DENTAL HEALTH…PERIODONTITIS – Advanced stages of gum disease

Mar 06, 2016 News

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By Dr. Neromini Fagu
One of the hardest things for me to do as a Dentist is to tell a patient that he or she will lose a tooth.  And because people are not aware of how serious gum disease is, it is easier for them to hear that the reason for a lost tooth is due to tooth decay rather than gum disease.  But gum disease is silent and usually the pain is not noticeable until the condition becomes worse.
When gingivitis is left untreated it may progress to periodontitis.  This form of gum disease is irreversible and the ligaments and bone that are lost will not be replaced by the body.
There are several stages of periodontitis and the earlier it is diagnosed the better the prognosis of treatment.
Early Periodontitis: This is the stage after gingivitis, and where the redness of the gums increases.  There is bleeding when brushing and flossing, and bad breath worsens.  The ligaments that attach the tooth to the bone become inflamed and there is minor loss of attachment, and pockets measuring between 4 to 5 millimetres (mm) may start to develop between the gum and the teeth.The tooth is not shaking (mobile) at this stage.
Moderate Periodontitis: Here the infection extends deeper below the gum and destroys the supporting bone and ligaments.  There is 30% to 50% loss of bone support and slight tooth mobility.  The pocket depth increases to between 6 and 7mm. At this stage eliminating the bacteria through daily oral hygiene is impossible and the bacteria are regularly entering your bloodstream causing stress to your immune system.
Advanced Periodontitis: This is advanced breakdown of supporting periodontal tissues with pocket depth extending to greater than 7mm and significant gingival recession.  There is severe attachment loss and more than 50% loss of bone support and greater tooth mobility.  Periodontal abscesses occur more frequently and spontaneous bleeding and pus drainage occurs.
Test and Diagnosis
In order to determine the severity of your periodontitis your dentist may do the following:
·    Measure Pocket Depths:  A special instrument called a periodontal probe may be used to determine the depth of the pockets around your teeth.  In a healthy mouth, this depth usually measures between one and 3mm.  Pockets deeper than five mm may indicate periodontitis.
·    Dental X-rays: A series of x-rays may be taken of your whole mouth or specific areas where deeper pockets are noticed in order to assess the amount of bone loss.  The x-rays will be used at a later date to evaluate the progress of any treatment, or any continued bone loss.
Treatment
The type of treatment will depend on the severity of the condition.  The main goal of all treatment is to remove the tartar and bacteria and to stop the destruction of bone and ligaments.  In the early stages of periodontitis the following non-surgical treatment methods may be used:
·    Scaling: Removal of tartar and bacteria from the tooth surfaces and beneath the gums using instruments or an ultrasonic device.
·    Root planing: Smoothing of the root surfaces to prevent tartar build-up.
·    Laser therapy: Laser is used to disrupt bacteria from around the tooth and inside the gum pocket giving bone and gum pocket a chance to heal.
·    Medications: Antibiotics may be prescribed to help control bacterial infection. This includes the use of medicated mouth rinses, the insertion of antibiotic gels in the pockets or taking systemic antibiotics.
In cases of advanced periodontitis, surgical treatment may be needed.  These include:
·    Flap surgery: This treatment aims at reducing the pocket depths. Tiny incisions are made in the gum to lift the gum tissue back to expose the roots for scaling and root planing.
·    Soft tissue grafts: One of the consequences of gum disease is the loss of gum tissue.  In this treatment small amounts of tissue are removed from the roof of your mouth (palate) or another donor source and attached to the affected area. This procedure can help reduce further gum recession, cover exposed roots and give your teeth a more pleasing appearance.
·    Bone grafting: If the bone surrounding your tooth is destroyed bone grafting may be done.  Small of amounts of your own bone or synthetic or donated bone may be placed at the affected site.  The bone graft helps to anchor your tooth in place and also serves as a stimulus for natural bone regrowth.
·    Enamel matrix derivative application: A special gel containing the similar proteins found in developing tooth enamel is applied to the affected area to stimulate the growth of healthy bone and tissue.
For more information contact OMNI DENTAL at 295 Quamina Street, Georgetown Tel: 227-0025, Parika Tel: 260-3133 or send emails to [email protected].

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