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Refined Aesthetic Periodontics
and Dental Implants

Gum Disease

PERIODONTAL (GUM) DISEASE

Periodontal disease, or gum disease, is a chronic bacterial infection that damages the gums and bone supporting the teeth, which eventually leads to tooth loss if not treated.  Other more serious health problems have been associated with periodontal infection, such as cardiovascular disease, diabetes and pre-term, low-birth-weight babies.

Indications of periodontal disease include:  swollen, painful, or bleeding gums, bad breath, and loose or sensitive teeth.  Unfortunately, periodontal disease is not always obvious.  Bacterial infection may be silently and progressively destroying the soft tissues and bone that support the teeth.

There are many factors that contribute to periodontal disease, such as oral hygiene habits (grinding or clenching), poorly fitting dentures or bridges, stress, general health, medications, systemic diseases, genetics, poor diet, and tobacco use, which can also influence treatment effectiveness and disease recurrence.
 
 



Stages of Periodontal Disease

Gingivitis is a mild form of the disease, caused by bacteria irritating the gums.  Plaque, a sticky film that forms on the teeth and gums hardens into calculus, which forms a rough surface along the gum line on which more plaque accumulates, causing more irritation and swelling.  Although this usually results in sore, bleeding gums, bad breath and spaces between the gums and teeth (pockets) there is no damage to the bone at this point.

Periodontitis occurs when plaque and possibly calculus are found below the gum line.  The gums are irritated and bright red.  They bleed easily and shrink back, or recede.  The ligaments that attach the tooth roots to the bone break down and the gum detaches and pulls away from the teeth.  The pockets deepen and fill with more bacteria.  The damage to ligaments and bone results in loose teeth.

Advanced periodontitis is the most severe stage of the disease process.  When periodontitis progresses to the advanced stage, pockets deepen and may fill with pus.  There is typically swelling around tooth roots and sensitivity to hot or cold.  As bone loss increases, tooth loss generally occurs.  Sometimes the teeth need to be removed to preserve the overall health of your mouth.
 
 

 

PERIODONTAL TREATMENT

If you have bee diagnosed with gum disease, there are a variety of treatment options, depending upon the severity of the bone loss around your teeth.  The most conservative approach in each case will be the procedure necessary to help you keep your teeth for the longest period of time with the best predictability.

Non-Surgical Treatment
If periodontal disease is diagnosed early, nonsurgical therapy may be the only treatment necessary.  This involves the removal of plaque and calculus, which controls the growth of bacteria and treating the conditions that encourage gum disease.

Scaling is a type of cleaning that removes plaque and calculus from the teeth at and slightly below the gum line.  Root planing is a procedure to smooth the surfaces of the tooth roots, so the gum tissue can heal and reattach to the tooth surface.

Surgical Treatment Options
As periodontal disease progresses, the pockets that form between the teeth and gums become deeper and the bacteria that develops around the teeth accumulates and advances under the gum tissue. The result is damage to the supporting tissues and loss of bone.
 
Gingivectomy
A gingivectomy is necessary when the gums have pulled away from the teeth, creating deep pockets, and it is usually performed before gum disease has damaged the bone supporting the teeth.  The procedure involves removing and reshaping loose, diseased gum tissue to eliminate the pockets between the teeth and gums.  After removing the gum tissue, a puttylike substance is placed over your gum line to protect the gums while they heal.
 
Pocket Reduction Surgery
To prevent further damage to the bone and gum tissues caused by the progression of the disease and infection, it is necessary to reduce the pocket depth and eliminate the existing bacteria.  This will also make it easier for you to keep the area clean.

The procedure to reduce the pockets involves folding back the gum tissue and removing the bacteria that causes the disease, then securing the gum tissue snugly around the teeth.  

It may also be necessary to smooth irregular surfaces of the damaged bone and reshape it.  This makes it more difficult for bacteria to accumulate and grow and increases the chance of saving teeth that otherwise would have been lost.
 
 


ADVANCED LASER TREATMENT

Today, periodontal (gum) disease can be treated with new laser technology, which allows the periodontist to remove the diseased gum tissue without surgery.   This minimally invasive procedure provides greater comfort for patients than traditional periodontal surgery, as well as fewer appointments and a reduced recovery period.

The LANAP Procedure produces long-lasting results, with studies indicating that 98% of patients treated remain stable after five years.
Some of the benefits of this procedure include:
  • No incisions or suture (stitches)
  • Less discomfort 
  • Fewer appointments 
  • Shorter recovery period
  • Long-lasting results

Dr. Sinks is one of the few periodontists in the San Diego area offering the LANAP Procedure as an alternative for treating patients with periodontal disease.
 
 


MEDICAL RESEARCH

Dr. Sinks is concerned about our patients’ overall health and believe it is important that they are well informed regarding the complications that can occur as a result of periodontal disease, such as heart disease and low birth weight in babies.

Periodontal Disease and Heart Disease

There are several types of cardiovascular disease, which is the leading cause of heart attacks and strokes. Among these is infective endocarditis, which involves inflammation of the interior lining of the heart and heart valves. It is usually the result of bacterial infection. While damaged and abnormal heart valves are at greatest risk, the condition can also occur in normal valves when a large amount of bacteria is present.

Another type of heart disease, coronary artery disease, is characterized by gradual thickening of the coronary artery walls as a result of fatty proteins. Often blood clots form in the narrowed arteries, obstructing normal blood flow and depriving the heart of needed nutrients and oxygen.

An individual with periodontal disease can injure the gum tissue during normal tasks, such as chewing and brushing. This type of injury allows bacteria to enter the bloodstream. It is believed that the accumulation of these bacteria on heart valves can lead to a fatal endocarditic infection. It also appears that the bacteria can attach to fatty plaques and possibly contribute to clot formation, which can be life threatening in patients with coronary artery disease.

Individuals with periodontal disease are twice as likely to suffer from coronary artery disease.  And a recent study showed that patients who experience a stroke or heart attack are more likely to have periodontal disease.

Periodontal Disease and Diabetes

The link between periodontal disease and diabetes has been well documented. Research has found that periodontal disease is more prevalent in diabetics than in non-diabetics, and that diabetics lose more teeth. This prevalence is most likely due to the fact that diabetics are more susceptible to infections. Recent research has shown that periodontal disease can negatively impact diabetic control, making it more difficult to regulate blood sugar/insulin levels. Consequently, it is important that patients with diabetes receive treatment for any periodontal problems.
 
Following periodontal treatment, many diabetics show a reduction in their need for insulin due to resolution of the periodontal infection. Furthermore, long-term studies show that control of periodontal disease is an important factor in the stability and progression of diabetes.
 
 
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