PERIODONTAL CARE

The word periodontal means "around the tooth." Healthy gum tissue fits like a cuff around each tooth. Where the gum line meets the tooth, it forms a slight v-shaped crevice called a sulcus. In healthy teeth, this space is usually three millimeters or less.

Periodontal diseases are infections that affect the tissues and bone that support teeth. As the tissues are damaged, the sulcus develops into a pocket that is greater than three millimeters. Generally the more severe the disease, the greater the pocket depth and bone loss. The enlarged pockets allow harmful bacteria to grow and make it difficult to practice effective oral hygiene. Left treated, periodontal diseases may eventually lead to tooth loss.

The mouth is filled with countless bacteria. Periodontal disease begins when certain bacteria in plaque (the sticky, colorless film that constantly forms on the teeth and the surfaces lining the mouth) produce toxins and enzymes that irritate the gums and cause inflammation. The resulting inflammation, which may be painless, can damage the attachment of the gums and bone to the teeth.

During your dental checkup, Dr. Takamatsu or the hygienist examines your gums. A periodontal probe is gently used to measure the depth of the sulcus surrounding each tooth. The periodontal probe can indicate whether you have developed any pockets and the depth of those pockets. Generally, the more severe the disease, the deeper the pocket.

There are many types of periodontal diseases and they can affect individuals of all ages from children to seniors.

• Gingivitis: It is the mildest form of periodontal disease. It causes the gums to become red, swollen, and bleed easily. There is usually little or no discomfort at this stage. Gingivitis is reversible with professional treatment and good oral care at home.
• Chronic Periodontitis: It is a form of periodontal disease that results in inflammation within the supporting tissues of the teeth. Patients experience progressive loss of tissue attachment and bone. Chronic peridontitis is characterized by pocket formation and/or recession of gum tissue and is the most frequently occuring form of periodontitis. It is prevalent in adults, but can occur at any age. Progression of attachment loss usually occurs slowly, but periods of rapid progression can occur.
• Aggressive Periodontitis: It is a highly destructive form of periodontal disease that occurs in patients who are otherwise clinically healthy. Common features include rapid loss of tissue attachment and destruction of bone. This disease may occur in localized or generalized patterns.
• Periodontitis as a Manifestation of Systemic Diseases: This form of periodontitis is associated with one of several systemic diseases, such as diabetes. Patients who have rare but specified blood diseases or genetic disorders frequently show signs of periodontal diseases.
• Necrotizing Periodontal Diseases: They are infections characterized by necrosis (death) of gingival tissues, periodontal ligament and alveolar bone. These lesions are most commonly associated with pain, bleeding, and a foul odor. Contributing factors can include emotional stress, tobacco use and HIV infection.

Periodontal treatment methods depend upon the type and severity of the disease. The first step usually involves a special cleaning, called scaling and root planing. This procedure removes plague and tartar deposits on the tooth and root surfaces. This helps gum tissue to heal and pockets to shrink, which makes it more difficult for plaque to accumulate along the root surfaces. This is sometimes referred to as "periodontal" or "deep cleaning" and may take more than one visit.

Once your periodontal treatment is completed, you will be seen at regular intervals. In some cases, your appointments may alternate between Dr. Takamatsu and a periodontist. You may be recommended more frequent checkups to periodontal disease under control.