Periodontitis and Gum Disease Treatment
It's natural to want to lump people together in some Big Category. Natural, but wrong. Like, "Baby Boomer." President Clinton and home run slugger Mark McGwire are both "Boomers." But are these two guys exactly alike?
It's the same in health and dental care. Your oral chemistry is as unique as your thumbprint. Yet magazine stories claim "you" need only one dental appointment a year to stay healthy. They don't know you. They're referring to an "average" patient. Dental insurance plans also tend to believe in this mythical "average patient" and may not pay for more than a biannual visit.
Sure, two visits are fine for many patients, even most. But some mouths build up more tartar than others. Others are naturally decay-prone. Still others - and this is critical - may be showing signs of periodontal (gum) disease.
Bleeding gums need to be taken seriously. They're signs of an infection that can be a significant risk factor for heart disease, and, in fact, many serious illnesses. If you had a bleeding sore on your hand that didn't heal you'd get to a doctor for a checkup, right? Type I periodontitis (gingivitis) consists of tender gums and a little bacteria-filled pocket between your tooth and gum. It's easily treatable at this point. But if the infected pockets are allowed to enlarge and you get swollen gums, that inflammation can extend to the bone beneath and erode it.
Your periodontist's concern is for your health and your teeth, not whether you've made the standard number of appointments for this year. He or she wants the chemistry to be right in your mouth... and between the two of you.
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Periodontal Regeneration Dentistry Treatment
Periodontal regeneration means restoring the bone and supporting tissues adjacent to teeth with advanced bone loss. Frequently, periodontal regeneration treatment will prolong the use of the involved teeth. A periodontist or dentist will diagnose the problem by taking a careful medical and dental history.
The tissues adjacent to the teeth will be gently probed with a calibrated, ruler-like instrument. These measurements, together with a dental X-ray, will help determine the appropriate treatment for the involved teeth.
There are many regenerative techniques and methods. Bone purchased from bone banks has been used effectively as a regenerative material for over 30 years. This bone is procured from healthy individuals, is carefully processed, and has been proven safe. Treatment consists of carefully moving the gum tissue away from the involved teeth and removing tarter (calculus) deposits from the root surfaces.
The bony defect is gently filled with the bone bank material (allogenic bone) or other synthetic materials. The gums are then replaced around the neck of the teeth with small sutures. The sutures are removed within five to seven days, and gentle tooth brushing can resume.
Synthetic bone substitutes have been developed to simulate natural bone. These materials are safe, and may help support the involved teeth. Such substitutes are implanted through periodontal surgery. Recently, cow bone, which is carefully prepared, sterilized, and safe, has been used to repair defects next to teeth. This bone is porous, allowing bone from the patient to grow into the pores. New technologies have developed porcine (pig) proteins, which, when painted onto teeth, allow for natural regeneration of tooth cementum and bone. These materials have demonstrated early promising clinical results.
The use of barrier membranes to protect and isolate bony defects has been used for over 15 years. These are made from synthetic, non-dissolvable materials, dissolvable materials, or bovine collagen (cow collagen). Membranes are frequently used either with synthetic graft materials or with bone purchased from bone banks. Recently, proteins have been joined to synthetic bone.
This material enhances cell attachment to root surfaces and may provide an effective method for periodontal regeneration. In the future, proteins that stimulate bone formation and enhance formation of new root cementum will make periodontal regeneration a simple, effective method to save teeth with advanced disease.
The materials discussed above have been published in dental journals, are safe, and generally result in tooth retention with bone fill of the treated bony defects. Articles relating to periodontal regeneration can be researched from PubMed using the following key words: "periodontal," "regeneration," "allogenic bone," "synthetic bone grafting," and "barrier membranes."
By William Becker, DDS