Local Dental Care - Gum Disease Periodontitis

The Lowdown on Gum Disease

Dentistry has surely shifted its focus from cavity control, thanks to fluoride and early dental care. Now we are learning more about periodontal disease, and for good reason. These days, tooth loss is the likely result of gum disease.

Q. I used to come in twice a year for cleanings. Now the dental hygienist says I need more attention, more often. My insurer limits coverage to six-month visits. What's up?

A. First, we know more about diagnosing the disease and have come upon some very dangerous systemic relationships to other conditions. That is, if you have heart problems, diabetes, or you're expecting a baby, we'll have to watch you closer than the next patient. Ongoing treatment for advanced mouth disease (periodontitis), too, should be scheduled more often.

Q. OK. What will periodontal treatment cost? I want to keep all the teeth I have.

A. You'll have to contact your periodontist's office for specific pricing but to treat a light case of gingivitis - the very first stages of disease - is the least expensive. Deep pockets around teeth and apparent bone loss - a complex case - will cost more. Periodontitis that requires surgery, and maybe the services of a specialist, costs much, much more. A good argument for early gum disease treatment and prevention.

Q. When you're done with me, am I cured?

A. Periodontal and gum disease prevention is the best defense because nobody walks away from it. Unfortunately, periodontal disease is incurable. But with your help, we can keep it under control. So much of your tissue health depends on how much work you're willing to put in. There's nothing magical about brushing and flossing. You just have to do it.

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Increasing Gum Around a Tooth with Soft Tissue Grafts

If an individual has gum recession as a result of periodontal disease, or has thin gums that need to be augmented before dental procedures, their dentist may recommend a soft tissue (gum) graft. The purpose of the gum graft is to cover exposed root surfaces and to increase the amount of gum around a tooth. It can be done to improve the esthetics of the gum line, prevent further recession, as preparation for other dental procedures (restorations or orthodontics), or to protect the tooth from root sensitivity and cavities.

A graft is the transplantation of living tissue from one part of the body to another. In the case of a gum graft, the tissue is usually taken from the roof of the mouth and placed on the exposed root surface. In some instances, it may be possible to move gum tissue from a site right next to the root surface or to use tissue donated from a different source. One or several teeth can be treated simultaneously.

Gum grafts have been done since the 1960's with exceptional success. The techniques have changed since then, making the procedures even more predictable, comfortable, and esthetic. Today it is possible to match the texture and color of the gum tissue with minimal scarring.

What to Expect from Periodontal Gum Grafts

Soft tissue (gum) grafts are done in the dentist's office with local anesthesia (lidocaine). After obtaining the donor tissue, it is secured on the recipient site with stitches (sutures) or tissue glue. The donor site (usually the roof of the mouth) may also require stitching, bandages, or tissue glue. Post-surgical discomfort is usually minimal and can be easily managed with commonly available over-the-counter medications such as aspirin, acetaminophen, or ibuprofen. Patients can expect to follow their normal routine the day after oral surgery. The dentist will provide special instructions related to diet, exercise, and medications.

The stitches are usually removed five to ten days after the surgery. Follow-up appointments are scheduled as necessary to evaluate healing and plaque control.

Benefits of Gum Grafts

Soft tissue (gum) grafts are beneficial to help reduce further gum recession and bone loss as well as to help protect the root surface from decay and sensitivity. In addition, a dentist should be consulted about gum grafting procedures if individuals have exposed root surfaces or long-looking teeth that create a cosmetic problem. If a general dentist does not frequently perform soft tissue grafts, he or she may refer the patient to a periodontist who specializes in this technique.

By Laura Minsk, DMD