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Detection and Treatment of Periodontal Disease

Healthy Gums
A firm pink collar of gum over firm bone forms a healthy, attractive and strong support for the teeth.

Gingivitis
Accumulation of bacterial plaque along the gum line results in inflammation of the gums. Red, puffy, bleeding gums indicate the presence of gingivitis.

Early Periodontitis
Continued inflammation of the gums can result in the gums pulling away from the teeth, allowing for formation of "pockets" filled with bacterial plaque, calculus (tartar), food debris and pus. This painless infection now has resulted in damage to the bone (socket) supporting the teeth.

Moderate Periodontitis
Further spread of the gum infection results in further loss of bone support. Loose, shifting teeth and more obvious recession of the gum can be seen.

Advanced Periodontitis
Advanced gum disease is one of the leading causes of tooth loss in adults. Painful gum abscesses can occur as the deeper infection gets trapped under the gum, resulting in a buildup of painful pressure.

Infected gums represent a very common form of gum disease known as periodontitis. Bacterial plaque in our mouth can accumulate in hard to clean areas along the gum line and between the teeth, causing inflammation and damage to the gum tissue. The gums pull away from the tooth allowing gaps or "pockets" to form which fills with more bacterial plaque, tartar (calculus), pus and food debris. As this painless infection progresses, the bone support anchoring the teeth also begins to dissolve away. Periodontitis is the leading cause of tooth loss in adults. The use of antibiotics alone would be of only limited help in eliminating this infection since the deposits of plaque, tartar, food debris and pus would still remain stuck under the gum long after the antibiotics have been completed.

Conservative (non-surgical) periodontal therapy is an effective way to control infection and to allow for natural healing. This approach consists of education in personal oral hygiene techniques in order to insure a healthy environment for healing, followed by a series of regular and deeper cleanings to remove contamination above and below the gum line including the root of the teeth. These procedures are referred to as "scaling" and "root planing" and are usually done in one section of the mouth at a time using local anesthesia for the patient's comfort. Once the patient has had a few such cleanings, the condition of the gums can be re-evaluated to determine the extent of permanent damage to the gum tissue and bone.

The use of antibiotics as an adjunct to conservative non-surgucal management is often helpful in certain cases. Since there are a variety of bacteria that can cause periodontitis, and these bacteria are often resistant to common antibiotics, it is frequently helpful to have a sample of the bacteria to determine which antibiotic would be most effective at eliminating the disease causing bacteria. Antibiotics can be given in an oral systemic dose or can also be placed directly into the gum pocket for a more targeted attack. Permanent damage resulting from periodontitis often can often be repaired using corrective periodontal surgery. Done a section of the mouth at a time using local or general anesthesia, the damaged gum and bone is reshaped around the tooth in order to close off any remaining gaps or pockets that still remain and are trapping disease causing plaque. In certain cases it is even possible to perform surgery to allow for regeneration of new gum and bone tissue.

To insure a successful result following periodontal therapy, patient cooperation in maintaining excellent oral hygiene is essential. More frequent professional cleanings can help reduce the likelihood of the disease ever returning.