Perio 101
Periodontics is one of the seven dental specialties recognized by the Canadian Dental Association. Periodontal comes from two Greek words that mean “around the tooth”. The periodontium refers to the anatomical structures around teeth: the gum, bone and the periodontal ligament that attaches the tooth to the bone.
Periodontists are dentists that have three additional years of training to specialize in the prevention, diagnosis and treatment of the diseases that affect the gums and supporting structures of the teeth. Periodontists are also experts in the placement and treatment of dental implants.
Periodontal disease is the major cause of tooth loss in adults. Approximately, three out of four Canadians over age 35 have some form of Periodontal Disease. Gingivitis is the mildest form of periodontal disease and the most common infection in the world. But if left untreated it can progress to periodontitis - the loss of bone and tissues that support the teeth. Periodontal diseases can be localized to a few teeth or generalized, in which most of the teeth are affected. It can affect people of all ages and without proper treatment, periodontal disease can result in tooth loss and even complications of systemic diseases.
There are several different forms of periodontal disease. Each can progress at different rates. The same disease can have periods when it develops slowly and others when it progresses quite rapidly. Most of the time, periodontal diseases are painless. But they may have acute episodes that result in severe pain and a dental emergency. The rate of periodontal disease progression is dependent on a multitude of factors including the presence of certain risk factors that make people more susceptible to periodontal breakdown.
All periodontal diseases are caused by an accumulation of bacteria at and below the gum-line. The bacteria release toxic substances that trigger the breakdown of the gum and bone. The gums become red, swollen and bleed easily. The gum tissue then separates from the teeth, forming a gap called a periodontal pocket or exposing the root surface in what is called recession.
The body responds to the bacteria with an inflammatory response in which it essentially 'turns on itself' and destructs the bone and tissues around the teeth. This is the body’s way of warding off infectious agents. The teeth can start moving and shifting and eventually if there is advanced bone loss, the teeth can be lost.
If the Periodontal disease is more advanced, surgical treatment may be indicated. The purpose of this phase of treatment is to create an environment that is more amenable to health and if possible regenerate some of the bone that was lost to the disease. In some forms of periodontitis, antibiotic treatment may be indicated. If this is the case, a bacterial culture may be required to test for harmful bacteria and to establish what antibiotics they are susceptible to.
Periodontal disease is a chronic disease that, like many other chronic diseases, has to be closely monitored, even after active treatment. The maintence, or third phase is crucial to the success of any treatment. Daily brushing and flossing is essential in controlling the ever-developing plaque. So is periodic periodontal maintenance care with professional scaling of the teeth. The periodontal status has to be closely monitored so that changes can be identified and treated as early as possible.
Everyone should be routinely screened for periodontal disease. All dentists are qualified in detecting and treating the early stages of periodontal disease, but if you suspect that you are at risk, or you know you have periodontal disease, you may want to see a periodontist who has extensive advanced training in the diagnoses and treatment of periodontal diseases. With today's knowledge about periodontal diseases and the new advances in treatment, you can expect to keep your teeth for a lifetime and ward off the effects that periodontal disease may have on your overall health.
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