If you believe that tooth loss is a natural consequence of aging, think again. Your teeth can last a lifetime, but they cannot repair themselves. This means that their longevity depends on the care you give to your teeth and oral tissues.

Gum diseases affect a majority of the American adult population to varying degrees. If you are one of the many people experiencing problems with your gum tissue, visiting a periodontist is a good idea, as it will help you deal with the problem before it escalates to a more serious periodontal condition.

Simple habits such as regularly brushing your teeth and scheduling dental cleanings every year can make a huge difference in preventing serious gum diseases. But if these conditions occur, you can visit Washington Dental, Lomita offices to have your gums checked.

Definition and Overview

Periodontics is a branch of dentistry dealing with the support structures surrounding the teeth. These structures are collectively called the periodontium and consist of the gums, the jawbone, the cementum (connects the tooth to the jawbone), and the periodontal ligament.

A periodontist is a specialist dealing with conditions occurring on the gums, jawbone, and other structures of the periodontium. You go to a periodontist when you have issues with your gums. In some cases, the dentist might refer you to a periodontist if they see signs of periodontal diseases.

The goal of a periodontist is to preserve as much of your healthy tissues as possible using different periodontal procedures that we will discuss shortly. But, before that, let us look at some of the common periodontal diseases that these specialists deal with.

Periodontal Diseases

Periodontal diseases affect approximately one in every two Americans. These diseases are the leading cause of tooth loss among adults.

Periodontal diseases do not happen overnight; it takes time before plaque accumulates enough to cause gum disease. However, before the full-blown disease manifests, there are certain early warning signs that you are on the path to developing these conditions. Some of the early warning signs include:

• Your gums start receding.
• Your teeth become loose or start separating from each other, and the gum
• Red, tender or swollen gums
• Changes in your bite
• Bleeding when brushing or flossing
• Bad breath or a bad taste that doesn’t go away
• Pain when chewing
• Tooth sensitivity

Gingivitis and periodontitis are the most common periodontal diseases, with gingivitis affecting approximately half the adult population in the US.

Gingivitis is a type of gum disease that causes inflammation of the gums. The disease results mainly due to poor oral hygiene and could lead to more serious conditions and tooth loss. The two main causes of gingivitis include:

• Accumulation of dental plaque
• Non-plaque induced gingivitis due to factors like bacteria, fungi, viruses, genetic influences, or allergic reactions.

Dental plaque starts as a film on the tooth as bacteria attempts to stick on the teeth. While these bacteria might protect the teeth from harmful bacteria, it also increases the risk of tooth decay leading to periodontal problems such as gum infections.

When the plaque is not removed properly, it hardens into tartar or calculus near the base of the teeth. Plaque is a yellowish or grayish substance that adheres to the surfaces of the tooth. It can also adhere to dental restorations.

Plaque is a biofilm consisting of bacterial and other material, which absorbs minerals in the saliva and calcifies if you do not remove it from your mouth through brushing or flossing. As this biofilm hardens, it forms the basis for additional layers of plaque buildup.

Removing plaque requires professional help from your dentist. When not removed, the tartar continues to irritate the gums leading to inflammation at the base of the teeth. The inflammation results in the dilation of blood vessels in the affected area as the body attempts to clear the infection.

Apart from the accumulation of plaque, other factors such as the following increase the likelihood of developing gingivitis:

• Hormonal changes during puberty, pregnancy, menstruation, and pregnancy
• Diseases such as cancer, diabetes, and HIV
• Certain medications, especially those that reduce saliva flow
• Smoking
• Age
• Vitamin C deficiency
• Family history of gingivitis

When you have gingivitis, you will notice signs and symptoms such as:

• Bright red gums
• Tender gums, painful to the touch
• Bleeding when brushing or flossing
• Bad breath
• Swollen gums
• Receding gums

Early treatment for gingivitis is important in preventing the disease from progressing into periodontitis. During treatment, the periodontist will remove plaque and tartar and teach you proper oral hygiene techniques that you should adopt. Depending on the extent of the plaque buildup, the dentist might schedule additional cleanings to remove the buildup.

