|
|
|
 |
|
|
Periodontal Health
Periodontology is an entire branch of dentistry dedicated to studying the tissues surrounding the teeth, researching new techniques for treating periodontal diseases and replacing lost teeth with dental implants.
A Periodontist is a dentist who specializes in the prevention, diagnosis and treatment of periodontal diseases. A Periodontist also plans, places and maintains dental implants to replace missing teeth or support dentures.
Periodontal Disease
Approximately 75% of all Americans have some form of periodontal disease, known by many as gum disease. These usually painless diseases often go undetected until it's too late. Periodontal disease is an infectious and inflammatory disease caused by the bacteria in plaque. Periodontal disease will not go away by itself or with improved home care. If left untreated, gum disease can destroy the bone and tissue surrounding the teeth, causing them to become loose and, in some cases, painful. In addition gum disease can cause bad breath, a bad taste in your mouth and will change the appearance of your smile. If the condition progresses untreated you will lose your teeth. Gum disease is the number one cause of tooth loss today. Although the bacteria in plaque is the primary cause of periodontal diseases, other factors can affect the health of your gums including: smoking/tobacco use, pregnancy and puberty, stress, medications, clenching or grinding your teeth, diabetes, poor nutrition and systemic diseases. Furthermore, recent scientific based evidence has demonstrated a link between periodontal disease acting as a risk factor in heart disease.
How can periodontal diseases be prevented?
To keep your teeth for a lifetime, you must remove the plaque from your teeth and gums everyday by proper and thorough brushing and flossing. Our dental professionals can help you fine tune your technique and put you on the right regimen. Regular dental visits are also important, while daily at home cleaning will keep plaque accumulation to a minimum, it won't completely prevent it. A professional cleaning at least twice a year is necessary to remove bacteria and calculus (hardened plaque) from places your toothbrush and floss miss. If you've had periodontal disease and have been treated, you may need professional maintenance more frequently.
Gingivitis
In this early stage, your gums may look normal but they may be red, puffy, and bleed easily when you brush or floss your teeth. You may also notice some mouth odor. Bacteria in the plaque which has accumulated on your teeth has caused this infection and condition. There is usually little or no discomfort at this stage. Gingivitis is reversible with professional treatment and good home oral care.
Early Periodontitis
Early Periodontitis occurs when the bacterial infection spreads from the gums to the bone that supports the teeth. The bacteria then cause small spaces called pockets to form between your gums and bone. Normal spaces measure between 1 and 3 mm deep, measurements over 3 mm are cause for concern as the bone is being destroyed. As the pocket grows and the amount of bacteria increases, the gums recede down the root of the tooth, increasing the pocket depth. If caught early enough nonsurgical therapy can arrest your disease. Supportive periodontal treatment, a regular schedule of thorough cleanings, will in most cases be necessary to insure your infection remains under control.
Advanced Periodontitis
When half or more of the original bone holding the tooth has been lost, and pockets are very deep, it is called Advanced Periodontitis. The tooth may appear longer because the root is exposed, your teeth may be shifting, and the tooth may loosen and eventually fall out, or have to be removed. Surgery is indicated and bone grafting may be performed in order to regenerate bony support for the teeth.
The link between Gum Disease and Health Concerns
The oral bacteria that is found in patient's with periodontal disease can enter into the blood stream. From here the bacteria can travel throughout the body. Inflammation sets in, but your body's immune response sometimes falls short. These bacterial colonies can cause serious problems such as:
- Stroke: A new study of fatty deposits lodged in carotid arteries of stroke sufferers shows that 70% contain bacteria, and 40% of that bacteria comes from the mouth.
- Heart Disease: Studies have found the incidence of heart disease is about twice as high in people with periodontal disease. Bacteria get mixed up with blood-clotting cells called platelets, forming a clump that travels through the blood vessels. These clumps of cells and bacteria irritate vessel walls and may promote formation of heat stopping blood clots. The inflammation also produces a protein that can irritate the interior of blood vessels, creating sites where fatty deposits can form clogging circulation and raising blood pressure.
