Periodontics is that
specialty of dentistry which encompasses the prevention, diagnosis
and treatment of diseases of the supporting and surrounding
tissues of the teeth or their substitutes and the maintenance
of the health, function and esthetics of these structures and
tissues.
Periodontal disease is
a bacterial infection that affects the attachment fibers and
supporting bone that hold your teeth in your mouth. A periodontal
screening is an easy way for your dental care professional to
determine the state of your periodontal health. During this
screening, a small measuring probe is gently placed between
your tooth and gum to assess your periodontal health. Early
detection and treatment of periodontal disease can help you
keep your teeth for a lifetime.
- When gums bleed during
brushing
- Swollen, red or tender gums
- Longer teeth
- Pus appears when pressing the gums
- Loose teeth
- Change is position of teeth
- Change in the way your teeth fit when you bite
- Bad breath or bad taste
Periodontal disease starts
by a bacterial infection that destroys the gums, bone and ligaments
supporting the teeth. Periodontal disease progresses silently,
often without pain or symptoms. It may develop slowly or progress
rapidly.Nine out of ten people are afflicted with some form
of periodontal disease in their lifetime. Periodontal disease
affects more than half the population over 18 years of age.
After 35, approximately three out of four adults develop some
form of gum disease.
Bacteria called plaque
forms at the point where the teeth meet the gums, as well as
between the teeth. If it is not removed daily, plaque multiplies
into colonies. Unremoved plaque hardens into tartar, a tough
gritty deposit which, because of its roughness, collects more
plaque. Tartar can only be removed by a dentist or dental hygenist.
If plaque is allowed to develop, an inflamation of the gums
occurs called gingivitis. As gingivitis worsens, gums begin
to pull away and recede from the teeth. Pockets of bacteria
form and deepen, reaching the bone and destroying the bone that
anchors the teeth. The advanced stage of this disease is called
periodontitis, which can lead to tooth loss if not treated.
Other causes of periodontal disease, aside from plaque (the
chief cause), are conditions affecting the immune system such
as diabetes, hormone imbalances, thyroid malfunction and pregnancy,
and also some medications and hereditary factors.
During checkup, the periodontist
uses an instrument called a periodontal probe. This determines
if there is any breakdown in the attachment of the gums to the
teeth, or early development of pockets between the teeth and
gums. The depth of the pockets is measured in millimeters with
the periodontal probe. Up to three millimeters is considered
normal.. deeper than three millimeters indicates a potential
problem. X-rays are taken if there is concern over possible
bone destruction.
The main goal of periodontal
treatment is eradication of the disease process from the gums,
ligaments and bones that surround the teeth, and restoration
of health that can be predictably maintained in the future.
PHASE I
Initial treatment involves
educating patients in the proper methods of effective, daily
plaque removal and oral hygiene. This is a critical component
of successful therapy.
Scaling and root planing are performed to clean the tooth structure
and remove bacterial plaque and calculus deposits (the source
of the infection) from the gum pockets. This may be the only
treatment necessary in cases of gingivitis and very mild periodontitis
PHASE II
In cases which demonstrate
deeper gum pockets and underlying bone loss, it becomes necessary
to eliminate the diseased gum pockets and bony destruction with
osseous (bone) surgery. The gum is "flapped" and retracted
away from the teeth to expose the underlying roots and bone
deformities. The bone is contoured to approximate a normal physiologic
profile, and the gum is sutured back to place. When the gum
heals, normal probing depth is re-established between the gum
and tooth (ideally 1-3mm). The attainment of minimal probing
depth facilitates easy removal of plaque by patients at home
and by hygienists during professional cleaning.
Additional treatment modalities may be necessary to
treat periodontal disease and restore health.
These may include:
- Bone grafts
for bone regeneration
- Gum grafts to treat gum recession and pathological
root exposure
- Cosmetic plastic surgery of the gums to improve
appearance
- Fabrication of night guards for bruxism (
tooth grinding )
- Splinting or bonding teeth
together for increased strength and stability
- Orthodontics ( braces ) to straighten and
realign teeth
- Removal of diseased roots on some types of molars
- Use of medications such as antibiotics, fluoride and antimicrobial
rinses
Laser Dentistry Procedures and Effects:
LASER
PERIODONTAL THERAPY
Laser dentistry or laser
periodontics allows for the treatment of gum disease at any
earlier stage. In addition, it can be useful to pregnant women
and people with debilitating medical conditions. While there
is no guarantee of total "pain free laser dentistry"
discomfort is greatly reduced. By receiving dental laser treatments,
patients often have no need for Novocain or other anesthetics!
Dental laser treatment, often referred to as laser periodontal
treatment, works well for treating canker sores and bacterial
infections around teeth and gums.
During a treatment it is
also common for the patient to wear protective glasses toprotect
his/her eyes from continued exposure to bright light. The laser
emits a tiny ticking sound-a far cry from the days of traditional
dental drills. However, keep in mind that a laser might not
be appropriate for all procedures. Today, many dental services
can be performed with either the laser or traditional treatment,
and are generally covered by most insurance plans. Dr Phillip
F. Ajaje should be able to determine whether or not laser dentistry
is right for you.
• Laser soft tissue curettage
(The removal of tissue or growths from a body cavity)
• Laser removal of diseased,
infected, inflamed and necrosed soft tissue within the periodontal
pocket
• Removal of highly inflamed
edematous tissue affected by bacteria penetration of the pocket
lining and junctional epithelium
• Removal of granulation
tissue from bony defects
• Sulcular debridement (removal
of diseased or inflamed soft tissue in the periodontal pocket
to improve clinical indices including gingival index, gingival
bleeding index, probe depth, attachment loss and tooth mobility)
• Osteoplasty and osseous
recontouring (removal of bone to correct osseous defects
and create physiologic osseous contours)
• Ostectomy (resection of
bone to restore bony architecture, resection of bone for grafting,
etc.)
• Osseous crown lengthening
- refer below
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Osseous
Crown Lengthening
When it comes to a procedure
like osseous crown lengthening, the OPUS 5 excels. Because it
cuts soft tissue, hard tissue and bone, you can use a single
instrument to create the biologic width necessary for problem-free
aesthetic restorations.Pre-op view, no biologic width for crowns
Once the active phase
of treatment is complete and health has been restored, it is
extremely important that patients be seen by a hygienist for
routine dental and periodontal cleaning on a regular basis.
This regimen, along with diligent home care and oral hygiene,
will give the best chance for preventing recurrence of disease
and maintaining long term periodontal health.
