Gum disease is a common dental issue affecting nearly one-third of US adults. Poor oral hygiene and genetics typically create conditions for bacteria to multiply, setting the stage for infection and damage to the gum tissue. Plaque and bacteria irritate and inflame gums, which, over time, can create numerous problems for oral health and hygiene. Dr. Jennifer Mohr is dedicated to providing comprehensive periodontal disease treatment at Mohr Smiles in Tucson, AZ. Understanding and treating periodontal disease is crucial for maintaining overall oral health.
Periodontal Disease Therapy in Tucson, AZ
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 crevice called a sulcus. In healthy teeth, this space is usually three millimeters or less. Periodontal disease, also known as gum disease, is a chronic inflammatory condition that affects the gums and bones supporting the teeth. It begins with bacterial growth in the mouth, leading to plaque buildup. If left untreated, it can result in tooth loss and other serious health issues.
In its early stage, called gingivitis, the gums can become swollen and red, and they may bleed. As the tissues are damaged, the sulcus develops into a pocket that is greater than three millimeters. With this more serious form called periodontitis, the gums can pull away from the tooth, bone can be lost, and the teeth may loosen or even fall out. 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.
Early signs of periodontal disease include red, swollen, or bleeding gums. As the disease progresses, symptoms can become more severe, such as persistent bad breath, receding gums, and loose teeth. Pain while chewing and sensitive teeth are also common symptoms.
Detecting periodontal disease early is essential for effective treatment. Regular dental check-ups with Dr. Mohr can help identify the disease in its initial stages. Early intervention prevents further damage to the gums and bone.
What causes periodontal disease?
The mouth is filled with countless bacteria. Periodontal disease begins when certain bacteria in plaque (the sticky film that forms on the teeth) produces 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.
Plaque that is not removed becomes hardened by the minerals in your saliva into rough, porous deposits called calculus, (sometimes called tartar). This calculus harbors plaque and bacteria and cannot be removed with a toothbrush.
The periodontal-systemic disease interrelationships
Tooth loss is not the only potential problem posed by periodontal disease. There is strong evidence that toxins and inflammatory cells in the gums get into the bloodstream daily. These toxins go wherever the blood flows. Research suggests that there are links between periodontal disease and other health concerns such a diabetes, heart disease, stroke, bacterial pneumonia, and increased risk during pregnancy.
Heart Disease: Bacteria from inflamed gums that have reached the bloodstream can attach to platelets and form clumps that lodge inside blood vessels causing stroke and heart attack.
Diabetes: The presence of gum inflammation makes it more difficult for a diabetic to control their blood sugar. Elimination of periodontitis can directly improve diabetic control.
Bacterial pneumonia: The bacteria in your mouth are inhaled into the lungs. The bacteria that cause gum disease are the same as are found in bacterial pneumonia and other respiratory disease.
Pregnancy: Women with periodontal disease are seven to eight times more likely to give birth prematurely to low birth weight babies. Researchers believe that gum disease causes the body to release inflammatory chemicals, which are linked to pre-term birth.
Are you at risk for gum disease?
There are several factors that increase the risk of developing periodontal disease:
- Studies show that smoking just a half a pack of cigarettes a day can increase your risk of periodontal disease to three times that of the general population. Smokers’ and tobacco chewers’ symptoms are often masked for years and do not exhibit inflammation and bleeding that leads to early diagnosis. As a result, the disease has often progressed to an advanced state by the time it is treated.
- Straight teeth are easy to clean. If you have crooked teeth, cleaning out the debris and plaque that gets caught between them becomes much harder. And incomplete plaque removal causes periodontitis. If any of your teeth are facially displaced, the bone around them is thin. Those teeth are highly susceptible to early gum recession. Crooked teeth also cause trauma when biting to the supporting structures and cause loss of bone around the teeth.
- Systemic diseases, such as diabetes, blood cell disorders, HIV and AIDS can lower the body’s resistance to infection, making periodontal disease more severe.