- Infective Endocarditis: A potentially fatal disease in which the inner lining of the heart becomes inflamed.
- Diabetes: Studies have shown that diabetics with gum disease were three times more likely to have heart attacks than those without gum disease.
- Spontaneous pre-term births: Women with gum disease are 7 to 8 times more likely to give birth prematurely to low-birth-weight babies. Researchers believe that the low-grade infection causes damaged cells to release inflammation causing substances that have been linked with pre-term births.
- Lung infections: In people with chronic lung diseases
- A weakened Immune System: that can slow wound healing and diminish a person's response to hepatitis B and flu vaccines.
Non-Surgical Therapy
Scaling and Root Planing
Scaling and root planing is a necessary procedure in the treatment of gingivitis and periodontal disease. Gingivitis is a mild inflammation of the gums caused by plaque buildup and is the first stage of periodontal disease. Generally with gingivitis no pain is felt, instead you may notice the warning signs of red, swollen or bleeding gums. If left untreated gingivitis can lead to a more serious stage of periodontal disease called periodontitis. With periodontitis the bone that supports the teeth can be destroyed. In advanced stages of periodontitis the teeth become loose and will eventually fall out or become infected and need to be extracted.
If we diagnose you with gingivitis or periodontitis our first step in clinical treatment is scaling and root planing. This procedure involves our specially trained dental hygienists removing plaque, calculus (calcified plaque) and toxins from the root surfaces. The root surfaces are smoothed making it very difficult for new plaque to attach. During the treatment the gum tissue is also treated allowing it to attach firmly to the smooth root surface. Part of the procedure will involve polishing your teeth which will remove all stains and plaque from the crown of the tooth. This not only brightens your smile, stains attract plaque and bacteria which cause gingivitis and periodontitis.
The dental hygienist can also perform a procedure called subgingival irrigation. A prescription antiobiotic mouthrinse is used between the gums and teeth to assist in healing.
Thorough oral hygiene instructions specific to your needs are very important and always included in your treatment.
Periodontal Maintenance
Maintenance therapy describes the follow-up care after any periodontal procedure. With the advances in periodontal dentistry today we have the capabilities to arrest and sometimes even reverse the damage done to gums and supporting bone.
Periodontal diseases are chronic diseases that require constant attention. Unfortunately neglect can quickly "redo" the damage. Our offices provide maintenance therapy in order that we can assist you in remaining in a state of dental health. Our clinical teams are specially trained to provide you the best guidance and care possible to achieve a successful long term result and to keep your infection under control. When the surgical therapy is finished the maintenance therapy begins!!
Antibiotic Therapy
Periodontal disease is a chronic bacterial infection, and like most bacterial infections, can be treated with an antibiotic. Locally administered antibiotics play an important role in treating periodontal infection. Administered directly into the infected area, antibiotics kill microorganisms in the periodontal pockets. Prescription antibiotic pills are also available and appropriate for some people. There are a variety of methods for administering dental antibiotics, the doctor and hygienist will decide which method you can benefit from the most and discuss your options with you.
Surgical Therapy
Dental Implants
Implants are an excellent solution to missing teeth! A dental implant is a synthetic or "man-made" tooth root that is placed into the upper or lower jaw where teeth are missing. Extensive research over several decades has provided us with materials which are compatible with human bone, and that actually bond chemically to our natural bone.
When teeth are lost, the supporting bone is also lost. Where implants have been placed and properly maintained, the supporting bone is preserved because the bone is being used in many ways as it was when the natural tooth was present.
