Periodontal disease, or gum disease, is the major cause of tooth loss in adults. The word periodontal literally means "around the tooth." Periodontal diseases are caused by bacterial infections that destroy the attachment fibers and supporting bone that hold your teeth in your mouth. Daily brushing and flossing will prevent most periodontal conditions. There are many forms of gum disease. The most common ones include:

Gingivitis

Gingivitis is the mildest form of periodontal disease. It causes the gums to become red, swollen, and bleed easily. There is usually little or no discomfort at this stage. Gingivitis is reversible with professional treatment and good at home oral care.

Mild Periodontitis

If gingivitis, the mildest form of periodontal disease, is left untreated, it can advance to periodontitis. In the mild stage, periodontal diseases begin to destroy the bone and tissue that support the teeth.

Moderate to Advanced Periodontitis

Moderate to advanced periodontitis develops if earlier forms of the disease like gingivitis and mild periodontitis are left untreated. This is the most advanced form of the disease in which extensive bone and tissue loss occurs.  It starts out as gingivitis that then spreads down to the root surface causing alveolar bone resorption and pocket formation. This can eventually lead to damage to the periodontal ligament and tooth loss. Other complications include periodontal abscess and osteomyelitis of the jaws.

If you have any of the following warning signs or symptoms please go and visit your dentist who will determine if you have periodontal disease:

The main cause of periodontal disease is bacterial plaque, a sticky, colorless film that constantly forms on your teeth. If not carefully removed by daily brushing and flossing, plaque hardens into a rough, porous substance known as calculus (or tartar). Other factors can also affect the health of your gums, including:

Treatment methods depend upon the type of disease and how far the condition has progressed.

In the early stages of periodontitis, Dr. Richards will recommend a non-surgical treatment called scaling and root planing which is then followed by a re-evaluation examination. If this treatment is successful he will prescribe supportive periodontal therapy, a program of regular visits with the dental hygienist designed to make sure your infection remains under control.

When deep pockets between teeth and gums (6 mm or greater) are present, it is difficult to thoroughly remove plaque and tartar during scaling and root planing. Consequently, at the important re-evaluation exam Dr. Richards will determine if additional treatment is needed to restore periodontal health. This treatment, called periodontal surgery, requires local anesthesia, may cause some discomfort, and healing is expected in 7-21 days. Antibiotics or other drugs may be prescribed.

Periodontal Surgery

There are 4 types of surgical therapy that we most commonly prescribe:

Scaling and root planing is the most common treatment for for gingivitis and mild periodontal disease. This conservative procedure involves scraping of the plaque, calculus and inflamed soft tissue in the pockets around the tooth with a special instrument called a curette, to help gums heal.

Scaling and root planing is usually performed in one section of the mouth at a time and local anesthesia may be used for your comfort. Antibacterial medications (rinses, for example) may also be needed. Scaling and root planing is followed by a re-evaluation examination and may be sufficient to allow complete healing of early stages of periodontitis. For more advanced stages of the disease scaling and root planing is also prescribed but additional treatment may be necessary to repair any damage to the gums, teeth, and bone.

Periodontal maintenance therapy (PMT) or supportive periodontal therapy (SPT) is a program of regular visits to the dental hygienist designed to prevent periodontal disease from recurring in patients who have undergone periodontal surgery or who are prone to mild periodontal disease or gingivitis. This ongoing treatment will allow Dr. Richards to monitor your periodontal health and make sure your infection remains under control. During maintenance therapy, your mouth is examined (which includes probing your peridontal pockets and checking for oral cancer), new calculus and plaque are removed, your teeth are polished and, if necessary, your bite is checked.

How often should I have maintenace therapy?

This depends on your periodontal needs and will vary from person to person. Dr. Richards and your general dentist will work together to tailor a schedule that will optimise your oral health. In general, to keep your mouth healthy periodontal maintenance therapy is recommended every three months or four times per year. You may alternate your PMT visits between Dr. Richards' office and that of your general dentist.

You recommend that I have my teeth cleaned every 3 months, but my insurance only pays for a cleaning every 6 months. What do I do?

Dental implants are substitute tooth roots upon which a tooth crown is attached resulting in a very effective, long-lasting replacment tooth.

Implants are an ideal option for people in good general oral health who have lost a tooth or teeth to periodontal disease, an injury or some other reason. Under proper conditions implants can last a lifetime. Long-term studies continue to show improving success rates for implants. Dr.Richards has determined that ITI implants are the most biomechanically stable.

A gentle surgical procedure is used to place the implant into the jawbone. The implant remains undisturbed for a period of as little as 6-8 weeks while the bone remodels around it. A small connector is then attached and the implant is ready for restoration by your general dentist.

What are the benefits of this procedure?