Periodontics and Oral Surgery

While there are many diseases that affect the tooth-supporting structures, plaque-induced inflammatory lesions make up the majority of periodontal issues. These are divided into two categories—gingivitis and periodontitis. While gingivitis, the less serious of the diseases, may never progress into periodontitis, it always precedes periodontitis.

Dental plaque is the primary cause of gingivitis in genetically-susceptible individuals. Plaque is a sticky colorless film, composed primarily of food particles and various types of bacteria, which adheres to the teeth at and below the gum line. Plaque constantly forms on the teeth, even minutes after cleaning.

Bacteria found in plaque produce toxins or poisons that irritate the gums, causing them to become inflamed, red, swollen, and bleed easily. If the irritation is prolonged, the gums separate from the teeth causing pockets (spaces) to form. If daily brushing and flossing are neglected, plaque may also harden into a rough, porous substance known as calculus (or tartar). This may occur both above and below the gum line.

If gingivitis progresses into periodontitis, the supporting gum tissue and bone that holds the teeth in place deteriorates. The progressive loss of this bone, the alveolar, may lead to loosening and subsequent loss of teeth. Periodontitis is affected by bacteria that adhere to the tooth’s surface, along with an overly aggressive immune response to these bacteria.

Periodontal disease is dangerous as it often exhibits no symptoms or pain. 80% of Americans will be afflicted with periodontal disease by age 45, and 4 out of 5 patients with the disease are unaware they have it. It’s important to maintain proper home oral care and regular dentist visits to reduce the risk of this disease affecting the gums.

We encourage you to schedule an appointment at our office without delay if you experience any of the following symptoms:

• Bleeding while brushing or eating normal foods: unexplained bleeding while performing regular cleaning or consuming food is the most common sign of a periodontal infection
• Bad breath: ongoing halitosis (bad breath), despite rigorous oral cleaning, may point to periodontitis, gingivitis, or the beginnings of a gum infection.
• Loose teeth and gum recession: longer-looking and loose-feeling teeth may indicate recession of the gums and/or bone loss as a result of periodontal disease
• Related health concerns: patients with heart disease, diabetes, osteopenia, or osteoporosis are often diagnosed with correlating periodontal infections. The bacterial infection may spread through the bloodstream, affecting other areas of the body

The Perioscope is new technology developed for the treatment of periodontal disease. The perioscope is an endoscope, specifically designed to explore and visualize the pocket (space) under the gums of teeth involved with periodontitis. An image on a computer monitor shows the diseased tooth’s root surface.

The perioscope enables the clinician to see the contents of the periodontal pocket and to analyze the root surface of the tooth for disease, causing bacterial accumulations (plaque and calculus).

The perioscope guides the clinician during the process of cleaning the root surface, ensuring it’s free of plaque and calculus—the treatment for periodontitis. It also allows the clinician to identify other problems (cracks, perforations, and other disease-causing flaws of the tooth root’s surface) located under the gum that previously required surgery to detect.

Most people are familiar with the links between tobacco use and lung disease, cancer, and heart disease. Now, based on current studies, we can add periodontal disease to the list. Cases of periodontal disease are more severe in smokers and tobacco users than those who do not use tobacco.

There is a greater incidence of calculus formation on teeth, deeper pockets between gums and teeth, and a greater loss of the bone and fibers that hold teeth in the mouth. In addition, the chance of developing oral cancer increases with the use of smokeless tobacco.

Chemicals in tobacco such as nicotine and tar also slow down healing and the predictability of success following periodontal treatment. Quitting smoking and tobacco use can have numerous benefits for overall and periodontal health.