Periodontal disease tends to be a condition involving inflammation around the teeth that involves a breakdown of the sulcular epithelium and can lead to progressive or intermitant bone loss around teeth. Often dentists diagnose it by measuring sulcular pocket depths and feel that pockets greater than 4 mm may indicate the presence of periodontal disease. Actually active periodontal disease is detected by presence of bleeding on probing and pocketing. Periodontal disease tends not to occur without inflammation and dentists associate this with bleeding on probing.
To understand how to get rid of it, first it helps to understand the factors that tend to encourage its development.
Poor plaque control
altered immune response by some factor(smoking, stress, diabetes, illness, pregnancy)
Not having frequent enough cleaning and the associated tarter build up that can occur.
The presence of sub gingival tarter
Presence of unhealthy bacteria in crevicular fluid.
All of the above mentioned factors can result in gingival inflammation and if we can remove from someone with periodontal disease their gingiva often responds by becoming more healthy and less inflamed,
When a patient comes to our office and is diagnosed with active periodontal disease, we first perform a general full mouth cleaning of their teeth and check their home care. Often time is spent demonstrating the techniques they need to employ on a daily basis to get their teeth cleaner. They must understand how to clean all the tooth surfaces in their mouth. Proper tooth brushing and cleaning interproximal is the way to accomplish this goal.
If after a general cleaning, a patient still has pocketing with suspected subgingival calculus, root planning is initiated Usually one quadrant at a time (one quadrant Is cleaned each week or two.) At these sessions the patients homecare is checked and areas that need improvement are pointed out.
Often in our office a patient undergoing root planning procedures are placed on a regime of low dose doxycycline for 90 days(20mg twice per day) since this medicine seems to promote better healing and periodontal pocket resolution in some patients.
At the completion of this initial treatment of periodontal disease , pockets are measured again and if all pockets are not resolved the patient is offered the option of seeing a periodontist in order to access if periodontal surgery might be a good further option for them.
When our initial treatment phase is completed the patients are placed on a periodontal recall schedule that most often results in them getting their teeth cleaned every three months .
Over the years many patients have undergone this treatment at our office and many have had their periodontal disease go into remission. For many this remission is permanent with and patients gingiiva and supporting bone can be seen to be healthier even years later.
