Healthier Gums

The first step in controlling gum disease is to understand what it is and how it works. Gum disease is an infection in the space between the gum and the tooth, and it is almost always painless and undetectable to most people. It first appears only as a swelling of the gums, but often progresses in adults into a much more serious infection called periodontitis. When this happens, the infected gums literally “detach” their connection to the root of the tooth.

 

As gums “detach” the space between the gum and the root deepens, and eventually becomes a deep, oxygen-free recess called a pocket. Oxygen-free zones under the gums can be dangerous, because they allow the growth of aggressive, destructive anaerobic bacteria. Anaerobic bacteria thrive in an oxygen-free environment, and are rarely found in a healthy mouth. Those bacteria accelerate the infection, and promote even deeper pockets. The deeper the pockets become, the more damaging the anaerobic bacteria become. 

The underlying bone that supports the teeth lies directly in the path of the infection. As the pockets grow deeper, the loss of bone can lead to a devastating loss of teeth. Furthermore, the infection can affect you whole body, since the bacteria and inflammatory by-products created by this chronic infection are carried away by the blood stream.  

Medical researchers have recently connected the type of inflammatory products caused by periodontitis with heart disease. These products appear to destabilize fatty plaque deposits in arteries, allowing them to rupture and become blood-born clots capable of blocking the tiny arteries that feed the heart, causing heart attacks. 

This phenomenon may explain why 50% of the 450,000 people a year who have heart attacks or strokes, do not even have high levels of cholesterol. Some medical doctors feel that the test for a certain type of inflammatory substance, called C-reactive protein (CRP), should be done for all adults, and that those showing risk factors should begin taking statins. Statins (such as Crestor) seem to reduce the ability of inflammatory products to trigger heart attacks and strokes.

Because it’s the most common chronic infection in the body, researchers have long suspected the impact of periodontal disease on heart attack, stroke, diabetes, low birth-weight-babies, kidney disease and other problems. Scientific proof of a direct connection has yet to be established for some. Nonetheless, the destructive role of chronic infection in the body and its impact on the immune system is well documented.

It’s been estimated that up to three out of four adults have some form of periodontal disease. But because periodontal disease is painless, most people don’t know they have it. Successful management of periodontal disease depends on three essential steps:

Step 1: Find it.

One of the most straightforward methods of detecting periodontal disease is to examine the gums around the teeth for telltale pockets. Pockets are measured in millimeters, from the top of the gum to the point where it connects on the tooth. Anything over three millimeters is potentially a problem. 

If pockets exist, then they can be recorded on a map called a periodontal charting which shows the location, pattern and severity of the infection. A current periodontal charting is the standard of care in dentistry—everyone who is seen regularly in our office has a current periodontal charting. 

Digital x-rays, which reduce radiation significantly, can be used to evaluate how much bone loss has occurred. Using this information, we prescribe therapy for your specific needs.

Step 2: Arrest it. 

It’s not always possible to reverse all of the destruction of periodontal disease. Fortunately, it often isn’t necessary. It is possible to return the gum tissue to a healthy state, even if some pockets still exist.

 

When we remove the calcified deposits on the surfaces of the teeth below the gums, the bacteria lose their “base of operations.” If the tooth surfaces can be kept free of bacterial plaque and calcified plaque called calculus (tartar), the infection can be arrested. The gums can’t heal in the presence of calculus.

The main thing to know is that arresting periodontal disease can be accomplished painlessly, often without surgery. That’s right, painlessly—and usually without surgery.

The deposits can be removed from the teeth with traditional hand instruments similar to those used for cleanings, or with an instrument that produces sonic waves. We offer both, and find that most people prefer the sonic instrument. We use the gentlest form of sonic waves, called piezo waves.

For most people, the teeth and gums can be numbed without injections for this procedure. We use a special anesthetic that needs only to be placed along the teeth on the gums, and the deep-cleaning sonic action of the piezo instrument is painless.

For deeper pockets where bacteria have become established, we use highly effective laser therapy to neutralize harmful bacteria and infected tissue, and leave an antibiotic called Arrestin between the tooth and the gum. Arrestin finishes the job of stopping the bacteria, allowing the pocket to heal—without subjecting the body to systemic antibiotics. Often, this therapy reduces the pocket depth.

Periodontal disease is preventable. We set up an appropriate schedule for you to return for regular maintenance (evaluation and cleaning). It isn’t based on office policy—it’s based on what you need as an individual. We base your appointment interval on the depth of any remaining pockets and your ability to keep them free of infection. Protect your teeth and your health today. Make an Appointment to schedule a periodontal evaluation for this painless disease.