Periodontal Disease
Periodontal disease is a bacterial infection of the soft tissue of the mouth that can cause loss of bone that supports the teeth. In advanced cases, teeth are lost because the jawbone supporting the teeth is eaten away by toxins.
Periodontal disease is associated with an increased risk of heart attack or stroke. It is also a factor in premature birth for pregnant women with the disease. Research is showing that the bacteria from the disease enter the bloodstream and can cause a buildup of plaque in areas such as the carotid and coronary arteries.
It is common for the spouse of a periodontal patient to also develop the disease, particularly if he or she displays poor oral hygiene and/or poor resistance to the bacteria that cause the disease.
There are different stages of the disease. Below is a description of these stages.
- Gingivitis - At this stage, there is no detectable bone loss, but soft tissue is inflamed; at this stage, there is gum tenderness when being cleaned and gums may bleed easily. Gingivitis occurs when home care is inadequate, when dental cleaning visits are infrequent, or when stress allows bacteria to take hold in the mouth. Improved home care and more frequent dental visits will generally clear up this condition. If you have this condition, we would advise you to have your teeth cleaned at three month intervals until the condition is eliminated. We may also prescribe an antimicrobial rinse for use at home and may use an antimicrobial solution during your dental cleaning to reduce the bacterial populations.
- Isolated Areas of Infection - This may include some bone loss. At this stage, it is important for the patient to be particularly careful in keeping these areas flossed, and to schedule an additional cleaning in three months to monitor the situation. We may also place an antibiotic powder or gel in the pocket to reduce the bacterial population.
- Moderate Periodontal Disease - some generalized bone loss, less than six millimeters. At this point it appears that the bone loss is not too severe and the disease is treatable with periodontal scaling, antimicrobial treatment, and careful home care. A patient at this stage must have his or her teeth scaled and then follow up with antimicrobial irrigation administered at this office every three months. We may also use an antibiotic powder or gel to reduce pocket depths. At this stage, periodontal disease does not go away, it can only be controlled to keep it from advancing
- Advanced Periodontal Disease - with isolated pockets, some bone loss greater than six millimeters. At this stage of the disease, we may not be able to remove the hardened calculus and toxins without surgery. The treatment at this stage is periodontal scaling to eliminate as much calculus as possible and possible placement of an antibiotic powder or gel in the worst pocket areas. Laser therapy is a non surgical adjunctive treatment that we are using in our office. This procedure is designed to specifically remove diseased tissue and to selectively kill the bacteria associated with periodontal infections. After treatment, we follow up in six weeks to determine future needs.
- Advanced Periodontal Disease - widespread bone loss, greater than six millimeters. The disease at this stage is a serious infection, and can lead to tooth loss and affect overall health. There are new chemotherapeutic treatment modalities that involve the application of bactericidal agents in custom fitted oral trays that is showing promise in the treatment of advanced and stubborn periodontal infections. We may advise referral to a periodontist if the aforementioned treatment modalities are not effective.
Laser treatment of periodontal disease
When periodontal disease is advanced, we use our laser system as an alternative to periodontal surgery. With this therapy we can removed diseased tissue and reduce bacterial levels in deep pockets.
Links between Periodontal disease and systemic disease
Several recent studies have established a link between periodontal disease and systemic diseases such as cardiovascular disease, diabetes, and pregnancy complications. Periodontal disease bacteria have been shown to increase the presence of C reactive protein and other mediators of inflammation. Recent studies have demonstrated that in patients with cardiovascular disease, endothelial dysfunction, a sign of early pathology in atherosclerosis, was reduced with periodontal treatment for patients with severe periodontitis. Bacteria that are associated with periodontal disease have been found in the carotid artery and there is a correlation between stroke and periodontal disease. Several studies have shown that premature birth is a complication of pregnancy associated with periodontal disease.
