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Periodontal Disease & Treatment | Plano

Updated on December 1, 2008

Periodontal disease is a condition affecting the gingiva, also known as gum tissue. If left unchecked, periodontal disease can have serious consequences such as tooth loss, among other more serious negative health effects.  According to Vickie Barry, a dental hygienist who works with Dr. Jodi Danna, a cosmetic dentist in Plano, “Periodontal disease can have a number of consequences if left untreated. These consequences include the onset of Type I or Type II diabetes, an increased risk of stroke, or premature births in some pregnancies.” 

What is Periodontal Disease?

Periodontal Disease is a chronic bacterial infection that affects gum tissue as well as the bone that supports the teeth. Gingival inflammation and bone destruction are largely painless therefore go undetected. The gum tissue is not attached to the teeth as high as it may seem. This results in a shallow v-shaped crevice called a sulcus between the tooth and gums. Periodontal disease is the result of the sulcus becoming infected and breaking down. As the tissue is damaged the sulcus develops into a pocket. Normally, the deeper the pocket the more severe the periodontal disease. 

Types of Periodontal Disease

There are basically two types of periodontal disease. At the onset of infection, the first stage of periodontal disease is known as gingivitis. Gingivitis is an infection caused by the accumulation of plaque and tartar, also known as calculus, in the sulcus. This bacterium can and does cause an inflammation of the gum tissue. If left unchecked, gingivitis will lead to a more serious condition, called periodontitis. Periodontitis is the second stage of periodontal disease. The inflammation due to gingivitis occurring in the sulcus will eventually lead to the formation of deep pockets in the sulcus, which will begin to affect the bone and gum tissue holding the teeth in place. Periodontitis can cause bone loss, which eventually leads to tooth loss.

Cause of Periodontal Disease

The most common cause of gingivitis and periodontitis is the accumulation of plaque on the teeth. Plaque is basically a sticky film consisting primarily of bacteria that can cause irritation in the soft tissue of the mouth. If not properly removed with good oral hygiene practices, such as brushing or flossing, plaque can harden, or calcify, into a substance known as tartar or calculus.  

Calculus formations can only be removed by a professional cleaning and, if left unchecked, result in a constant inflammation due to gingivitis. This gingivitis will eventually lead to periodontitis.

Risk Factors

There are a number of risk factors that could increase the likelihood of periodontal disease in some individuals. Individuals who use tobacco products are at a higher risk for gingivitis or periodontitis, as are individuals who suffer from other systematic diseases such as diabetes. Certain medications, such as steroids, anti-epilepsy drugs, cancer therapy drugs, calcium channel blockers, and oral contraceptives can also increase the risk of infection. Other dental issues, such as crooked teeth or ill-fitting bridges, can also prove to be risk factors.  

Diagnosing Periodontal Disease

Screening for periodontal disease can be done at a dentist’s office. According to Missey Yeats, who also works with Dr. Jodi Danna in Plano, “In a periodontal assessment, we will look for some of the classic symptoms of gingivitis or periodontitis. These symptoms include certain gum issues, such as gum recession, as well as missing teeth. Assessment will also be done using a periodontal probe, which is an instrument that has markings to measure the depth of a pocket, similar to a ruler. The probe is used to test the depth of the sulcus. Any pocket deeper than three millimeters is abnormal.”  

Common warning signs for periodontal disease include chronic bad breath, red or swollen gums, gums that are tender or easily bleed, gum tissue that has pulled away from the teeth, loose or sensitive teeth, or painful chewing. 

Treatment of Periodontal Disease

The basic procedure for the diagnosis and treatment of periodontal disease is a process that takes place over a period of time. The procedure starts on the first visit of a new patient. 

According to Missey Yeats “When a patient comes into the office, we will evaluate to see what type of cleaning they need. This is done by measuring the pockets they have and getting an overall picture of their oral health.” 

Patients who have pockets that fall into the “normal” range will be given a standard cleaning. If pockets are deeper than three millimeters, it is clear that periodontal disease has developed and steps must be taken to prevent gingivitis from progressing to periodontitis. 

“If we have a patient whose gums are measuring a little deeper with a moderate amount of tartar build up, we will proceed with a Debridement procedure followed by another cleaning in four to six weeks,” says Yeats. 

A debridement procedure involves the use of an ultra-sonic instrument to break up the hardened calculus that has accumulated on the teeth. The second cleaning follows after several weeks so a final scaling can be done to make sure all tartar has been removed from the teeth. Home care evaluation can also be done and altered if needed at this appointment. Also, after the procedure, the gums are allowed to heal for several weeks. During the follow-up cleaning, the gums will be re-measured to determine the effectiveness of the debridement procedure.  

“If a patient comes in and they show signs of bone loss with deep pocketing,” says Yeats, “then a scaling and root planning is recommended. This procedure is usually divided into two appointments, one for the scaling and root planning and then a follow up cleaning required four to six weeks after the scaling and root planning treatment is completed.” 

 A scaling and root planning procedure is accomplished through the use of a ultrasonic device supplemented with scalers.  Scalers are instruments with a cutting edge used to remove calculus, plaque, and other staining from the surface of the teeth, along with a root planning, which removes infected cementum and dentin. During the procedure, the patient is usually numbed as gum sensitivity can otherwise make the deep cleaning procedure quite an uncomfortable experience.  

Four to six weeks after the scaling and root planning procedure is done, the patient will return for their follow up cleaning. During this cleaning the sulcus will be re-measured to ensure that the periodontal disease has been properly treated. If the gums still show deep pocketing, further treatments such as antibiotics may be required; or, the patient might be referred to a periodontist, who specializes in the treatment of periodontal disease.  

Insurance Coverage of Periodontal Disease Treatment

Insurance coverage varies for treatment of periodontal disease. While some procedures are fully covered, other treatments involve the patient shouldering the burden.  

According to Vickie Barry, most insurance companies offer good coverage for a regular cleaning procedure. In the case of a debridement procedure, some insurance companies offer 50-80% coverage while other companies do not cover the procedure at all, leaving the patient responsible for all of the costs of the procedure. Finally, scaling and root planning is usually covered for 50-80% of the cost with the patient making up the difference. The follow up visits are not always covered, and may be downgraded to a regular cleaning if they are covered, which requires the patient to again cover the difference.  Additional follow-up cleanings are required, in three month intervals. The costs of the visits are typically covered by most insurance companies at 50-80% every other visit. 

Prevention of Periodontal Disease

Periodontal disease is an extremely serious condition that can cause other negative health issues throughout the rest of the body. This condition can be avoided through the practice of several preventative measures. 

It is important for people to maintain a good oral hygiene regimen to prevent the development of gingivitis and periodontitis. This includes proper brushing twice a day coupled with flossing. Additionally, regular visits to the dentist are effective in the discovery of the first signs of periodontitis or gingivitis, which enables oral health practitioners to treat periodontal disease before it progresses. A well balanced diet is effective in maintaining proper health throughout the body, including oral health. Finally, an avoidance of tobacco usage will significantly reduce the risk factors of periodontal disease. 

Conclusion

Known as a silent killer, periodontal disease can creep up on an unsuspecting person with serious consequences. Periodontal disease has been linked to a number of negative health issues, such as diabetes and cardiovascular disease. It is important for people to take preventative measures to prevent the development of gingivitis, which can lead to the more serious periodontitis. Regular visits to the dentist are important to ensure that gingivitis and periodontitis do not develop, and if they do, to quickly and effectively treat the conditions.   

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    • periodontics profile image

      periodontics 

      6 years ago from 4312 Woodman Ave Sherman Oaks, CA 91423

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