The two most common diseases in the mouth are dental caries (tooth decay) & periodontal disease. Over the age of 30, periodontal disease becomes more common than caries & is second only to cold & flu as the most common of human diseases. Periodontal disease occurs in two forms:
This is the first & a reversible stage of periodontal disease. It can be very localized or it can affect the entire mouth depending on how one cleans the gum. Areas left unclean, results in plaque build-up on tooth surfaces, between teeth & under the gum line, thus causing inflammation–, & bleeding of the gums when plaque bacteria produce toxins that irritate gum tissue. The gums gradually become red, swollen (spongy) & move away from the teeth forming pockets. Generally the condition is painless. By removing the cause, PLAQUE, it will clear up within a few days. Please note that prescribing antibiotics will only help to treat the symptoms & not the disease! If left untreated, Gingivitis will often progress to result in Periodontitis.
The terminal stage of this disease was once referred to as "Pyorrhea". Periodontal disease is a slowly progressing chronic inflammation that affects approximately 34% of the population over 30 by affecting the structures supporting the teeth (gums & periodontal ligament). In most cases, periodontal disease can start–, develop– & progress to the loss of some or all of the teeth without the patient experiencing any pain whatsoever! Even though bleeding of the gums is an early warning sign, bleeding may disappear as the disease progresses giving the false impression that the disease is no longer present!
Dentists need to consider the severity of the condition & be aware of the limitations of non-surgical therapy. Over emphasis on non-surgical therapy may lead to patients not being referred to a Periodontist for special care in a timely fashion, or may not be receiving adequate initial periodontal therapy in general dental practices.
More importantly, after patients are successfully treated, they need to be monitored & re–evaluated periodically to determine if disease in progression has occurred.
In order to assess the state of health in your mouth, your Periodontist must perform a detailed clinical examination consisting of the inspection of the gum tissue, measurements of the extent of gum destruction around the entire mouth & taking of a set of full mouth radiographs.
Treatment usually consists of:
In order to assess the state of health in your mouth, your Periodontist must perform a detailed clinical examination consisting of the inspection of the gum tissue, measurements of the extent of gum destruction around the entire mouth & taking of a set of full mouth radiographs.
Non–surgical therapy is limited to:
Where the condition is advanced, minor surgical procedures may be necessary to gain access to the roots, as well as to correct any major bone changes. When tartar deposits are found under the gums, it is necessary to first lift the gums away from the tooth & the bone. By lifting/deflecting the gum the root surface is exposed thus ensuring efficient cleaning (the depth of the pocket is reduced).
Surgical therapy in indicated in cases where:
You will be scheduled to commence a periodontal maintenance programme which will usually consist of six monthly visits to your Periodontist & Oral Hygienist. With regular maintenance therapy screening will be carried out to ensure that your oral hygiene technique remains efficient & to detect & treat any recurrence of the disease as early as possible.
Panoramic x-ray showing severe adult periodontitis, bone loss, calculus: