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Posts for tag: gum disease

By Scott A. Allegretti, DDS Provincetown Dental Arts
October 01, 2019
Category: Oral Health
Tags: gum disease  
DifficultorNotPlaqueRemovalisNecessaryforStoppingGumDisease

When we refer to periodontal (gum) disease, we’re actually talking about a family of progressive, infectious diseases that attack the gums and other tissues attached to the teeth. Caused primarily by bacterial plaque left on tooth surfaces from inefficient oral hygiene, gum disease can ultimately lead to tooth loss.

There’s only one way to stop the infection and restore health to diseased tissues — remove all of the offending plaque and calculus (hardened plaque deposits) possible from tooth and gum surfaces, including below the gum line at the roots. The basic tools for this task are specialized hand instruments called scalers or ultrasonic equipment that vibrates plaque loose. A series of cleaning sessions using these tools could stop the infection and promote healing if followed with a consistent, efficient daily hygiene habit.

There are times, however, when the infection has progressed so deeply below the gum line or into the tissues that it requires other procedures to remove the plaque and infected tissue. One such situation is the formation of an abscess within the gum tissues, a pus-filled sac that has developed in response to infection. After administering local anesthesia, the abscess must be treated to remove the cause and allow the infectious fluid to drain. The area is then thoroughly flushed with saline or an antibacterial solution.

The gum tissues are not completely attached to the tooth surface for a small distance creating a space. These spaces are called periodontal pockets when they are inflamed and continue to deepen as the disease progresses. These inflamed and sometimes pus-filled pockets form when tissues damaged by the infection detach from the teeth. If the pockets are located near the gum line, it may be possible to clean out the infectious material using scaling techniques. If, however, they’re located four or more millimeters below the gum line a technique known as root planing may be needed, where plaque and calculus are shaved or “planed” from the root surface. As the disease progresses and the pockets deepen, it may also be necessary for surgical intervention to gain access to the tooth roots.

To stop gum disease and promote soft tissue healing, we should use any or all treatment tools at our disposal to reach even the most difficult places for removing plaque and calculus. The end result — a saved tooth — is well worth the effort.

If you would like more information on treating periodontal disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Treating Difficult Areas of Periodontal Disease.”

By Scott A. Allegretti, DDS Provincetown Dental Arts
October 16, 2018
Category: Oral Health
IncreaseYourImplantsSuccessChancesbyKeepingYourGumsHealthy

If you’ve just received a dental implant restoration, congratulations! This proven smile-changer is not only life-like, it’s also durable: more than 95% of implants survive at least 10 years. But beware: periodontal (gum) disease could derail that longevity.

Gum disease is triggered by dental plaque, a thin film of bacteria and food particles that builds up on teeth. Left untreated the infection weakens gum attachment to teeth and causes supporting bone loss, eventually leading to possible tooth loss. Something similar holds true for an implant: although the implant itself can’t be affected by disease, the gums and bone that support it can. And just as a tooth can be lost, so can an implant.

Gum disease affecting an implant is called peri-implantitis (“peri”–around; implant “itis”–inflammation). Usually beginning with the surface tissues, the infection can advance (quite rapidly) below the gum line to eventually weaken the bone in which the implant has become integrated (a process known as osseointegration). As the bone deteriorates, the implant loses the secure hold created through osseointegration and may eventually give way.

As in other cases of gum disease, the sooner we detect peri-implantitis the better our chances of preserving the implant. That’s why at the first signs of a gum infection—swollen, reddened or bleeding gums—you should contact us at once for an appointment.

If you indeed have peri-implantitis, we’ll manually identify and remove all plaque and calculus (tartar) fueling the infection, which might also require surgical access to deeper plaque deposits. We may also need to decontaminate microscopic ridges found on the implant surface. These are typically added by the implant manufacturer to boost osseointegration, but in the face of a gum infection they can become havens for disease-causing bacteria to grow and hide.

Of course, the best way to treat peri-implantitis is to attempt to prevent it through daily brushing and flossing, and at least twice a year (or more, if we recommend it) dental visits for thorough cleanings and checkups. Keeping its supporting tissues disease-free will boost your implant’s chances for a long and useful life.

If you would like more information on caring for your dental implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Gum Disease can Cause Dental Implant Failure.”

