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Lawrence M. Spindel, DDS Periodontal Disease
Larence Spindel DDS
Periodontal Disease 
by Lawrence M. Spindel, DDS
Wednesday, March 21, 2007, 6.30 AM
If you are worried you have gum disease, or worse been told you've got it , what does it mean?
 Periodontal Disease describes a syndrome characterized by bleeding gums, bone loss with or without pocketing. Mobiltity of teeth , bad breath and/or receeding gums may be present. Why does it happen.? Perio Disease happens to be one of the bodies responses to inflamation caused by bacteria around and attached to teeth. Plaque left on tooth surfaces long enough gets progressively nastier(has more anaerobic bacteria) and more toxic to the body. Inflamation is the bodies defense against the bacteria and they're toxins, and it seems that this inflamation can lead to breakdown of the bodies collegen and bone which leads to "pocketing"(crevices of more than 3mm between the gums and the teeth). These pockets tend to be harder to keep clean and tend to harbor nasty bacterias which can lead to even further bone breakdown. they also tend to gather tartar which often is not removed with ordinary cleanings by the hygienest.
So what to do about it? 
Deep scaling and rootplanning (or Initial Therapy for Gum Disease) is the best place to start. The patient is anaeshetized and quadrants of the mouth are meticulously cleaned using currettes gently placed under the gums. Some of this is normally done by the hygienest during a normal cleaning , but a better, more definitive job can be done one quater  of the mouth at a time while the mouth is numb. At these initially therapy visits(2or 4 vistits usually) homecare training is given. This patient education may be the most important part of the visits since a patients ablility to keep their mouth clean will probalbly determine whether their mouth remains healthy afterwards. Also patients are often dosed with tetracycline drugs,either topically or in pill form during and after treaments since they tend to allow for better shrinking of the pockets and lessen inflamation which might make your condition worsen.
When this initial therapy is over, It is best to place patients on a frequent recare schedule and their mouth remains healthy .  Cleaning with our hygienests every three months is usually recommended.  If there is a worsening of the periodontal condition this will be caught during a  subsequent recare examination.

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Dental Tip of the Day Treatment of periodontal disease has changed its emphasis over the years. Now most treatment tends to be "non surgical". Treatment begins with a series of 'deep cleaning' and the use of a type antibiotic. Patients are placed on three month recall after wards. For many patients this is all the treatment that is planned. Some patients still benefit from flap surgery, especially those with infra bony defects that will not be eliminated by root planning alone. Full thickness flap surgery allows the periodontist an opportunity to either recontour bone defects or add bone grafting material to add to defects. If dealt with at an early stage, teeth with cracks can be corrected by crowning and this protection can lessen the likelihood of the crack propagating. .

Sunday, July 14, 2013

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