Gum Disease

Gum Disease is referred to by many names: Gingivitis, Periodontitis, Pyorrhea, and Periodontal disease.  Periodontal disease is a bacterial infection of the tooth root and adjacent tissues.  Left untreated, periodontal infections dissolve away the bone that supports teeth.   Eventually affected teeth may become hopelessly loose.  Gum disease has many levels of severity.   Three out of four American adults are estimated to be effected by periodontitis.  Periodontitis is the #1 cause of tooth loss in the United States.   Fortunately, like most dental conditions, when recognized and treated early, disease progression can be stopped and tooth loss prevented.

Who needs a scaling and root planning (deep cleaning)?

In the early stages of gum disease patients rarely experience any symptoms; consequently treatment is often delayed.  To determine if deep cleaning is beneficial, dentists and hygienists examine your gum tissue for areas of inflammation, they gently slide an instrument across the tooth root surface to detect roughness caused by hardened plaque (calculus & tartar) and they measure the depth of the crevice between the tooth and gum.

Benefit of Early Treatment

Early gum treatment prevents the bacteria which causes gum disease from penetrating into the tooth root surfaces.   It is often said that gum disease can only be treated but not cured.  This is true in part because bacteria can lodge within the porous root surface,  at which time treatment can slow but not eliminate the progress of gum disease.  While it’s rarely too late to help, treatment before inflammation, bleeding or bad breath occur will yield the best results and possible prevent periodontal gum and bone loss from ever occurring

Types of Periodontal cleaning  (Non-surgical gum treatment)

Periodontal cleaning:   Scaling and root planning is a treatment for gum disease which thoroughly cleans teeth below the gum line. This non-surgical service can prevent periodontal disease from progressing. When periodontitis is detected and treated early, scaling and root planning can halt disease progression. Untreated, periodontal disease often advances without symptoms until the bone, which holds teeth in place, dissolves and tooth loss occurs.  At Roman Dental this deep cleaning is done while the teeth are anesthetized to ensure a through result and a more comfortable experience.  Some patients choose the benefits of nitrous oxide sedation, making this treatment more pleasant.

After having completed periodontal (gum) treatment, patients often experience fresher breath as well as a reduction of redness, tenderness, bleeding, and “morning mouth”. 

Antibiotic treatment of Periodontal disease:  Because periodontal disease is caused by a bacterial infection, dentists and hygienists may recommend a unique non- systemic antimicrobial treatment following scaling and root planing.  Two common antibiotic treatments for the treatment of periodontitis are Arestin (minocycline) and Periostat (Doxycycline).  Antibiotic treatment has the potential ability to disinfect porous tooth root surfaces which harbor microscopic bacteria left behind after scaling and root planning.  Antibiotic treatments are proven to reduce the depth of periodontal pockets.

Arestin (Minocycline HCL)   Unlike antibiotics that are swallowed, Arestin is delivered in powder form directly to the root surfaces of the teeth effected by periodontitis.  Arestin powder is made up of tiny “microspheres” which slowly release minocycline into the infected periodontal pocket.

Periostat (Doxycycline)  is an antibiotic taken by mouth in a very low, 20-mg, dose.  Taken in small regular dosages, Periostat inhibits the breakdown of collagen in periodontal pockets.

Hand Scaling:  Dentists and hygienists commonly use instruments called “scalers” to remove stain and hardened deposits from tooth surfaces.  Hand scaling is simply the manual (by hand) usage of these scalers to clean the surfaces of teeth.

Ultrasonic Dental Cleaning:  Often an ultrasonic dental cleaning instrument is used to remove calcium buildup, hardened plaque, bacteria, tartar and calculus from teeth.  This instrument has a rounded tip, a little thinner than a pencil point, which vibrates at ultrasonic speed.  When the tip is placed upon a tooth it will simply “vibrate off” hardened bacterial buildup.   This thin tip will not remove any tooth structure but very quickly removes plaque and tartar.  The tip, moving at ultrasonic speed is cooled with a fine mist of water.  The watery mist, mild tooth sensitivity and squealing noise made by ultrasonic instruments is objectionable to some patients. Most patients, however prefer ultrasonic instrumentation because of the thorough cleaning and the dramatic reduction of time spent in the dental chair.

Research supports ultrasonic dental cleaning as being significantly more effective, verses hand scaling, for the removal of bacterial buildup and the pathogens that cause gingivitis and periodontitis.  

Air Polishing:  A very effective instrument called an air polisher (Prophy Jet) can be used to remove stains from teeth.  A hand held wand with a very small tip is attached to a mechanism that, with compressed air, delivers a spray of ultrafine baking soda through the tip of the wand.   The fine baking soda spray is directed at stains between teeth.   Although the spearmint flavored baking soda and air spray can be somewhat unpleasant, the Propy Jet does an incomparable job of removing coffee, tea and tobacco stain from between teeth and around the gum line.  No other method of dental cleaning can come close to achieving the level of stain removal between teeth. 

TREATMENT AFTERCARE:  For people that have needed deep cleaning, periodontal maintenance visits should be performed at least twice a year.  During your cleaning, your hygienist can help you create a good at-home oral care habits.

Periodontal patients commonly require periodic deep cleaning despite their best at-home dental hygiene efforts.  However, regularly having your teeth cleaned is the best path to reduce the chance of needing re-treatment.

Gum line correction (Crown Lengthening )

An uneven “gum line” can detract from an otherwise beautiful smile.  Some people show too much gum tissue when the smile (“gummy Smile”) others may have overgrown gums that cover the upper portion of the teeth making them appear short.  Gum line irregularities usually are not the result of gum (periodontal) disease and can be easily corrected.   These corrections often are very comfortably corrected and heal quickly because they may involve only the soft tissue surrounding the teeth.  Let us evaluate your unique situation; Dr. Kotlarek often performs this service with a dental laser, creating little discomfort and very rapid healing.

Gum recession and root exposure grafts:

Gum recession may present problems that include root sensitivity, esthetic concern and tooth root cavities.  Gingival (gum tissue) grafting can resolve these issues. Gingival grafts cover the root for better aesthetics and cavity protection.  Additionally, these grafts when placed around teeth or dental implants create a protective non-mobile layer of “attached or keratinized” gingivae that protects against recurring recession and breakdown caused by periodontal disease.

gum recession

Cosmetic gum surgery done along with bonding, composite resin or porcelain dental veneers can provide beautiful improvements to the appearance of a person’s smile.