Treating Periodontal Disease in Valparaiso
providing exceptional customized & comprehensive dental care
Periodontal disease, commonly known as periodontitis or gum disease, is a progressive disease that affects the gums and jawbone. If not properly treated, periodontal disease worsens and the ultimate result is tooth loss and jawbone loss. Periodontal disease is the #1 reason for tooth loss among adults. Periodontal disease begins with plaque releases bacterial toxins into the gum tissue. These toxins populate and penetrate into the gum tissue where they breakdown and destroy the gum tissue and create gum pockets. The pockets deepen and if there is no early intervention or periodontal treatment the end result is tooth loss and jawbone loss.
Without early treatment gum disease can rapidly compromise an individual’s oral health and general health. At Michael Drone Dentistry & Prosthodontics, Dr. Drone is able to diagnose your stage of gum disease and with the most evidence-based literature, techniques and advanced dental technology we can help individuals regain optimal health, function and appearance.
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Dr. Drone is a native of Wheatfield, IN and has been practicing dentistry since 2003 and opened his private practice in Valparaiso, IN in 2007. Dr. Drone earned his Doctor of Dental Surgery from Indiana University School of Dentistry and earned his advanced specialty degrees in Prosthodontics and Maxillofacial Prosthodontics from Indiana University School of Dentistry and Medicine.
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General Health Correlations
There is very strong medical and dental evidence about the correlation between periodontal disease and general health. According to several scientific studies, the bacteria that causes periodontal disease has been link to an increased risk of developing the following health conditions: cardiovascular conditions such as heart attack & stroke, diabetes, respiratory diseases, osteoporosis, and pregnancy-related complications such as premature birth and low birth weight. It is essential for individuals to be seen by Dr. Drone so he can diagnose your gum disease and design a treatment plan with your physician to address the dental-medical issues. There are several options for treating periodontal disease and our goal is to provide exceptional customized care for every patient and their associated gum condition.
The Role of a Periodontist
A periodontist is a dental specialist, credentialed by the American Dental Association, who specializes in the soft tissues diseases of the mouth, advanced gum disease, bone graft procedures, gum recession conditions and placement dental implants. A periodontist must first graduate from an accredited dental school and then complete additional three year advanced graduate program in periodontics at an accredited dental school or medical school. As a prosthodontist, Dr. Drone works closely with several dental specialists and may consult or refer you to a periodontist if the treatment needed is beyond the scope of the practice.
Causes of Periodontal Disease
There are several genetic and environmental factors linked to the onset of periodontal disease, the risk of developing periodontal disease and the progression of periodontal disease. Many of the common causes of periodontal disease are listed here:
Preventing gum disease and decay (cavities) always begins with excellent oral hygiene, well balanced and routine dental visits which include dental exams, professional cleaning and x-rays. When bacteria and calculus (tartar) are not removed then toxins are released and breakdown the gum tissue and bone around the teeth and will lead to gingivitis or periodontitis. The combination of meticulous home care and professional dental cleanings will help remove the bacterial toxins that are above the gum line and below the gum line to promote healthy gum tissue and bone.
Tobacco products such as cigarette smoking, pipe smoking and chewing tobacco have been proven to be significant factors in causing periodontal disease. Continual use of tobacco products will cause further breakdown of the gum tissue and decrease the blood flow to the
gum tissue and body organs in general. Smokers are more prone to have calculus on the teeth, deep gum pockets, inflamed gum tissue and more jawbone loss.
Genetics are another factor for gingival and periodontal diseases and there can be as much as a 30% of the population that may have a genetic predisposition to gum disease. Even with meticulous oral hygiene habits, this group of individuals is more likely to develop periodontal disease. Genetic tests can be used to determine susceptibility and early intervention can be performed to keep the oral cavity healthy.
Bacteria and their toxins are the primary cause for periodontal disease and a healthy, nutritional diet strengthens the immune system. Diets that are deficient in important nutrients compromise the immune system making it more difficult for the body to fight off bacterial infection, such as periodontal disease. Poor diets have been associated with obesity and there is a minor correlation between the risk of periodontal disease with obesity.
Several studies have shown that older people have the highest rates of periodontal disease. The Centers for Disease Control and Prevention indicate that over 70% of Americans over the age of 65 have periodontitis.