- Puberty, pregnancy, and oral contraceptives change the body’s hormone levels. This can cause gum tissue to become more sensitive to toxins and enzymes and an accelerate growth of some bacteria. Some patients may be predisposed to a more aggressive, severe type of periodontitis. Patients with a family history of tooth loss or who have parents wearing dentures should pay particular attention to their gums.
- According to some studies, periodontal disease may be passed from parents to children and between couples. Research suggests that bacteria that cause periodontal disease are passed through saliva.
Treatment Options for Periodontal Disease
Treatment methods depend upon the type and severity of the disease. The least invasive treatment is always the first step.
We may recommend a prophylactic cleaning (prophy) for the treatment of gingivitis or the maintenance of healthy gums.
A debridement may be necessary to remove heavy plaque and calculus from your teeth for either or both of these reasons:
- The presence of debris and calculus makes it impossible to complete your comprehensive exam.
- The removal of debris and calculus, followed by a period of improved home care, is needed to evaluate your tissue response and accurately diagnose your periodontal condition.
A debridement is followed by an appointment to determine the effect of debris removal and further need for treatment.
Scaling and root planing (SRP) is the first line of treatment for periodontitis. This procedure removes plaque and calculus deposits and smooths the root surfaces of your teeth. The removal of these toxins helps the gum tissue to heal and pockets to shrink. The planing of the root surfaces helps prevent new plaque and calculus from sticking. Additionally, we may give a local anesthetic to make you comfortable during the procedure.
SRP is followed by an appointment to evaluate its effect and determine further treatment needs.
When this treatment is performed, your dentist will recommend 3 or 4 hygiene visits per year to maintain the cleanliness of your periodontal pockets.
Laser Bacterial Reduction Therapy
For patients maintaining healthy gums, especially those with uncontrolled periodontal disease, we offer Laser Bacterial Reduction (LBR). We perform LBR with a diode laser without the need for local anesthetic. Often, we use this in conjunction with regular hygiene visits. The goal of this treatment is the reduction in the number of virulent pathogens in the gum tissues that cause inflammation and bleeding. A hygienist manually cleans these areas during a regular hygiene prophylactic or periodontal maintenance visit. However, only the laser energy can penetrate the soft tissues to reach the pathogens they harbor inside. After completing your gums, Dr. Mohr performs a laser curettage of the most inflamed areas. The result is immediate. We see tighter, healthier-looking gums before you leave. You shouldn’t experience discomfort with this procedure. In fact, we recommend it for all patients at every hygiene visit.
Minimally Invasive REPaiR Procedure
The REPaiR protocol is a new way to treat gum disease using laser technology. With this minimally-invasive approach we can preserve tissue and bone without the need for more extensive periodontal surgery.
REPaiR offers significant advantages, including a better patient experience and faster healing. Patients treated with laser energy simply recover more quickly. We use the Erbium laser in this procedure to perform incisions precisely and disinfect the operative site, as it works to help you heal faster.
REPaiR therapy helps patients who have completed but not responded to phase I treatment. Phase I involves the removal of biofilm and calculus from areas above and below your gums through scaling and root planing. Our hygienist will generally perform this procedure.
Our team performs REPaiR under local anesthesia. The goal is to remove calculus and biofilm from areas deep below the gingiva and near the bone, remove infected tissue from inside the gums, and remove excess tissue that causes deep un-cleansable pseudo-pockets around your teeth, and promote the healthy reattachment of gum tissue to your teeth, reducing the depth of periodontal pockets.
Periodontal surgery is necessary when the depth of pockets and shape of the supporting bone structure make it difficult to remove plaque and calculus completely. When calculus remains, your pockets will not heal after SRP, and the disease will continue to progress. A periodontist performs periodontal surgery to visualize hard-to-reach areas and remove the calculus. Additionally, the surgeon will recontour supporting bone structure and reshape gums to facilitate easier home care and maintenance.