Periodontal disease is a chronic infection of the gums and bone supporting the teeth. Left untreated, it will lead to food impaction, sometimes bleeding, bad breath, loose teeth, bone loss and inevitably tooth loss.
What is Gum Disease?
Gum disease is not just ONE disease. Gingivitis commonly referred to on TV can be treated quite easily in most cases while periodontal disease is primarily a multifactorial bacterial infection of various severities, individual immune issues and treatment options.
There are established guidelines that classify the severity of periodontal disease and who is qualified to treat it appropriately. In the first instance you should ask your dentist whether you have a problem and how severe it is. But for your knowledge: any pocket greater than 4mm is PERIODONTAL DISEASE.
What may I see or notice that would alert me to the fact that I have gum disease?
With periodontitis you will also see one or more of the following:
- Bleeding and swollen gums are common to both forms of gum disease: gingivitis the minor form & periodontitis the severe form.
CLICK HERE to watch a video about gum disease.
- Gum shrinkage & the loss of gum tissue between your teeth.
- Loose teeth.
- Teeth that have moved creating spaces between your teeth.
- Bad taste or bad breath.
- Gum abscesses.
CLICK HERE for a quick questionnaire to see if you are at risk?
Treatments to Save Your Teeth:
Often people are referred to the periodontist for "their pockets". What this means is that there has been slow gradual bone loss (WHICH DOES NOT HURT AND YOU DO NOT FEEL IT HAPPENING) over years and when first identified; the pocket has "unzipped" to the receded bone level.
In order to mend these pockets, the first step is to start with INITIAL THERAPY (ie periodontal cleaning) often with local anaesthetic (for comfort) which is different than your dental cleaning. Also LPT (laser periodontal therapy) is commonly used as State of the Art today.
This way Dr. Desai can determine if further treatment (surgery or LPT) is indeed indicated or whether it can be avoided. The goal of the periodontal cleaning is to remove not only the bacteria, tartar and toxins above the gum line but more importantly the bacterial toxins below the gum line. Dr. Desai can suggest antibiotics in select cases as well. When bacterial deposits are left below the gum line - continual bone loss occurs without any pain and eventually the tooth's longevity is in question when it abscesses and loosens.
CLICK HERE for a video about the therapy
Laser Reduction (LPT)
Dr Desai is also the only specialist in Kamloops with laser usage to supplement this Initial Therapy and will indicate when it can be used in your case to sterilize the pockets if needed.
Periodontists in general would agree that the majority of people do respond favourably to this periodontal hygiene and do not require any more than ongoing maintenance therapy to sustain health.
Non-surgical therapy has its boundaries of success and if you don't achieve shallow maintainable pockets after this then Dr. Desai may suggest surgical pocket elimination and/or regeneration.
Research is now very clear in showing that gum disease must be under control before implants are placed in order to not risk implant infection down the road.
Pocket Reduction: Surgical Pocket Reduction or Regenerative Pocket Therapy
This procedure is minor and done with local anaesthetic just like a filling or a crown and most people return back to work the next day. The goal of periodontal pocket elimination is the same as periodontal hygiene ; ie to reduce the pockets. Predictably, only the top 4mm of a pocket can be cleaned with dental hygiene instruments effectively. Anything deeper then 4mm can ONLY be predictably cleaned by visualization and access. Thus the gum is elevated like a "shingle" the root surface is cleaned and detoxified and the gum is replaced and it re-attaches itself. The gum reattaches itself naturally to a lower level because this is where the gum wants to "live" and thus, the pocket is eliminated as things are healthier and detoxified on the root surface.
Sometimes it is possible to regenerate a bony pocket with bone graft or regenerative material. Through experience, Dr. Desai will assess whether this is a predictable option in your case.
Dr. Desai will suggest a schedule of maintenance depending on each individual case: sometimes she would like this maintenance to be just in her office every 3 months, otherwise most people can start to return to their general dentist for alternating appointments with Dr. Desai's office or even some need only be seen every 1-2 years. Each case is individual and periodontitis has been deemed to be akin to diabetes ; controllable but not curable. Once you are a periodontal patient - you will always be one. This stage of periodontal treatment is THE most important part of periodontal therapy. Once stability of the periodontium is achieved either non-surgically or surgically one must MAINTAIN the ground gained as opposed to losing it and starting all over again. Once you have periodontal disease, you will ALWAYS be at risk for rebound if NOT maintained and monitored. Another analogy would be similar to doing a complete automobile engine rehaul; if you don't follow up with oil changes on the car, all the energy and time spent on the rehaul will be for naught!