What is gingivitis?
Gingivitis represents the initial stage of gum disease. Although it doesn’t cause overt discomfort and often goes unnoticed, there are specific signs to be aware of that indicate the start of a problem. If you notice your gums bleed when you brush, look red and inflamed, or feel a little tender, you more than likely have gingivitis.
The good news is that by treating gingivitis early, the tissue damage associated with more advanced stages of gum disease can be avoided. Despite the presence of inflammation, the overall integrity of the periodontal tissues in this stage remains intact.
Treatment instituted at this point is often sufficient to reverse the course of the disease and to avoid any permanent damage to the periodontal tissues. A series of deep dental cleanings, an improved home care regimen and a commitment to regular maintenance may be all that is required to prevent this stage of periodontal disease from progressing.
What is Periodontitis?
When left untreated, a case of gingivitis develops into a more advanced and damaging stage of gum disease, known as periodontitis. At this point, the connective tissue and bone that hold the teeth in place begin to break down. With the progression of periodontal disease and periodontitis, more and more tissue loss ensues. Damage often includes an increase in pocketing between the teeth and bone, gum recession, and bone loss. As unresolved periodontitis goes from mild to moderate to severe, it increasingly compromises the soft and hard tissues supporting the teeth.
Periodontal treatment in this phase is designed to halt the progression of the disease and to restore tooth support as possible. Treatment may involve medications to control the bacteria and reduce the size of the pockets between the teeth and gums, gum surgery, as well as bone and tissue grafts.
Let Us Help You Maintain Optimal Periodontal Health
At the office of Stonewall Dental Associates, we offer personalized, state-of-the-art solutions to help you maintain healthy gums and an attractive, well-functioning smile. As skilled providers of care, we utilize leading-edge technology and treatment methods to address a broad range of periodontal conditions and needs.
Thanks to advances in care, periodontal treatment today not only helps to halt the progression of gum disease but also delivers effective solutions, including bone grafting and regenerative procedures to repair tissue damage, restore bone volume, improve cosmetics, or provide adequate support for the placement of dental implants.
How is gum disease treated?
The type of periodontal treatment you receive depends on several factors including the stage of periodontal disease, the extent of tissue damage, your overall oral health, existing medical conditions, and other considerations in care. After a thorough assessment of your case, we’ll discuss your options to reestablish and maintain optimal periodontal health. We welcome your questions and are always on hand to provide guidance and address your concerns.
Periodontal treatment can be categorized in the following ways:
- Non-Surgical Periodontal Treatment
When periodontal disease is detected early in its onset, conservative or non-surgical methods of care combined with improved hygiene routines can restore periodontal health. While periodic, professional cleanings are sufficient to maintain periodontal health in patients that do not have gum disease, once gingivitis is present, deeper cleanings and possibly other non-surgical methods of care are recommended to treat the condition.
The American Academy of Periodontology emphasizes achieving periodontal health by means of the least invasive and cost-effective treatment approaches to care. Deeper cleanings, which include Scaling and Root planing, are non-surgical procedures that are considered the first line of defense against the progression of periodontal disease.
With scaling and root planing, any plaque and tartar (hardened dental plaque) that have accumulated below the gumline are carefully removed, and then the root surfaces of the teeth are smoothed. Since periodontal disease is an inflammatory response to plaque, tartar, and bacterial toxins, by simply mechanically eliminating these agents, the progression of gum disease can be halted. In addition to removing plaque and tartar with a scaling and root planing procedure, antimicrobial medication placed under the gumline or systemic medications can be used as adjuncts to care to further reduce the bacterial population.
If non-surgical approaches to managing periodontal disease do not achieve the desired outcome, surgery may be recommended to halt its progression and repair damage as possible.
When gum disease has advanced beyond the initial stage, periodontal surgery is often recommended to effectively remove bacteria and tartar from around the teeth, reduce gingival pocket depth, restore lost tissue as possible, and halt disease progression. It’s essential to keep in mind that gum disease is a progressive condition. If appropriate measures are not taken, gum disease continues to compromise the support of the teeth and have consequences to one’s overall dental health and well-being.
As untreated gingivitis evolves into more advanced stages of gum disease, periodontal pockets deepen, the bacteria become more difficult to remove, and the gaps between the surface of the teeth and gums get larger. When pocket depth increases to the point of being beyond the reach of deep cleanings and other conservative methods of care (5mm or more), gum surgery to clean and treat the damage to gums and underlying bone is typically recommended.
The good news is that with proper surgical treatment followed by improved oral hygiene, the chances of tooth loss, further damage to the bone and soft tissues supporting the teeth, and complications from health problems that are linked to periodontal disease can be decreased.
The goals of pocket reduction surgery are to accomplish the following:
- Remove sub-gingival bacteria beneath the gums and from the surfaces of the roots of the teeth
- Halt damage to the underlying bone, and recontour the affected hard tissues as needed
- Reduce pocket depth to facilitate easier cleaning of the teeth and gums and the maintenance of optimal periodontal health
In many cases, a periodontal procedure, which is known as flap surgery, is frequently recommended. During this procedure, the gums in the affected area are reflected away from the teeth and supporting bone. Now, the pocket and roots of the teeth can be thoroughly cleaned and supporting tissues recontoured as needed. When this step gets completed, the tissue flag gets sutured back into place.
Today, in addition to conventional surgical approaches to care, dental lasers are also used to perform select periodontal procedures. When applicable, laser technology can help treat periodontitis, reduce pocket depth, address peri-implantitis, and remove or recontour gingival tissues for cosmetic purposes.