Gum diseases are infections and inflammation of the gums and bones that support the teeth structures. There are two types of gum diseases: gingivitis (early stage gum disease and reversible) and periodontitis (severe gum disease and chronic). According to the CDC, 47% of adults over 30 and 70% of adults over 65 suffer from some forms of gum diseases.
Causes and Symptoms:
Improper home care and a sugary diet can lead to the buildup of a bacterial biofilm known as dental plaque on and between your teeth. Over time, plaque hardens into tartar (calculus), and bacteria spreads to the gum tissue surrounding the base of your teeth (gingiva) causing inflammation. When the gums become swollen and irritated, they separate from the teeth and form spaces called periodontal pockets. This process leads to gingivitis. Common symptoms of gingivitis include bad breath and red swollen gums that may bleed when brushing or flossing. Gingivitis can be reversed, so early detection and intervention is crucial. Tartar can not be removed by simply brushing or flossing and requires a professional cleaning at your dentist office.
Left untreated, gingivitis can progress into periodontitis, a severe inflammatory disease that affects the gums, bones, and the connective tissue that hold the teeth in place. Periodontitis is a leading cause of tooth loss and has been shown to negatively impact systemic health.
Periodontal charting and X-ray
During the routine cleaning, you may hear your hygienist calling out numbers while gently probing the gum tissue surrounding the teeth. This procedure is called periodontal charting, and its purpose is to assess the health of your gums by measuring the depth of the space between the gum and the teeth (pocket). Healthy gums are indicated by a pocket depth of 1-3mm with no bleeding or sensitivity. Pocket depth of 4mm may indicate gum inflammation – an early stage of gum disease known as gingivitis. Pocket depth of 5mm or greater indicates periodontitis and potential bone loss due to the spread of bacteria. A periapical x-ray is taken to evaluate the extent of bone loss and severity of the periodontitis.
Scaling and Root Planing Procedure (Deep Cleaning)
If gingivitis progresses to periodontitis, scaling and root planing (SRP), also known as periodontal deep cleaning, is typically recommended. SRP requires the administration of local anesthesia, which can be in the form of a topical numbing gel or an injection.
Scaling removes plaque and calculus beneath the gums, between the gums, and on the base of teeth crowns. Scaling is either done manually or with an ultrasonic instrument, such as a Calvitron. Both techniques loosen plaque and remove hardened tartar. Bleeding may occur during the cleaning but will stop after the procedure and you can return to normal activities right away. Patients may experience minor discomfort for a day or so after the procedure.
Scaling and root planing are divided into two appointments to avoid numbing your entire mouth all at once. During the first appointment, your hygienist numbs and cleans the upper and lower quadrants of one side of your mouth. The other two quadrants are cleaned in the second appointment. Ideally, the two appointments are scheduled within two weeks. Four to six weeks after SRP, you will return for a reevaluation of the periodontal pockets. Areas of the gum tissue where no improvements are observed will receive laser gum therapy and/or antibiotic treatment.
Laser Assisted New Attachment Procedure (LANAP)
After the tooth and pocket have been debrided, the fiber optic tip is gently placed at the top of the periodontal pocket between the gum and teeth. The laser selectively kills the bacteria that cause periodontal disease and removes the diseased tissue inside the pocket while leaving the healthy tissue unharmed. The laser then sterilizes the soft tissue, root bone, and bone. The laser also stimulates the formation of a blood clot which contains fibers that reattach the tissue to the tooth and seal out debris and bacteria to encourage regrowth of bone and soft tissue. Arestin, a localized antibiotic, can also be placed locally in the depths of the pocket to aid in the tissue healing process.
Depending on how well your gum tissue heals, your hygienist will recommend a periodontal maintenance cleaning every 3 to 4 months in order to closely monitor your periodontal status. It is important to practice good oral hygiene to prevent the recurrence of periodontal disease. In addition to regular brushing, flossing, and mouthwash, we highly recommend incorporating water flossing (Waterpic) as part of your home care routine to keep the periodontal pockets clean of debris and plaques following SRP.
My hygienist name is Jessie. She is always super friendly and does an amazing job cleaning my teeth! Thanks again Jessie. Dr. Wilhelms is great. Always willing to take the time to explain any concerns I may have and very professional. I’ve been going to Parkview Dental for a very long time and I would highly recommend them.
We’ve been going to Parkview for at least 15 years. Staff are always considerate and helpful. We’ve never had a less than wonderful experience.
Everyone at Parkview was extremely friendly and kind. They explained the dental work that I need to have done, answering every question I had.
Great experience at Parkview Dental. Tiffany was very professional and thorough. Dr. Wilhelms is always kind and professional. We have never had a bad experience at Parkview Dental. Great for all ages and all dental needs.
I have been a long time patient since the early 90s. Dr. Wilhelms and his staff have been calming and professional every visit for the last several years. Thank you!
I have been a patient at Parkview for over 30 years and counting. The staff is awesome and Dr. Wilhems has been a wonderful dentist and I couldn't be happier with the service.
Always friendly. courteous staff and a positive experience. Knowledgeable dentists and support staff. Will work with your insurance and also any excess payments you might need to make.
After not being at the dentist for sometime I was a bit worried how my first cleaning would go. I was very pleased!
Dr. Limke is the best dentist I have ever had! He tells it to you straight and is invested in your overall health. The staff is always friendly and accommodating! I tell all my friends about Parkview Dental!
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My hygienist was great. I would recommend her.
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