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Periodontal Disease Treatment Slows Periodontitis

One of the goals of periodontal disease treatment is to arrest and control the progression of the bacteria that cause gingivitis and periodontal disease. As the bacteria infect the gum tissues, they release toxic substances that trigger the breakdown of gum and bone. The gum then separates from the teeth, forming a gap that is called a periodontal pocket. These spaces are inaccessible to daily oral hygiene techniques. Bacteria settle in these pockets and continue to accumulate and reproduce, creating further gum and bone destruction.

Periodontal disease treatment such as scaling and root planing involve the removal of the irritants and bacterial deposits (plaque and tartar) that have accumulated above and below the gum line in the periodontal pockets. The root surfaces of the teeth are planed (smoothed) to promote healing and to help prevent future bacterial reattachment. At the same time, gingival (gum) curettage can be done to remove the infected soft tissues that line the periodontal pockets.

Most of the time, scaling and root planing is done in two to four visits. For patient comfort, the gums can be numbed by the periodontist using a local anesthetic. One-quarter of the mouth is usually treated at the time and treatment of each quarter can take 45 minutes to an hour (three to four hours for the entire mouth). Most patients report minimal discomfort during these periodontics treatments.

During scaling and root planing appointments, the dental care provider will review oral hygiene techniques that are aimed at improving the person's ability to control plaque and to help avoid bacteria from re-infecting the pockets. Patients also will receive advice on the modification of certain risk factors associated with periodontal disease.

In some circumstances, the dental care provider may recommend the use of adjunctive products for periodontal treatment. To be effective, antimicrobial products such as Chlorhexedine, PerioChip, and Atridox should be used in combination with scaling and root planing. Periostat is also a product that can be used as an adjunct to scaling and root planing in order to impede further tissue breakdown and promote healing.

Several weeks after completion of scaling and root planing, a periodontal re-evaluation should be completed. The purpose of this exam is to assess the response to treatment and determine if there is a need for further treatment.

The best way to stop the progression of periodontal disease is to mechanically remove the bacterial plaque and tartar that have accumulated in the periodontal pocket. Daily oral hygiene and supportive periodontal treatment (see article "Supportive Periodontal Treatment") is key to the success of scaling and root planing. Without treatment, the tartar and plaque buildup underneath the gums will continue to cause periodontal tissue breakdown, progression of periodontal disease, and eventually tooth loss and/or systemic (general) complications.

By Laura Minsk, DMD

Diabetes and Periodontal Disease

It's important for your dentist to know if you have diabetes, and how you're controlling it. Good control of your diabetes affects your oral health as well as your overall health.

Diabetics tend to be less resistant to infection than non-diabetics, have more fragile bones, and take longer to heal after an operation.

An oral infection can make diabetes worse, which makes the infection worse, which makes the diabetes worse - and so on into a major medical problem.

Diabetics develop severe gum disease more often, too, especially over the age of 40. Once gum inflammation - gingivitis - sets in, it can erupt into periodontal disease or even infection in the jaw. In undiagnosed or uncontrolled diabetics, this could mean tooth loss.

How to hang on to your teeth?

Practice preventive dentistry and follow the medication, diet, and meal schedules recommended by your physician. This, with balanced rest and exercise, will bolster your resistance to disease, including oral infections and cavities.

If you're taking insulin injections, you may want to schedule appointments around your medication times. The stress of an examination or procedure can change the way your body uses insulin. Your dentist will want to be prepared to help you in case you have a reaction. And let him or her know if you are taking any other medications. Drug interactions can be serious.

You may want to have your gums examined (and have a dental cleaning) by a dental hygienist more often than twice a year - just to make sure nothing suspicious gets started.

And on the home front, good dental hygiene - controlling plaque, the invisible bacterial film that undermines teeth - is crucial. Home care rules to live by: brush at least twice a day and floss at least once a day. The more, the better.

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.