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Treating Periodontitis

Gum disease is a chronic infection, which may cause tooth loss as well as overall health problems. It has been shown to increase the risk of stroke; heart attack; and low-weight, pre-term babies among other health concerns. Treatment of gum disease is critical to obtain overall health and may incorporate one or more of the following procedures.

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Oral Hygiene Instruction

An antibacterial mouth rinse and proper cleaning techniques are very important to remove the bacteria that cause gum disease. These bacteria are prevalent in every mouth and form a sticky film around the teeth every 24 hours.

Maintenance cleanings with the hygienist may be necessary as frequently as every 1-2 months or as infrequently as every 6-12 months. Usually, three-month intervals are suggested after gum treatment. If deep pockets remain and cannot be kept clean, bone surgery may be necessary, or bone destruction may continue as well as infection may spread to other parts of the body.

If the patient smokes, we encourage quitting. Smoking does not allow tissues to heal properly.

Bite Adjustments and Bite Appliances

In addition to bacteria, the uneven pressures of your bite can make your teeth feel sore or sensitive, accelerate the destruction of your jawbone, and loosen your teeth. Also teeth that hit or chew with too much pressure can create grinding and clenching habits, which may damage your jaw joint and your jaw muscles. Bite treatment attempts to correct the uneven pressures of your bite.

Bite treatment may consist of a bite adjustment. A bite adjustment is accomplished by reshaping and minor polishing of the chewing surfaces of the teeth. This will correct the chewing pressures and make them even. This procedure may require several appointments. It does not harm the teeth in any way, nor is it uncomfortable. As the teeth shift in the future, additional adjustments may be necessary.

Bite treatment may also include bite guards. Bite guards are made from molds of the patient’s teeth and are fabricated to fit the chewing surfaces of the teeth. They stabilize the teeth, comfortably relax the jaw joint, and equalize the biting pressures. These appliances are sometimes used instead of a bite adjustment or in conjunction with a bite adjustment.

If unhealthy biting pressures are not corrected, teeth may become loose and eventually be lost. The jaw joint may develop severe deterioration resulting in joint pain and sounds, and loss of jaw function. The muscles of the jaw also may become very sore, and headaches may become common.

Deep Cleaning

Deep cleaning is a conservative, non-surgical way to remove disease from under the gum tissue. The disease could be thought of as a splinter under the gum that has not been removed. Specifically, a deep cleaning is the removal of tartar deposits from the roots of the teeth under the infected gum tissue and the smoothing of these root surfaces so that the gum tissue will become healthy and tight around the roots of the teeth again. These procedures are done after the gum tissue is first numbed.

After a deep cleaning, the gum tissue will begin to look firmer and pinker. Swelling in the gum as a result of the infection will diminish. Some shrinkage of gum tissue around the root may occur.

If a deep cleaning is indicated but is not done, further destruction of the jawbone around the teeth will continue. Eventually, the affected teeth will become loose and may fall out or must be removed. Also, the infection may spread to other areas of the body via the blood stream.

Following a deep cleaning, deeper bone defects may require bone surgery to be treated properly.

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Bone Surgery

Bone surgery is a procedure where the gum is lifted away from the tooth to gain access to deeper bone defects and tartar. The gum is then sutured back into place or into a new position.

Bone surgery is done when it is impossible for a patient to keep pockets clean (usually over 5 mm. deep). These pockets become sites of further infection and bone destruction. The goals of surgery are to remove deep tartar, to reduce the pocket, and to arrange soft tissue into a shape that will be easier to keep clean and healthy.

If bone surgery is necessary but is not done, further bone destruction will occur. Infection will continue to progress through the bone as well as the rest of the body via the bloodstream. Eventually, the affected teeth will become loose and may fall out or must be removed.

Bone Grafting

At times, severe damage of the bone around the teeth may require help to heal. During a bone surgical procedure, a bone graft could be placed as scaffolding around a damaged tooth to help a patient’s own bone to regenerate new bone.

Soft Tissue Grafting

A soft tissue graft is a tough barrier of tissue surgically placed over the exposed root of a tooth and the bone holding the tooth. The donor tissue usually is taken from an area on the inside of the upper teeth. Sutures are placed to secure the graft and the graft site. The patient will wear a comfortable healing appliance covering the roof of the mouth during the first week after surgery. This acts like a Band-Aid and makes it easy to speak and eat without any discomfort. Sometimes graft tissue from a tissue bank is used instead of a patient’s own tissue. This will avoid taking tissue from the roof of the mouth.

A soft tissue graft will help cover the exposed root and reduce root sensitivity. It also will help prevent further recession, bone destruction, and the possible loss of the tooth.

Creating Healthy, Beautiful Smiles in the Lowcountry