Periodontics is a dental speciality that focuses on oral health and the foundation supporting teeth. This includes gums, bone, and roots of teeth. The field of periodontics helps patients maintain gum and bone health as well as treat periodontal disease.
A periodontist is a dental specialist that completes three additional years of resident training after receiving their dental degree. Their focus is on preventing, diagnosing, and treating periodontal disease. In addition, periodontists are trained as dental implant specialists to provide tooth replacement options for patients that are missing teeth due to periodontal disease, tooth fracture, tooth decay, and other factors that lead to tooth loss.
Procedures that periodontists perform are non-surgical therapy such as scaling and root planing, surgical therapy such as extractions, gum recontouring, periodontal surgery to modify or regenerate bone, soft tissue grafting to correct gum recession, place dental implants with or without bone and/or soft tissue grafting, as well as bone and sinus augmentation for future dental implant placement. Your periodontist will work with your dental team in order to maintain oral health and strategize treatment options that works for you.
Periodontal disease is commonly associated with bacteria and inflammation affecting the health of the gums and bone. When bacteria accumulate in the form of plaque and calculus, they cause inflammatory damage to the underlying foundation of the tooth. This can lead to bleeding gums, tooth mobility, gum recession, tooth sensitivity, and if severe, tooth loss.
Periodontal disease typically is not symptomatic and typically does not cause pain. Patients will not know if they have this disease until they visit a dental provider such as a hygienist, general dentist, or dental specialist. In addition, medical concerns such as smoking, and diabetes are known risk factors for developing periodontal disease. In such cases, your periodontist can work with your medical doctor to make suggestions to maintain systemic and oral health. When periodontal disease is diagnosed, it is important to treat it early to prevent further periodontal destruction that could lead to tooth loss.
Gingivitis is the mildest form of periodontal disease. This type of periodontal disease is caused by plaque, the sticky, colorless film of bacteria that is constantly forming and building up on your teeth throughout the day. It can be removed through regular brushing and flossing. However, if plaque is not removed, it will harden and/or calcify. This substance is known as tartar, and it will have to be removed by a dental professional.
Gingivitis is often caused by inadequate oral hygiene. It primarily affects the gums and causes them to become red, swollen, and prone to bleeding, though there is usually little to no discomfort at this stage. Gingivitis is reversible with professional treatment and good oral home care.
Factors that may contribute to gingivitis (besides inadequate oral hygiene) include diabetes, smoking, aging, genetic predisposition, systemic diseases and conditions, stress, inadequate nutrition, puberty, hormonal fluctuations, pregnancy, substance abuse, HIV infection, and certain medication use.
Periodontitis is a serious gum infection that damages the gums and can destroy the jawbone. The disease is common, yet fairly preventable. The cause of periodontitis is usually poor oral hygiene and ignoring the early signs and symptoms of gingivitis.
With time, the plaque found in gingivitis can spread and grow below the gum line. The toxins produced by the bacteria in plaque start to irritate the gums and stimulate a chronic inflammatory response, which basically causes the body to turn on itself. Later on, the tissues and bone that support the teeth are broken down and destroyed. Eventually, the gums are separated from the teeth and spaces from between the teeth and gums. These are known as periodontal pockets. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed, advancing into periodontitis.
Symptoms include swollen and tender gums, bad breath, toothache, bright red gums, loose teeth, receding gums, and tooth loss. It can be prevented with regular brushing, flossing, and mouth wash use, and regular professional dental cleanings.
Treatment includes professionally cleaning the pockets around teeth to prevent damage to the surrounding bone. Advanced cases may require surgery, gingivectomy (gum tissue removal), and/or gingivoplasty (reshaping healthy gum tissue).
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Like most dental problems, periodontal disease varies in its aggressiveness depending on the stage of the disease. There are three stages:
The disease can be treated, reversed, and eventually cured if it is detected before it progresses to a more harmful stage where the bone is impacted. The disease can even be preventable given proper oral care routine, including regular dental and periodontal visits. As mentioned previously, some periodontal disease symptoms can be mild and, therefore, often overlooked. Regular professional teeth cleanings and a periodontal visit can help maintain your oral health, as well as prevent chronic and aggressive gum diseases.