Periodontal Treatments

Gum disease starts off as gingivitis. This early-stage form of periodontal disease is characterized by inflammation of the soft tissues. At this stage, you may not notice any changes in the look or feel of your mouth. If you do notice changes, they may be subtle and can include: 

• Gums that look redder than normal
• Gums that appear puffy 
• The presence of blood on your toothbrush or floss 
• Tenderness when you brush, floss, or touch your gums 

Since gingivitis can be “silent” or asymptomatic, it is essential to maintain checkups at our office as recommended by Drs Langenbach or Thomas. During these visits, they may uncover signs of gingivitis when you thought your gums were healthy because they continued to look and feel “fine.” The sooner that they can detect these problems, the better. When addressed promptly, the effects of gum disease can be reversed. The damage can be undone at this stage. 

If gingivitis goes untreated, it can progress to periodontitis. This advanced form of gum disease may itself be categorized as “mild,” “moderate,” and “severe.” This bacterial infection occurs as the disease progresses and the soft tissues pull away from the teeth. As the spaces that form between the teeth and gums grow larger, more soft and hard tissues are destroyed. Periodontitis may be marked by: 

• A “long in the tooth” appearance (caused as the gums pull away and expose more of the white part of the teeth, or the crown)
• Teeth that feel wobbly in your mouth
• Misalignment and other changes with how your teeth are positioned, and how they feel when you bite down 
• Challenges to how your oral appliances fit; for instance, dentures may slide around in your mouth or nightguards may not feel comfortable or fit anymore 
• Chronic halitosis or “bad breath” 

When these tissues are lost, they cannot regenerate without professional help and treatment. For this reason, our team really advocates for services that prevent the disease from reaching this stage in the first place. By protecting you from periodontitis, you avoid the loss of teeth and the deterioration of other supportive periodontal tissues in the jaw. In turn, you also avoid the need for more aggressive, costly, and time-consuming restorative dentistry procedures (such as tooth replacement with implants), or other treatments to restore lost tissues. 

Gum disease is primarily caused by inconsistent or inadequate oral hygiene. Bacteria feed off of the starches and sugars in lingering food particles. When you do not remove those foods with proper brushing and flossing, bacterial plaque forms. This plaque can inflame and irritate the gums, and sets off a process that ultimately leads to the breakdown of the soft and hard tissues. So, you may be at risk if your oral care at home is lacking. It is also essential to keep up with professional dental cleanings (prophylaxis) at our office, because when plaque hardens it cannot be removed with standard OTC oral care tools (like a typical toothbrush). Our dentists and hygienists work with you to identify and resolve any challenges to your good oral hygiene. 

We can also address any other risks that you may have, which include:

• Using tobacco products
• Vaping 
• Poor management of inflammatory conditions or comorbidities (such as Type 2 diabetes)

The above examples are modifiable risk factors. Whenever possible, we partner with you to modify or eliminate those risks that can be managed. After all, we understand that certain risk factors (like a family history of gum disease) are obviously not modifiable. However, even these risks can be overcome with good oral care at home and professional services. 

During your exam, we can “stage” the severity or extent of the disease. This staging allows for us to recommend the most appropriate treatments for your needs. Depending on how far the disease has progressed, we may recommend incorporating new techniques or products into your oral care routine. Or, you may benefit from what is often referred to as a “deep cleaning”: Scaling and Root Planing. This nonsurgical periodontal service removes bacteria, plaque, and its hardened form (tartar or calculus) from beneath your gums. The standard prophy involves cleaning the surfaces of your teeth and at the gumline, but it doesn’t reach deeply under the inflamed or infected tissues. Additionally, SRP involves “planing” or smoothing the rough surfaces of the teeth roots. These textured surfaces have the tendency to attract bacteria and plaque. By creating a nice, smooth surface, we reduce your risk of further damage and help the gums to heal. 

There is a huge body of medical literature that connects the dots between the inflammation and bacteria associated with periodontal disease and the inflammation and bacteria implicated in other serious medication conditions, including heart disease. Advanced gum disease has also been linked to poor diabetes control, respiratory illnesses, Alzheimer’s disease and dementia, and pregnancy/birth complications (including premature births).