At home, you can prevent plaque buildup by:

• Brushing at least twice a day
• Using an electric toothbrush
• Flossing at least once daily
• Regularly rinsing your mouth with an antiseptic mouthwash

If not treated early, gingivitis can lead to complications such as:

• Infection of the jaw bone
• Periodontitis
• Recurrent gingivitis
• Trench mouth

Periodontitis is another common periodontal disease. This serious gum infection often leads to tooth loss. Like gingivitis, periodontitis develops due to poor oral health, but other risk factors also increase the possibility of developing periodontitis. These risk factors include:

• Gingivitis
• Smoking
• Chewing tobacco
• Hormonal changes
• Recreational drug use
• Obesity
• Inadequate nutrition (Vitamin C deficiency is associated with poor periodontal health)
• Genetics
• Medications that cause gum changes or dry mouth
• Diseases such as diabetes and rheumatoid arthritis

Like gingivitis, periodontitis is a preventable infection. It develops from the accumulation of plaque, tartar, and calculus on the teeth. As the bacteria develop you could develop gingivitis. Gingivitis causes ongoing inflammation of the gums, and if not corrected, pockets form between your gums and teeth, eventually filling up with plaque, tartar, and bacteria. These bacteria eat up your dental tissues leading to tooth loss. The tooth loss occurs as the bacteria release chemicals that destroy the bone faster than it can restore itself. The continued inflammation of your gums also strains your immune systems, predisposing you to more health conditions.

The signs and symptoms that accompany periodontitis include:

• Puffy or swollen gums
• Bright red or dark red gums
• Gums that are tender to the touch
• Your gums bleed easily
• Bad breath
• Pus between the teeth and gums
• Loose teeth or tooth loss
• Pain when chewing
• New spaces between the teeth
• Receding gums (your teeth appear longer)
• A change in your bite

During treatment, the periodontist will measure the pocket depth (the groove between your gum and teeth) using a dental probe. Healthy pockets should be between 1 mm and 3 mm in depth. Those that exceed 3 mm are an indication of periodontitis.

If you have deeper pocket depths, the dentist will order a dental x-ray to check bone loss. Treatment for periodontitis includes surgical and nonsurgical alternatives. Non-surgical treatments include:

• Scaling to remove tartar and bacteria from the teeth surface and beneath the gums
• Root planing to smooth the root surface and discourage the further accumulation of bacteria on the root. Root planing also facilitates faster reattachment of the gum to the tooth surface.
• Antibiotics to control bacterial infection in the mouth

Surgical treatments for periodontitis include:

• Pocket reduction surgery where the periodontist makes a small incision in the gum allowing for effective scaling and root planing. The periodontist may also recontour the underlying bone tissue before suturing the gum in place. Once you heal, cleaning will become easier, helping you maintain healthy gum tissues.
• Soft tissue grafting may be necessary if you have receding gums. The periodontist will remove small tissue from the palate to replace lost tissue due to gum recession. Soft tissue grafting helps prevent further gum recession and covers exposed roots.
• Bone grafting is another surgical procedure used in treating periodontitis where the disease has damaged the bone around your roots. Bone grafts can be from artificial material, donated bones, or fragments of your bones.
• Guided tissue regeneration where the dentist places a biocompatible fabric between the existing bone and your tooth. This material prevents the entry of any unwanted tissue and allows the regrowth of your jawbone.
• The periodontist might use a special tissue-stimulating protein gel to stimulate the growth of healthy bone and tissue. The gel contains proteins found in growing teeth and enamel.

Healing recovery from periodontal diseases depends on your willingness to adhere to the periodontist's instructions and treatment plan. Failure to follow the treatment plan or refusing to improve your oral hygiene practices after treatment predisposes you to repeat periodontal diseases, and in worse cases, tooth loss.