By Scott A. Allegretti, DDS Provincetown Dental Arts
October 10, 2017
Category: Dental Procedures
FAQsKeepingYourMouthHealthyAfterGumDiseaseTreatment

Surgical treatment for periodontal (gum) disease can go a long way toward restoring your mouth to good health; however, it does not change your susceptibility to the disease. That’s why we recommend that you come in regularly for periodontal cleanings after your treatment. Here are some frequently asked questions about keeping your mouth healthy after gum disease treatment.

How often do I have to come in for periodontal cleanings?
There’s no “one-size-fits-all” answer to that question: It really depends on your individual situation. For example, some individuals may have a more aggressive form of periodontal disease that requires more frequent periodontal maintenance (PM) treatments to maintain control. Others may have greater success controlling the buildup of disease-causing plaque with at-home oral hygiene measures, and therefore need PM less often. However, for people with a history of periodontal disease, getting PM treatments at a three-month interval may be a good starting point.

What happens at a periodontal maintenance appointment?
A thorough cleaning of the crown and root surfaces of the teeth, aimed at removing sticky plaque and hardened dental calculus (tartar), is a big part of PM treatments — but there’s much more. You’ll also receive a thorough clinical examination (including oral cancer screening), a review of your medical history, and x-rays or other diagnostic tests if needed. The status of any ongoing periodontal disease will be carefully monitored, as will your success at maintaining good oral hygiene. Decisions about further treatment will be based on the results of this examination.

What else can I do to keep gum disease at bay?
Keeping your oral hygiene in top-notch condition — which includes effective brushing and flossing every day — can go a long way toward controlling gum disease.  In addition, you can reduce risk factors by quitting tobacco use and eating a more balanced diet. And since inflammatory conditions like diabetes, arthritis and cardiovascular disease can make periodontal disease worse (and vice versa), keeping these conditions under control will greatly benefit both your oral health and your overall health.

If you have additional questions about maintaining oral health after gum disease treatment, contact us or schedule an appointment.

By Scott A. Allegretti, DDS Provincetown Dental Arts
September 25, 2017
Category: Oral Health
Tags: gum disease   plaque  
TheSecrettoPreventingGumDisease-ControlBacterialPlaque

Here’s a sobering statistic: you have a 50/50 chance over your lifetime for developing periodontal (gum) disease. And it’s much more serious than irritated gums: if not treated aggressively you could experience bone loss, which can not only lead to tooth loss but actually increases your risk of heart attack and stroke.

Initially, you may not notice any symptoms unless you know what to look for: mainly red and puffy gums that frequently bleed during brushing and flossing. As the infection advances into the underlying support structures that hold teeth in place you may also notice receding gums (moving away from your teeth causing them to look longer), pus around the gums or lingering bad breath or taste. And one or more loose teeth are a definite sign the supporting structures have weakened severely.

So, how does gum disease happen? It starts with bacteria. Your mouth contains millions of these and other microorganisms, most of which are friendly and even beneficial. Unfortunately, a fraction of them can infect and harm tissues like the gums and underlying bone. Your mouth’s defenses can normally handle them if their numbers remain low. But a bacterial population explosion can quickly overwhelm those defenses.

Bacteria are like any other life form: they need a secure environment and food. Disease-causing bacteria establish the former by utilizing proteins and other components of saliva to form a sticky biofilm on teeth known as plaque. Within the safe haven of dental plaque bacteria quickly multiply and form a complex and concentrated ecosystem feeding on remnant food particles, especially sugar and other carbohydrates.

The key to gum disease prevention (as well as treatment) is to deprive bacteria of their home and food source by removing plaque and its more hardened form calculus (tartar). You can manage plaque buildup by brushing and flossing daily, seeing your dentist regularly for cleanings to remove any remaining hard-to-reach plaque and calculus, and eating a nutritious diet with fewer sweets or other carbohydrate-rich snacks.

You can further lower your disease risk by avoiding smoking and other tobacco products and moderating your consumption of alcohol. And be sure to see your dentist as soon as possible if you notice any signs of infection with your gums. Taking these steps can help you avoid gum disease’s destructiveness and help preserve a healthy and attractive smile.

If you would like more information on gum disease, please contact us or schedule an appointment for a consultation.