DR. TIMOTHY SHEN

La Mesa, CA Dentist

What Periodontal Therapy Is and Why It Matters

A complete, healthy smile is easily the most important part of a balanced and aesthetically beautiful face. A full set of healthy teeth fills the face out to prevent loose, sagging skin, deep hallows at the cheeks, and the look of advanced facial aging. Surprisingly, however, these and other negative developments often have less to do with the teeth themselves than the soft tissues that surround them. When the gums are unhealthy, swollen, and sore, and when bacteria have been allowed to permeate these tissues, countless problems arise. Periodontal therapy is designed to correct periodontal disease, and to reverse the functional and cosmetic damages that it’s caused.

What is Periodontal Disease?

Closeup of woman's mouth with dental mirror during 6 month preventive exam.

Periodontal disease or periodontitis is an unfortunately common health issue. Often caused by substandard brushing and flossing techniques, this progressive condition leaves the gums swollen, tender and sore. During the early stages of periodontitis, people may experience significant discomfort whenever the teeth are brushed or the gums are otherwise agitated. Brushing, flossing, or simply picking the teeth can also cause the gums to bleed. People with gum disease frequently struggle with pervasive mouth odors, and they often have a hard time fighting bad breath even when brushing and flossing are regularly performed.

Early forms of periodontitis are known as gingivitis. Gingivitis is usually the most painful stage of gum disease. As the condition progresses, soft tissues that have been damaged by bacterial activity will begin to draw back from the teeth. This is known as receding gums or gum recession. Receding gums leave the soft dentin of the tooth structure exposed, and open the door to serious and progressive tooth decay. When gum disease is left unchecked, the natural tooth structures can loosen and fall out. Given that decay-causing bacteria won’t remain contained solely to the soft tissues alone, these germs can go on to affect both the teeth and the underlying bone that supports them. Worst still, when these same infections are allowed to enter the bloodstream and become systemic, they can contribute to the formation of arterial plaque, heart disease, and many other chronic, general health issues.

The Consequences of Leaving Gum Disease Unchecked

Periodontal therapies are designed to both stop the ravaging effects of gum disease, and reverse the damages caused. Once gum disease has developed, failing to receive these treatments will leave the teeth at a higher risk of decay, infection, and loss. People with untreated gum disease also have higher rates of heart attacks, stroke, and lung disease. As widespread oral infections increasingly undermine the integrity of the underlying bone structure that supports the teeth, many options in cosmetic restoration will eventually be rendered inaccessible. For instance, when gum disease leads to both progressive tooth loss and bone deterioration, people may lack the stable surfaces for supporting the titanium posts that dental implants require. Ultimately, the sooner that periodontitis is identified, corrected, and reversed; the easier it is for people to regain healthy, balanced, and complete smiles.

Understanding the Risk Factors for Periodontitis

There are both controllable and uncontrollable risk factors for gum disease. Some people are naturally predisposed to experiencing problems with their gum tissues. For these individuals, even though their oral hygiene may be good, their gums can easily become sore, inflamed, and infected. This is frequently the case for:

  • Diabetics
  • People with poor circulation
  • Pregnant or lactating women
  • People going through puberty or other significant hormonal changes

Among some of the risk factors that people can mitigate on their own are:

  • Smoking or other forms of tobacco use
  • High-sugar or highly acidic diets
  • Poor oral hygiene
  • Failure to receive routine dental examinations

Given its effects on the mouth’s pH and its tendency to diminish blood circulation, tobacco use is one of the worst habits for the gums. People who brush regularly but rarely floss tend to have high rates of gum disease, as do people who maintain high-sugar diets or diets that are high in refined carbohydrates. Working with a dentist is the best way to get an oral hygiene plan that’s streamlined to suit the needs of your mouth. You can additionally consult with your doctor to establish an effective smoking cessation plan if needed, or to get help in establishing a low-sugar, low-carbohydrate diet that meets your health and nutritional needs.

How Periodontal Therapies Can Help

There are actually several different ways of treating gingivitis and advanced periodontitis. Treatment methods are often chosen according to the severity of gum disease that the individual is experiencing, and the level of functional, structural, or cosmetic damages that have occurred. One of the primary goals of gum disease treatment is protecting the teeth and the underlying bone structure from further damages caused by harmful bacteria. By clearing away trapped plaque and debris, and addressing adverse conditions on the tooth structure itself, these treatments can stop and even reverse gum recession, strengthen loose and failing teeth, and assist in the treatment of existing oral infections and cavities.

Different Options in Periodontal Therapy

There are both surgical and non-surgical methods for treating and reversing gum disease. Root scaling and planing is the most popular choice among periodontal therapies for mild to moderate cases of periodontitis. During these treatments, build-ups of plaque are cleaned from underneath the gums and removed from the tooth root. In some cases, the root of the tooth will also be smoothed and refined. This gives the soft tissues a healthy surface to adhere to, and prevents bacteria and infections from settling in these areas.

Surgically, gum grafting can be used to cover exposed dentin and to protect the tooth roots. With gum grafting, donor tissues or tissues that have been excised from other areas of the mouth are used to instantly reverse gum recession. Grafted tissues cover the diseased area to prevent further damage, and to restore overall smile aesthetics. Some dentists may even choose to use the pinhole surgical technique to address receding gums. With this procedure, tiny perforations are made in healthy gum tissues just above the area of recession. This loosens the tissues so that they can be gently finessed downward to cover the exposed dentin or tooth root. Both options minimize tooth sensitivity and stave off widespread oral infection.

Finally, gum flap surgery can be performed. This is a measure that the dentist might employ when gum disease is especially severe. During this procedure, the affected gums are cut and pulled back to reveal the tooth root. This allows the root to be thoroughly cleaned and smoothed as needed for preventing reinfection.

Is Periodontal Therapy Right for You?

Periodontal therapies are definitely worth pursuing for anyone with sore, inflamed gums, bleeding gums, or noticeable gum recession. It’s important to note, however, that periodontitis isn’t always painful. During its later and more severe stages, this condition may exhibit absolutely no symptoms at all. Thus, the absolute best way to know whether or not you’re in need of a corrective or preventive periodontal treatment is by scheduling an appointment with your dentist, and having a thorough examination performed.