While periodontal diseases can result in permanent tooth loss, the good news is that they are preventable with a few lifestyle changes. The steps you can take to prevent periodontal diseases include:

• Brush your teeth at least twice daily and floss at least once to remove bacteria that cause periodontal diseases. Brushing daily also removes food particles that serve as food for bacteria in the mouth. Brush using a rounded and soft-bristled toothbrush. Use an electric toothbrush if you have problems managing a manual one. Use the right brushing technique: hold your toothbrush at an angle of 45° with the bristles towards the gum. Brush the surface along your gum line in small circular motions until you cover the entire mouth. Remember to brush your teeth so you remove the bacteria on the tongue.
• Schedule and attend at least one dental checkup. You should visit the dentist for general checkups more often if you have certain risk factors such as smoking, a family history of periodontal diseases, hormonal changes, or diseases such as cancer, diabetes, and HIV.
• Eat a healthy diet to get the right nutrients that will help you in fighting gum disease. Calcium and Vitamin C are some of the essential nutrients that help in preventing gum disease.

Periodontal Procedures

A periodontist performs several procedures in the diagnosis and treatment of periodontal diseases. A periodontist can perform preventative procedures, such as regular dental cleaning to prevent the development of gingivitis and other periodontal diseases. Some of the procedures a periodontist will perform include:

1. Scaling and Root Planing

Scaling and root planing are the first procedures a periodontist will use to remove tartar in patients in the early stages of gingivitis. Periodontists use a scalar or a periodontal curette during the procedure. The scalar vibrates against the teeth, effectively breaking up tartar. After the scaling procedure, you have to take care of your oral health to prevent the buildup of tartar.

2. Dental Debridement

Every day, your body produces plaque, which forms a film on your teeth. If not removed through proper brushing and flossing, the plaque accumulates, all the while hardening into tartar or calculus.

Tartar is a hard substance that is hard to remove with regular dental cleaning. It requires professional removal. If you do not attend your annual dental checkups annually, calculus can become so hard and stubborn that regular dental cleaning cannot fully remove the tartar. In this case, the dentist will debride your teeth before beginning the examination.

The debridement process requires special electronic equipment that uses ultrasonic vibrations to break up calculus to make it easy to remove and clean. Once the dentist has removed the calcified tartar, they will scale the tooth and plane the root surfaces. A dental debridement removes the dense plaque and tartar and allows your dentist to examine your oral tissues.

3. Periodontal Surgery

Periodontal surgery is necessary when non-surgical procedures cannot adequately address periodontal diseases. Periodontal diseases, if untreated, can lead to permanent tooth loss; therefore, dentists will perform periodontal surgery to prevent the progression of gum disease and facilitate the regeneration of healthy gum and bone tissues.

The progression of periodontal disease results in the development of pockets between the gum and the teeth. These pockets are full of plaque and bacteria, which damage the tissues, and if left untreated, the disease can progress to affect the entire body.

The periodontist can perform one or more types of periodontal surgeries to handle the problem. The first type of periodontal surgery is flap surgery.

The periodontist administers anesthesia before the flap surgery procedure. Once the anesthesia kicks in, the periodontist makes small incisions to separate the gum from the teeth and then fold over the separated gum to access the root, bone, and supporting ligaments. The periodontist cleans this area and, when needed, treats the area with antibiotics.

Bone grafting is another type of periodontal surgery which the periodontist may perform alongside periodontal flap surgery. As mentioned earlier, the goal of bone grafting surgery is to facilitate the regrowth of natural bone tissues.

Recovery from periodontal surgery will depend on the severity of gum disease. You will experience slight bleeding and minor discomfort in the days after the procedure. However, you can resume most of your activities within a day.

During the recovery period, avoid certain habits, such as smoking, which impair the body's natural healing process. The dentist might also require you to use a special mouth rinse or take antibiotics after the procedure. You will also need to eat soft foods for about a week after the procedure to avoid hurting your oral tissues.

4. Osseous Surgery (Pocket Reduction)

Pocket reduction is a periodontics procedure aiming to reduce or eliminate the pockets that form as gum disease progresses. A healthy person has pockets of two to three millimeters in-depth, but gum disease can deepen these pockets allowing tartar to accumulate deep underneath the gum tissue.