Stress has been correlated with many medical conditions such as hypertension, stomach disorders, neurological disorders and many other health issues. Stress is a risk for periodontal disease. Stress makes it more challenging for the body to fight and eliminate infection, including
During pregnancy and menopause there are many changes and irregularities with the normal hormone cycles. These changes can cause gum inflammation and can progress to more conditions like gingivitis and periodontal disease. Excellent oral hygiene care, brushing, flossing and mouth rinses are critical in preventing gum disease.
Many medical conditions can intensify or accelerate the onset and progression of gum disease including respiratory disease, heart disease, arthritis and osteoporosis. All of these medical issue cause bacterial inflammation which some strains have been correlated with periodontal
disease. In addition, there is more bacterium that re-circulates throughout the blood stream.
Clenching or grinding of your teeth can significantly damage the supporting tissue surrounding the teeth. This excess force is usually associated with a “bad bite,” or the misalignment of the teeth. When an individual is suffering from gum disease, the additional destruction of gingival tissue due to grinding can accelerate the progression of the disease.
Periodontal disease is diagnosed by Dr. Drone during your periodontal examination. A periodontal exam is performed during a new patient first visit and at every dental check-up appointment. Dr. Drone and our hygienists will evaluate the health of your gums and jawbone at each visit.
A periodontal probe is a small dental instrument with measurement markings that is used to gently measure the sulcus (pocket or space) between the tooth and the gums. The periodontal probe helps indicate if the depth of the pocket is healthy or diseased. When the sulcus is healthy the pocket measures between 1-3 mm, but if the pocket measures 4 mm or greater then it is unhealthy and can be the early stage of periodontal disease. As periodontal disease progresses, the pockets usually get deeper without periodontal treatment.
Bleeding gums is a sign of inflammation and unhealthy gums. Your gums should not bleed when you brush your teeth, floss your teeth or after measuring the health of your gums with the periodontal probe. Without proper periodontal treatments such as dental prophylaxis or scaling and root planning, the bacterial toxins can break down the gum pocket, destroy the jawbone, cause tooth mobility and enter into the bloodstream and affect other organs or accentuate other medical conditions (diabetes, heart disease, etc). Improper oral hygiene techniques can cause the gums to bleed. Dr. Drone and our hygienists will demonstrate the proper techniques at each dental check-up. We highly recommend electric toothbrushes, specifically Sonicare Professional Series, because there are pressure sensors embedded in the brush to prevent too much pressure on the gums which can cause gum recession around the teeth or dental implants. Proper daily flossing can stimulate your gums and eliminate the bacterial toxins that cause inflammation of the gums. Dr. Drone recommends Glide Floss/Tape or Cocofloss. Our office also recommends the Waterpik Water Flosser to help remove the dental plaque and bacterial toxins between your teeth and inside the gum pockets. A combination of any of the oral hygiene products discussed can help eliminate and control the bacterial toxins that cause inflammation of the gums.
There are three stages of periodontal disease.
- Gingivitis: Gingivitis is the first stage of periodontal disease. Dental plaque and the bacterial toxins irritate the gums. Signs of gum irritation are: tenderness, bleeding when brushing or flossing, swollen or puffy gums and red gum tissue (healthy gum tissue has a coral pink appearance).
- Early Periodontitis: Dental plaque eventually turns into calculus or more commonly known as tartar). The calculus releases bacterial by products known as toxins and these toxins destroy the attachment between the gums and teeth by forming “gum pockets.” The toxins also destroy the jawbone around the teeth. Deeper pockets form between the gums and teeth and become filled with bacteria and pus. As this process continues the gums become very irritated, inflamed and bleed easily.
- Advanced Periodontitis: Advanced periodontitis has the same characteristics as early periodontitis but is move severe. The teeth lose more support and the gums, jawbone and the periodontal ligament continue to breakdown. Without periodontal treatment, the disease will worsen and the teeth will loosen resulting in tooth loss. Severe jawbone loss is very evident on the dental radiographs.
Signs and Symptoms
Periodontal disease is a progressive dental condition and is the leading cause for tooth loss in adults if untreated. Periodontal disease occurs when plaque and calculus (tartar) release bacterial toxins. These toxins cause irritation, inflammations, redness and bleeding of the gums resulting in gingivitis. If gingivitis is not treated then the bacterial infection will worsen and lead to destruction of the gum tissue and underlying jawbone known as periodontal disease. If periodontal disease is not treated, it can lead to loose teeth or tooth loss.
