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Posts for tag: periodontal disease

PeriodontalSurgerymaybeNeededtoHaltGumDiseaseandEncourageHealing

There’s only one way to effectively halt the progressive damage of periodontal (gum) disease — completely remove the bacterial plaque and hardened deposits (calculus) from above and below the gum line that are causing the infection. Although we can accomplish this in most cases with hand instruments called scalers, ultra-sonic equipment or both, some cases may require periodontal surgery to access and clean deeper “pockets” of infection.

As this damaging disease progresses, the supporting bone dissolves and the gum tissues will begin to detach from a tooth, leaving an open space known as a “periodontal pocket.” Besides plaque and calculus pus may also form as a result of the infection. All of this material must be removed from the pocket before healing and, hopefully, tissue reattachment can begin.

Shallow pockets near the gum line are usually accessed and cleaned with hand instruments. But deeper pockets (5 millimeters or greater in depth) may require a surgical procedure to completely clean the area also allowing for regenerative procedures to be done to regain attachment. This will reduce the depth of the periodontal pockets that will make them more accessible for future cleanings and maintenance. Flap surgery is a common type of such a procedure: a small opening (similar to the flap of a letter envelope) is surgically created in the gum tissue to expose the area of infection around the tooth root and bone.

There are also other types of periodontal surgery for repairing and stimulating regeneration of damaged gum tissues. Using grafts or other enhancements, these plastic surgical techniques are especially useful where gum tissues have receded above the natural gum line, leaving more of the underlying tooth below the enamel exposed to disease. These procedures have become more effective in recent years with the development of specialized technologies called “barrier membranes” and biologic growth factors. These materials have allowed bone grafts to be more successful as this technology is engineered for targeted tissue growth and repair, and then dissolve at an appropriate point in the regeneration process.

Periodontal surgery isn’t appropriate for every situation. Still, these procedures do play an important role for many patients to put a halt to the damage caused by gum disease.

If you would like more information on surgical procedures for gum disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Periodontal Surgery: Where Art Meets Science.”

SeekImmediateTreatmentforthisAdvancedFormofGingivitis

It takes only a short time neglecting your oral hygiene before you begin to notice some unpleasant things with your gums: swelling, redness or even bleeding. These are all signs of gingivitis, a periodontal (gum) disease that arises from bacterial plaque, a thin biofilm that builds up on tooth surfaces when a person doesn't brush or floss.

Fortunately, early stages of gingivitis can be treated effectively with comprehensive plaque removal during one or more office visits. If, however, it's not dealt with early, it can develop into something much more serious: acute necrotizing ulcerative gingivitis (ANUG). This form does more than leave you with unattractive teeth and gums and terrible breath — it could eventually cause you to lose your teeth.

ANUG is also known as trench mouth, a common ailment among front line World War I soldiers without access to proper dental care and hygiene. It's most prevalent today among individuals who are under a great deal of stress, not sleeping or eating well and haven't cleaned or properly cared for their teeth for an extended period of time. Tobacco smokers also seem more susceptible than non-smokers to the disease, perhaps because smoke dries the mouth and changes the bacterial environment.

Unlike common gingivitis, ANUG can be quite painful. In effect, the gum tissues begin to die (necrotize), especially the triangular peaks between teeth known as papillae. Besides the other symptoms of gingivitis, the tissues may become yellowish.

ANUG can be treated effectively. The first step is to relieve the symptoms of pain and inflammation through medication. The focus then shifts to treating the underlying cause, bacterial plaque. Besides plaque removal common in any treatment for gum disease, we may also need to initiate antibiotic therapy. Metronidazole is a common antibiotic that's been demonstrated effective against the specific bacterial strain associated with ANUG. We might also combine this with an antibacterial mouth rinse containing chlorhexidine.

The final step belongs to you: to keep ANUG or any other gum disease from reoccurring, it's important for you to adopt a daily regimen of brushing and flossing, along with regular dental visits for thorough teeth cleaning and checkups. Taking this proactive approach will help ensure you won't suffer from this painful and unattractive form of gingivitis again.

If you would like more information on acute gingivitis, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Painful Gums in Teens & Adults.”