Pocket reduction surgery can last up to two hours to complete. During the procedure, the periodontist will numb your gums before making a small incision on the gum line. The next step involves folding back the gum tissue and cleaning out the area underneath the gum tissue. Once the periodontist removes the tartar buildup and recontours the underlying bone, they will sew back the gum and apply a periodontal dressing to manage the bleeding.

You can resume normal activity days after the procedure. Meanwhile, you should avoid smoking, drinking with a straw, or eating hard foods. In addition, you should change the gauze regularly and rinse your mouth with salt water after 24 hours.

5. Dental Implants

Dental implants are artificial tooth roots placed into the jaw to hold an artificial replacement tooth. They mimic natural teeth in their placement and function.

Periodontics is also involved in the placement and maintenance of dental implants, including treating conditions that arise from conditions affecting patients with dental implants such as peri-implantitis. Due to the training they receive, periodontists are well equipped in handling the surgical placement of implants.

They are familiar with procedures such as bone grafts, which may be required depending on the patient’s periodontal health. Implants are an ideal tooth replacement option that offers the following advantages:

• They improve the appearance of your teeth as your periodontist can customize the implant to match your other teeth.
• Implants are one of the strongest tooth replacements, which can last a lifetime with the proper care and maintenance. Therefore, they come with reliability that patients can rely on when looking for dental replacements.
• They are comfortable. A periodontist will place the implant into the jaw, in the same position your natural teeth would stay. They do not need adhesives to stay in place, which makes them a convenient dental replacement choice.

Dental implants are a viable option for patients missing one or more teeth due to injury or infection. However, before a dentist can place an implant, they will evaluate your oral health to determine your suitability as a candidate for dental implants.

Dental implants require patients to have sufficient bone tissue and healthy gums to support the implant. In this case, a periodontist evaluates your gum and bone tissue before the procedure. If your tissues are not healthy enough to accommodate the implant, the periodontist might suggest certain treatments, such as a bone graft to facilitate the implant placement.

The periodontist is also involved in dental implant surgery to ensure the correct placement of the implant into the jawbone. Proper placement of the implant is critical in preventing implant failure. Despite being artificial tooth replacements, patients with implants are not immune to periodontal problems.

Problems can arise when bacteria form around the implant and damage the gums and structures around the implant leading to peri-implantitis. Peri-implantitis begins as a mild and easily treatable condition. When you report the symptoms of the infection early enough, your periodontist can take care of the implant and your tooth structures before a serious condition develops.

Like periodontal conditions, certain risk factors increase your chances of developing peri-implantitis if you have implants in your mouth. These risk factors include:

• Smoking or chewing tobacco
• Poorly controlled conditions such as diabetes, osteoporosis
• A history of periodontal diseases and non-compliance to treatment
• Poor oral hygiene
• Bruxism
• Lack of primary stability
• Premature loading of the implant during the healing period

Some of the symptoms that indicate possible infection around the implant area include:

• Inflammation, swelling, redness, and pain in the tissues surrounding the implants
• A receding gum line
• Exposure of the implant
• Loose implant
• Pus discharge from the tissues around the implant
• Soreness in the jaw (could be an indication of bone deterioration)
• Bleeding gums

Treatment for peri-implantitis depends on the severity of the condition. For mild conditions, the periodontist can prevent further bone loss and preserve the dental implant. The periodontist cleans the infested area and prescribes antibiotics to fight off the infection.

In severe cases, peri-implantitis might necessitate the removal of the implant. The periodontist might perform a bone grafting procedure to restore bone tissue and prevent further deterioration.

Find a Dentist Near Me

Our teeth play a vital function in nutrition and appearance, but they are as good as the supporting tissues around them. Periodontics concerns itself with the conditions that affect the tissues that support teeth, including the gum and jawbone. When these tissues have a problem, they affect the entire tooth and can cause permanent tooth loss. Washington Dental staff in Lomita help families maintain good oral hygiene by offering periodontal services to help prevent, diagnose and treat any periodontal conditions. Our dentists are available for a consultation at 310-326-5183.