Periodontal diseases and their non-surgical treatments

What is Periodontics?

Periodontics refers to the branch of dentistry which deals with diseases of the supporting and investing structures of the teeth. These structures are namely gums, cementum, periodontal membranes, periodontal ligament, alveolar bone.

A person trained to deal with the diseases of this area is called a periodontist. They receive up to the additional specialized training of three years in periodontal diseases. They are also experts in replacing missing teeth with dental implants.

Periodontal Diseases

• Periodontal diseases may take many forms and types but are a result of coalescence of bacterial plaque biofilm build-up of the red complex bacteria of the gingival and teeth, in combination with host immuno-inflammatory mechanisms and such other risk factors which lead to the destruction of the supporting bone around natural teeth. If these diseases are left untreated, they lead to alveolar bone loss and tooth loss.
  
  
  
• Gum disease is typically a chronic infection caused by bacteria working its way under the gum and also on the bone that supports the teeth. Bacteria can attach themselves to the tooth roots, under the gum lines firmly and due to this reason, regular dental cleanings may be inadequate to eradicate the infection. In these cases, planning referred to as deep cleanings may be required.

Related Article: Dental Cleaning Essentials

• Periodontal infections are usually silent and thus may be present for many years without even any significant symptoms without causing any pain in initial stages.Therefore, regular visits to periodontist are all the more required if you have other diseases like heart problems or diabetes. Though, sometimes some signs like red and/or swollen gums, bleeding gums (during flossing or brushing), chronic bad breath or loose teeth can give you an alert of the presence of gum disease.

Non-Surgical Periodontal Treatments

As per the dentistry guidelines, periodontal health should be achieved in the least invasive and most cost-effective manner. Thus the first try to treating periodontal diseases is non-surgical periodontal treatment.

Of course, this procedure has its limitations and if through this periodontal health cannot be achieved surgical methods need to be used.

Dr. Jaskaren Randhawa, a Manhattan Cosmetic Dentist, says that all periodontists should emphasis on a conservative periodontal treatment. Initial stages of periodontal diseases can be treated with a non-surgical periodontal method. It incorporates removal of bacterial plaque and tartar present at the gum line and below that.

Scaling and Root Planing

Scaling and root planing refers to a careful cleaning of the root surfaces to remove plaques and calculus (tartar) from areas like deep periodontal pockets and then smooth the tooth root to remove bacterial toxins. This cleaning is the initial treatment of periodontal diseases.

Standard cleanings and polishes only deal with the plaque above the gum line, and may not be adequate to treat gum diseases indeed. After this procedure, many patients may not require any further treatment, but a majority of the patients will inevitably need ongoing maintenance therapy to sustain health. These following therapies include local delivery antimicrobials, systemic antibiotics, and host modulation, varying from patient to patient.

‘Scaling’ is the first step in the treatment process, and is very important as it clears the way for a more in-depth clean.

‘Root Planing’ incorporates procedures of cleaning plaque from below the gum line. Local anesthetics are used in this case to numb the area so that there is not much feeling of pain. Collectively, these methods are the fundamentals of non-surgical periodontal therapy.

After giving these treatments, doctor schedules another appointment for the patients, generally after six weeks to examine the patient’s response to the treatment. If this therapy efficiently eliminates the gum disease, then the only requirements would be periodic maintenance after every 3-4 months.

Tray Delivery Systems

This system requires a custom-fit tray made from impressions of the patient’s mouth. This "tray" is used by the patient at home to deliver medications prescribed by the periodontist. 

Oral Hygiene Training

This training is the first step towards an ideal periodontal health. A person diagnosed with the periodontal disease must keep his/her teeth cleaner than most other people. One can ask their doctor for help regarding the products to be used, and also medication can be requested for if required. Electric toothbrushes, interproximal brushes between the teeth and dental floss can be used.

Prophylaxis

Prophylaxis is a routine dental cleaning performed on patients with normal and healthy mouths to maintain the health and prevent the diseases. These may be utilized for the management of mild gingivitis patients, not having significant calculus build-up below the gum line.

Locally Delivered Antimicrobials

These are the medications delivered directly into the periodontal pockets to suppress or completely eradicate periodontal bacteria. These are utilized along with scaling and root planing.

There are many non-surgical options available for the treatment of periodontal diseases. Visit a dental professional to find out which of the above treatments fit best for your condition.

References:

1. http://en.m.wikipedia.org/wiki/Periodontics
2. http://midtowndentalcarenyc.com/
3. www.mouthhealthy.org/periodoncia