Periodontal Maintenance
Among the causes for periodontal (gum) disease are genetic susceptibility, smoking, and other illnesses like diabetes. Periodontal maintenance involves removing plaque and tartar from above and below the gum line. Most gum diseases are preventable with proper oral hygiene. However, what can start out as gingivitis (inflamed or bleeding gums) can quickly turn into periodontitis. In such cases, gums pull away from the tooth to create “pockets,” thereby exposing a dental root to infection. It can also lead to prolonged bad breath, loose teeth, painful chewing and other complications.
Diagnosing Gum Disease
The following methods and symptoms are very useful in the diagnosis of gum disease: Measuring the gums: A dentist will use a periodontal probe to measure the depths of the pockets around all of the teeth in the mouth generally once per calendar year. Healthy gums will have pockets 1 mm-3 mm deep.
Further Treatment
Treatments for gum disease that don't involve surgery include:
- Professional dental cleaning. During a typical checkup your dentist or dental hygienist will remove the plaque and tartar (plaque that builds up and hardens on the tooth surface and can only be removed with professional cleaning) from above and below the gum line of all teeth. If you have some signs of gum disease, your dentist may recommend professional dental cleaning more than twice-a-year. Dental cleanings are not a treatment for active gum disease. They are, though, an important preventive measure that can help you stave off its development.
- Scaling and root planing. This is a deep-cleaning, nonsurgical procedure, done under a local anesthetic, whereby plaque and tartar from above and below the gum line are scraped away (scaling) and rough spots on the tooth root are made smooth (planing). Smoothing the rough spots removes bacteria and provides a clean surface for the gums to reattach to the teeth. Scaling and root planing is done if your dentist or periodontist determines that you have plaque and calculus (hardened plaque, also called tartar) under the gums that needs to be removed.
Some treatments for gum disease are surgical. Some examples are:
- Flap surgery/pocket reduction surgery. During this procedure the gums are lifted back and the tarter is removed. In some cases, irregular surfaces of the damaged bone are smoothed to limit areas where disease-causing bacteria can hide. The gums are then placed so that the tissue fits snugly around the tooth. This method reduces the size of the space between the gum and tooth, thereby decreasing the areas where harmful bacteria can grow and decreasing the chance of serious health problems associated with periodontal disease.
- Bone grafts. This procedure involves using fragments of your own bone, synthetic bone, or donated bone to replace bone destroyed by gum disease. The grafts serve as a platform for the regrowth of bone, which restores stability to teeth. New technology, called tissue engineering, encourages your own body to regenerate bone and tissue at an accelerated rate.
- Soft tissue grafts. This procedure reinforces thin gums or fills in places where gums have receded. Grafted tissue, most often taken from the roof of the mouth, is stitched in place, adding tissue to the affected area.
- Guided tissue regeneration. Performed when the bone supporting your teeth has been destroyed, this procedure stimulates bone and gum tissue growth. Done in combination with flap surgery, a small piece of mesh-like fabric is inserted between the bone and gum tissue. This keeps the gum tissue from growing into the area where the bone should be, allowing the bone and connective tissue to regrow to better support the teeth.
- Bone surgery. Smoothes shallow craters in the bone due to moderate and advanced bone loss. Following flap surgery, the bone around the tooth is reshaped to decrease the craters. This makes it harder for bacteria to collect and grow.
How Laser Therapy Works
In periodontal laser therapy, the provider uses a dental laser to access and remove the inflamed gum tissue from around the root of the tooth. When the infected tissue is removed and the root is exposed, the root scaling begins. This involves scraping off the calculus and plaque built up below the gumline and around the root. The dentist then smooths the root with instruments to remove any rough spots that might attract bacteria and cause future infections. The area between the gum and the root can then regenerate during the healing process.
Laser Therapy Benefits
There are ample benefits to using lasers for excising diseased gum tissue:
- No general anesthetic is needed, as is sometimes required for other forms of dental surgery.
- Lasers can target the diseased areas precisely and accurately.
- Bleeding, pain and swelling are limited because periodontal laser therapy is less invasive than regular surgery.
- Recovery and healing times are shorter.