Periodontitis (gum disease) is inflammation resulting in the loss of bone that holds in the teeth and loss of attachment of the gum tissue. With periodontitis, the gum tissue pulls away from the teeth, creating a "pocket" where virulent bacteria accumulate and cause infection. Periodontal disease is prevalent. It is estimated about 47% of people over the age of 30 and 70% of people over the age of 65 have some form of periodontal disease. Periodontal disease is not curable, but it can be stabilized. It can be triggered by several factors, including stress, smoking, and systemic conditions, such as uncontrolled diabetes and heart disease.
The dentist will use information from your dental radiographs to determine if there is any bone loss around your teeth and to what extent. The hygienist will measure your gums and evaluate your tissues for inflammation. Together this data from the x-rays and clinical exam will allow the dentist to diagnose a healthy mouth, gingivitis, or periodontitis. If you have periodontitis, the severity and likelihood of it getting worse will be assessed and given a "stage" and a "grade."
The technical name for a therapeutic cleaning is "scaling and root planing." This is a non-surgical treatment that may be provided by the hygienist or dentist. You may have heard this treatment described as a "deep cleaning," however it is more than just a cleaning and is an advanced hygiene care procedure used to treat active disease. Plaque and tartar build-up will be removed from above and below the level of the gums and the teeth roots will be smoothed to help your gums reattach to your teeth. Typically this treatment will be done in 2 visits, broken up into right side and left side and may require a local anesthetic. After 4-6 weeks, the hygienist will measure your gums and reevaluate your gum tissue for inflammation. The results will be reviewed with you and maintenance recall intervals and/or any surgical treatment recommendations will be discussed.
If you have extensive bone loss, very deep gum pockets, or areas that did not respond well to scaling and root planing alone, Dr. Chan may recommend that you see a periodontist for further evaluation and treatment. Potential treatments at the periodontist include pocket reduction surgery, bone grafting, and guided tissue regeneration.
The hygienist will see you at regular intervals every 3 or 4 months for periodontal maintenance. These are single visit appointments where the hygienist evaluates your gums and cleans the surfaces of your teeth.
Why can't I have a regular cleaning?
Periodontal disease is not a reversible process and cannot be cured, it can only be controlled. If you have periodontitis, it requires life-long supportive care to help prevent and, at times, provide timely retreatment for reoccurrence of active disease. Periodontal disease can be very destructive in a short period of time and can be unpredictable when it will act up again. Your disease makes you more susceptible to tooth loss and infection. You must be diligent in your home care and maintenance visits.