The office of:
Paul E. Thompson, DMD
Brandon R. Clements, DMD
Teeth are only as good as the bone that support them. It makes no sense to invest resources into the treatment of problems with your dentition if you neglect the very foundation upon which those teeth rest. You wouldn't build an expensive house on a poor foundation, would you? Recognition of periodontal disease, more commonly known as gum disease, and being proactive about treatment and prevention of this condition is a challenging and yet indispensable aspect of comprehensive dentistry.
Foundations of Healthy Teeth
Achieving and maintaining good periodontal health begins with understanding the process of periodontal disease.
Our immune systems are designed to recognize and mount a response to foreign bodies that can be harmful to tissue. Plaque and bacteria that are present in everyone’s mouth tend to aggregate, colonize and proliferate over time. Our bodies recognize this process and, in time, mount a response to try and combat it. This response is known as inflammation, when blood vessels enlarge, tissues swell and our immune systems begin to pump defensive measures into the affected areas.
While this is seemingly a good thing, ultimately the by products of the inflammatory pathway may lead to the distraction of soft tissues. When left untreated for extended periods of time, this process eventually damages hard tissue (bone) and with the loss of bone, teeth become unstable and mobile and eventually may be lost.
We define periodontal disease as the loss of bone tissue. Gingivitis is is defined as the initial inflammation of the soft tissue that precedes bone loss. The most effective way to mitigate damage to soft and hard tissue is to start at the beginning and remove or disrupt plaque and bacteria in order to prevent colonization and proliferation over extended periods of time.
The first line of defense in maintaining a healthy periodontium is proper home care. Brushing at least twice a day, flossing, useful adjuncts such as water flossers/piks, mouth rinses and inter-proximal brushes may all help the patient avoid periodontal disease.
Even with proper home care, bacteria will eventually gain a foothold and colonize the mouth. Calcified deposits known as calculus, consisting of minerals, dead and living bacteria and proteins, adheres to the surfaces of teeth and forms a scaffold upon which bacteria grow and flourish. This hardened material is impossible to remove with conventional brushing and flossing. It requires mechanical debridement with instruments designed to access all aspects of the dentition.
Routine visits to the hygienist knock back the growth process of these deposits and returns the cycle of colonization to normal levels. Recommendations put forth by the American Dental Association are based on the laws of averages. The average patient will begin to see these deposits form and inflammation of the soft tissues at around the six month mark after the last cleaning. Not every patient falls into this category, so it is important to discuss exactly what your needs are and find out just how frequently you may beed a professional cleaning in order to prevent tissue damage and bone loss. Some patients may need to be seen three or four times each year, whereas others may be able to go for longer periods of time between cleanings.
As we age, these demands may change. Our home care becomes more challenging, perhaps teeth begin to show more crowding, making them more difficult to adequately clean. Many medicines taken later in life may change the makeup of the chemistry within the mouth and thus predispose the patient to rapid bacterial colonization. Your hygienist and dentist should be able to help you understand your changing needs and appropriately treat your unique condition to help you maintain healthy teeth and gums for a life time.
We often see patients who may have neglected their cleanings for extended periods of time. Getting a heavily damaged mouth back to a healthy mouth may require more than just a routine cleaning. Such patients may find themselves needing what is known as root planing. Root planing is designed to clean deep beneath the gum tissue into what are known as pockets that surround the teeth. When these pockets become deeper than just a few millimeters and heavily laden with bacteria, plaque and calculus, we may need to anesthetize the tissues is so inflamed and sore that conventional techniques are too uncomfortable without medicine. Root planing is typically followed up closely on a recall visit a few weeks later and often is coupled with an antibiotic regimen and/or microbial rinse.
Our office provides several services in addition to cleanings and root planing, including topical desensitizing agents to add comfort to your cleaning, lasers to help reduce excess tissues in an atraumatic way, fluoride varnishes to prevent tooth decay, periodontal charting to document changes over time and local therapeutic agents such as gels fortified with antibiotics that can be placed in sites with active disease.