Teeth are not attached to the gums as firmly as one might think. A tooth’s root is anchored to its socket by fiber-like periodontal ligaments. A ring of gum tissue surrounds the tooth like a thick sleeve protecting the socket from invasion by bacteria. Heavy plaque build-up on the teeth can cause redness and swelling of the gums, gingivitis. If left untreated periodontal disease can set in. The gums shrink away from the teeth leaving pockets where the disease can cause further damage, destroying tissue and bone. Eventually, if too much bone is lost, the teeth will become loose and fall out. Periodontal disease is not a disease of the gums, not the teeth, although the teeth are in danger.
It is a fact that more teeth are lost through periodontal disease than tooth decay. At our practice we are committed to encouraging good oral hygiene and regular professional dental cleaning as prophylactic measures. We systematically examine for early signs of periodontal disease to prevent its progression. If the disease has already taken hold, our treatment methods combine successful therapy with a concern for the best esthetic results.
Concrement is hardened plaque residue, which forms on the surface of the root beneath the gums. Removal of this residue is a prophylactic measure. If not removed, the residue can trigger periodontal disease in the root support system. The preliminary stages of the disease can, in most cases, be treated by removing concrement without further intervention. An ultrasonic descaler with exceptionally fine filigree cleaning point cleans around the root contour and penetrates into the gum socket gently removing the bacterial deposits.
At our practice we specialize in ultrasound technology using instruments that can penetrate several millimeters under the gum tissue to gently clean and polish the surface of the root.
After treatment the gum tissue can heal and regenerate. When any swelling has subsided, we will reevaluate the condition of the root and bone to determine if further intervention is required. In our experience, after a subgingival cleaning procedure, further surgical intervention is usually not required, or only in a significantly reduced area.
The gentlest treatment for inflamed gums is laser treatment. The laser is not a “cure all” but it can “destroy” harmful bacteria. Relatively deep gum tissue bone pockets can be targeted and painlessly treated.
This method is used when other methods are not sufficient to cure the disease. The affected bone pocket is cleaned surgically. In this procedure the gum area is opened so that the deposits are visible and can be removed. In severe cases periodontal disease may have progressed so far that insufficient healthy gum tissue remains to support the tooth. In such cases the structural integrity of the tooth is compromised, and the tooth must be removed. In these unfortunate circumstances, medical necessity and functionality are a priority over esthetic considerations.
Recently-developed techniques – Guided Tissue Regeneration and Guided Bone Regeneration – assist the regeneration of gum tissue and the jawbone. The technique uses proteins that stimulate the body to use its natural ability to rebuild bone and tissue. The dental root system can regenerate sufficiently to help support the surrounding teeth. While a return to the original condition of the bone or a complete regeneration of gum tissue is very rare, at our practice we have had excellent results with this treatment. With timely surgical intervention followed by a program of post-operative treatment by our specialists, we can, however, guarantee a very good chance of success.
We recommend the application of GTR after a thorough examination and consideration of any possible effect the treatment may have to compromise the health of existing teeth. In some cases, when insufficient bone substance is present, the GTR procedure may be a requirement prior to an implant procedure.