The doctors at Park Dental Specialists have extensive training in the surgical procedures necessary to successfully place dental implants in a wide variety of clinical situations. Implant procedures are typically done in two stages. The "root" section is placed into the jaw bone, it is necessary for the implant and the bone to heal for a period of several months. The top part or crown is affixed several months later by your dentist after the implant and bone have fused together. In most cases the teeth are attached permanently and cannot be removed by you. The replacement teeth will often function and look identical to natural teeth. Chewing, swallowing, speaking and other functions can therefore be greatly improved.
The surgical placement of dental implants is usually done in our office under local anesthesia. Most of our patients tell us that the placement of an implant is easier than having the original tooth removed. You always have the option of intravenous sedation or general anesthesia. This is ideal if you are apprehensive or are having a lengthy surgical procedure.
Recovery from the placement of an implant is no more complicated usually than removal of teeth. Healing times may vary depending on any additional procedures that are performed. Fortunately, most patients can wear a temporary bridge or denture during the healing phase.
It is important to realize that implants can develop gum problems similar to your natural teeth. Anything that may irritate oral tissues such as excessive alcohol use, smoking or chewing tobacco, may promote tissue breakdown and lead to implant failure. Therefore it is important to maintain excellent oral hygiene and follow our instructions regarding home care and follow up visits.
No surgery is without possible complications. When the procedures are performed by experienced practitioners the risk of complications is very low but we feel that you should be aware of them and we will discuss this with you prior to therapy.
We would like to emphasize that dental implants are a proven, practical means to tooth replacement and that dental implants have been documented as a predictable and effective treatment for over 30 years.
Replacing a Single Tooth with an Implant
If you are missing a single tooth, one implant and crown can replace it. A dental implant will provide a stable replacement without needlessly damaging adjacent teeth.
The advantages of a single tooth implant over old-fashioned bridgework are numerous. In addition to looking and functioning like a natural tooth, a dental implant replaces a single tooth without sacrificing the health of the neighboring teeth. The other common treatment for the loss of a single tooth, a tooth-supported bridge, requires that adjacent teeth be ground down to support the cemented bridge.
Because a dental implant will replace your tooth root, the bone is better preserved. With a bridge, some of the bone that previously surrounded the tooth begins to absorb (deteriorate). Dental implants integrate with your jawbone, fooling the bone into thinking a tooth still resides and thus keeps the bone healthy and intact.
In the long term, a single implant can be more esthetic and easier to keep clean than a bridge. Gums can recede around a bridge, leaving a visible defect when the metal base or collar of the bridge becomes exposed (especially evident in the front of your mouth!). Resorbed bone beneath the bridge can lead to a very unattractive smile. The cement holding the bridge in place can wash out allowing bacteria to decay the teeth that anchor the bridge. Most bridges are replaced due to recurrent decay as flossing is very difficult around bridgework.
Most often you will be able to wear a temporary during the healing phase of the implant procedure. Post operative instructions specific to you will be given and should be strictly adhered to. Implants are extremely successful but small precautions are always taken to insure the success of your therapy. Most patients tell us the most difficult part of the procedure is waiting the 90-180 days it takes for the implant to bond to the bone before the dentist can custom make the crown to complete the process. This is a small sacrifice for a lifetime of chewing and smiling comfort.
Replacing Several Teeth with Implants
If you are missing several teeth, implant supported bridges can replace them. Dental implants are the clear choice and provide several advantages over other teeth replacements. In addition to looking and functioning like natural teeth, implant supported bridges replace teeth without support from adjacent natural teeth. Other common treatments for the loss of several teeth, such as fixed bridges or removable partial dentures, are dependent on support from adjacent teeth.
In addition, because implant-supported bridges will replace some of your tooth roots, your bone is better preserved. With a fixed bridge or removable partial denture, the bone that previously surrounded the tooth root may begin to resorb (deteriorate). Dental implants integrate with your jawbone, helping to keep the bone healthy and intact.
