stimulates the regrowth of bone and tissue, successfully healing bone loss caused by periodontitis.
Prevention is the best way to avoid the need for painful, costly, and time-consuming periodontal treatments. Focus on your preventive oral hygiene by meticulously taking care of your teeth and gums at home. Brush your teeth at least twice a day with a soft-bristled toothbrush using a fluoride-enriched toothpaste. Flossing and using a prescription mouthwash at least once a day can further help the progression of gum disease. If you do have advanced periodontitis, go on 4Smile.com to connect with the finest periodontists near you. Remember, periodontitis is reversible but that doesn’t mean you don’t try to prevent it!