There are many common types of periodontal disease including aggressive, chronic, necrotizing periodontitis and periodontitis associated with systemic diseases. Each type of periodontal disease has its own distinct characteristics and symptoms. Periodontal disease requires prompt treatment to prevent further destruction of the jawbone, gums and teeth. Michael Drone Dentistry & Prosthodontics is able to provide the proper periodontal treatment needed to prevent jawbone and gum tissue loss.
There are many common signs and symptoms of periodontal disease but is it is critically important to know that periodontal disease can occur without any signs or symptoms. This is why it so important to have routine oral health care exams.
Treatment of Periodontal Disease
It is critical to prevent of stop the progression of periodontal disease before it causes any further damage to the gums and jawbone. Dr. Drone and our hygienists will perform a periodontal examination of your entire mouth to diagnosis and recommend treatment for periodontal disease. Depending on the diagnosis the periodontal treatments might be one or a combination of the following options:
The gum pockets and gum tissue around and below the gum line are completely cleared of bacterial toxins using a combination of scaling and root planning along with a medicated ultrasonic dental device called a piezo. The piezo has two main advantages:
- It causes disruption of bacteria and it removes the bacteria more effectively than with routine dental hand instruments by using high frequency vibrations.
- It sprays medicated rinses directly into the gum pockets and around and below the gum line.
In more advanced cases where the result from routine scaling and root planning was not as successful, a referral to a periodontist is necessary who may recommend periodontal surgery. With the surgery a flap is made so the periodontist will be able to have direct access to each tooth and perorm a more advanced cleaning.
There are many methods available where genetic DNA testing is performed to help identify the specific bacterial toxins. Systemic antibiotics are commonly recommended in conjunction with non-surgical or surgical therapy. Antibiotic therapy is primarily used to help reduce the amount of bacteria and prevent it from harming other body organs. In many instances antibiotics can also be delivered into the gum pockets to promote good healing and kill any bacteria that remain.
If there is a considerable amount of gum and bone destruction, a periodontist can use a state-of-the-technology called LNAP Laser Surgery and is the only scientific evidence therapy to help regenerate bone and gum tissue.
If there is a considerable amount of gum and bone destruction, a periodontist may recommend a gum and bone graft procedure to stimulate more bone and gum tissue growth to replace the area destroyed the bacterial infection.
If there is a considerable amount of gum and bone destruction, a periodontist may perform a minor surgery in office to directly reduce the size of
the gum pockets.
After your periodontal treatment has been completed, Dr. Drone and our hygienists will recommend that you have a more advanced dental cleaning, periodontal cleaning or periodontal maintenance, and performed 3-4 times a year. Dental plaque can turn into calculus (tartar) in less than 24 hours. Even with excellent daily oral hygiene care, individual with periodontal disease are more compromised and the gum pocketing and bone loss makes it more challenging to remove the bacterial toxins, dental plaque and calculus. Additional periodontal cleanings are critical in halting the progression of periodontal disease.
During your periodontal maintenance appointments you gum tissue, gum pockets and jawbone will be carefully examined. An ultrasonic dental device known as a piezo will be used to help disrupt the bacteria, eliminate the bacteria and lavage with medicated rinses directly to the gum pockets and around and below the gum line. In addition to your periodontal cleaning and evaluation Dr. Drone and the hygienists will perform the following:
X-rays are essential for detection of dental decay, jaw bone tumors, tooth and root positions and any bone loss.
Each tooth will be critically examined to see if there are any areas of dental decay. If there are any areas of concerns then Dr. Drone will recommend a dental solution.
Any dental work such as fillings, veneers, crowns, bridges or implant dentistry will be critically examined. If there are any areas of concerns then
Dr. Drone will recommend a dental solution.
Dr. Drone and the hygienists will each perform and intra-oral and extra-oral cancer exam. We will be checking your tongue, roof of your mouth, gums, back of the throat, hard and soft palates, face, neck, lips and cheeks.
We will review and recommend any oral hygiene technique and products to help you achieve optimal oral health.
Fluoride will be applied to the surfaces of your teeth. Professional fluoride is highly indicated as it strengthens the teeth, prevents dental decay, helps with tooth sensitivity and has anti-bacterial benefits.