In the long term, implants are esthetic, functional and comfortable. Gums and bone can recede around a fixed bridge or removable partial denture, leaving a visible defect or causing extreme discomfort as your bone changes. Resorbed bone beneath bridges or removable partial dentures can lead to a collapsed, unattractive smile. The clasps found on most removable partial dentures also pull and push on the supporting teeth causing extensive damage to the teeth and bone. Removable partial dentures are also notoriously loose causing them to move around in your mouth and reduce your ability to talk and eat certain foods.
Replacing all Your Teeth with Implant Supported Dentures
If you are missing all of your teeth, an implant-supported full bridge or full denture can replace them. Dental implants will replace both your lost teeth and some of the roots.
Dental implants provide several advantages over other replacement options. In addition to looking and functioning like natural teeth, implant supported dentures are designed to be long lasting. Implant supported full dentures are more comfortable and stable than conventional tissue supported dentures, allowing you to retain a more natural biting and chewing capacity.
Because implant supported dentures will replace some of your tooth roots, your bone is much better preserved. With conventional dentures, the bone that previously surrounded your teeth roots begins to deteriorate (atrophy). Dental implants integrate with the jawbone, keeping the bone healthy and intact. The loss of bone that accompanies conventional gum supported dentures leads to recession of the jawbone and a collapsed, unattractive smile. When this happens wrinkles on the face near the mouth become deeper and many times are continually cracked and red from the moisture of the lips. Conventional dentures make it difficult to eat certain foods as they tend to move or float within your mouth. Implants allow the dentures to be "snapped" into place eliminating movement which in turn eliminates the need for adhesives. Implant dentures are extremely stable and comfortable providing improved digestion. In many cases an implant denture will eliminate the need for the roof of your mouth to be covered by the plastic of old fashioned dentures. You will be able to taste your food much better and speak much more naturally.
Implants also provide a non-surgical facelift. Implant dentures restore lip support minimizing wrinkles around the mouth which many denture wearers suffer from.
Cosmetic Gingivectomy
Periodontal cosmetic surgery refers to changing the way your gums frame your smile. Just as the beauty of a painting is influenced by the frame, the appeal of your smile is dictated by your gums. Cosmetic surgery is utilized to raise, lower or recontour the shape of your gum tissue. Asymmetries in teeth and gums draw attention to themselves and become the unwanted focus point. Utilizing cosmetic techniques can drastically change the impression your smile has on others and create a pleasing appearance.
Intravenous sedation is always available in our offices. Relaxing drugs are administered allowing the patient to basically sleep through surgery.
Bone Grafting of Periodontal Defects
Before today's technology the treatment of periodontitis (bone loss) could only arrest the progression of the disease. Today, a better treatment is available allowing you to virtually regrow bone; guided tissue regeneration (GTR).
Bone loss due to gum disease results in gum recession, tooth loss, bad breath and an unappealing smile. It is now possible to regain the damage that has occurred and reclaim your smile. GTR is this process. The idea of GTR is to cover the bony defect with a barrier that prevents gum tissues from going into the defect next to the tooth. The GTR creates a space over the defect allowing your bone to fill in underneath. Properly kept clean this new bone will support your teeth indefinitely.
Crown Lengthening
When a tooth is decayed or broken below the gumline, periodontal therapy may be indicated to adjust the gum and bone levels to expose more of the tooth so your general dentist can repair it.
Gum Tissue Grafting
Once the gums have receded, the only way to "replace" them is to do a gingival graft. Teeth have two types of gum tissue, attached and unattached (free) around them. The amount of attached tissue is important because this is necessary to maintain the tooth or teeth in a healthier, long-term manner. If the amount of unattached tissue is little or missing due to overzealous brushing, orthodontics, or strong muscle attachments a gum graft should be seriously considered. Grafts can also be done for sensitivity or to recreate a smile. In performing grafts we utilize tissue from other areas of your mouth and supplement the deficient area. Newer technology allows us to use donated tissue eliminating the discomfort of harvesting tissue from other areas of the mouth. We will be happy to discuss all of your grafting options with you.
|
|
|
|
