Periodontics is one of the eight dental specialties recognized by the
American Dental Association. Periodontal comes from two Greek words that mean
"around the tooth." The periodontium refers to the anatomical
structures around teeth: the gum, bone, and the periodontal
ligament that attaches the tooth to the bone.
Periodontists are dentists that have three additional years of training to
specialize in the prevention, diagnosis, and treatment of the diseases that
affect the gums and supporting structures of the teeth.
Periodontists
also are
experts in the placement and treatment of dental implants.
Periodontal disease is the major cause of tooth loss in adults. According to
the American Dental Association, three out of four Americans over age 35 have
some form of periodontal disease. Gingivitis is the mildest form of periodontal
disease and the most common infection in the world. But if left untreated, it
can progress to periodontitis -- the loss of bone and tissues that support the
teeth.
Periodontal diseases can be localized to a few teeth or generalized, in
which most of the teeth are affected. It can affect people of all ages and
without proper
periodontal treatment, this disease can result in tooth loss and even
complications of systemic diseases.
There are several different forms of
periodontal disease. Each can progress at different rates. The same disease can
have periods when it develops slowly and others when it progresses quite
rapidly. Most of the time, periodontal diseases are painless. But they may have
acute episodes that result in severe pain and a dental emergency.
The rate of periodontal disease progression is
dependent on a multitude of factors, including the presence of certain risk
factors that make people more susceptible to periodontal breakdown.
All periodontal disease
is caused by an accumulation of bacteria at and
below the gum line. The bacteria release toxic substances that trigger the
breakdown of the gum and bone. The gums become red, swollen, and bleed easily.
The gum tissue then separates from the teeth, forming a gap called a periodontal
pocket or exposing the root surface in what is called recession.
The body responds to the bacteria with an inflammatory response in which it
essentially 'turns on itself' and destructs the bone and tissues around the
teeth. This is the body's way of warding off infectious agents. The teeth can
start moving and shifting and eventually if there is advanced bone loss, the
teeth can be lost.
Periodontal diseases are treated in three
phases. The first is to stop the disease activity and progression of bone loss.
In the early stages of periodontal disease, scaling and root planning may be the
only treatment needed.
The bacterial deposits (plaque and tartar) that
formed above and underneath the gums need to be removed and the root surfaces of
the teeth smoothed to enhance healing and deter future plaque retention. During
this phase of treatment, the
periodontist will review the oral hygiene technique, and
give advice on the modification of certain risk factors associated with
periodontal disease.
If the periodontal disease is more advanced, surgical treatment may be
indicated. The purpose of this phase of treatment is to create an environment
that is more amenable to health and, if possible, regenerate some of the bone
that was lost to the disease.
In some forms of periodontitis, antibiotic
treatment may be indicated. If this is the case, a bacterial culture may be
required to test for harmful bacteria and to establish what antibiotics they are
susceptible to.
Periodontal disease is a chronic disease that,
like many other chronic diseases, has to be closely monitored, even after active
treatment. The maintenance or third phase is crucial to the success of any
treatment.
Daily brushing and flossing is essential in
controlling the ever-developing plaque. So is periodic periodontal maintenance
care with professional scaling of the teeth. The periodontal status has to be
closely monitored so that changes can be identified and treated as early as
possible.
Everyone should be routinely screened for periodontal disease. All
periodontists
are qualified in detecting and treating the early stages of periodontal disease,
but if you suspect that you are at risk, or you know you have periodontal
disease, you may want to see a
periodontist
who has extensive advanced training in the diagnoses and treatment of
periodontal diseases.
With today's knowledge about periodontal
diseases and the new advances in treatment, you can expect to keep your teeth
for a lifetime and ward off the effects that periodontal disease may have on
your overall health.
