Understanding Periodontal Disease
Hey everybody, this is Dr. Michael Hardcastle from Village Dental Care in North Dallas, Texas. I'm here today to talk to you a little bit about one of the questions we get about periodontal disease. I'll answer some of the most common questions about it to help you understand the condition, see if you might have it or suspect you might have it, and how we might be able to help you out. Let's get to it.
What is periodontal disease?
In a previous video, I talked about gingivitis and how it compares to periodontitis. Today, we're going to really hone in on what periodontitis is. Periodontitis is an infection of the gums caused by bacteria in your mouth. It's a naturally occurring bacteria that a lot of people have; not everybody, but many people got these bacteria from their parents.
Now, you've got a condition where you have chronically inflamed gums that have led to the actual destruction of the bone that supports the teeth. You can have it at an early stage, moderate, or late stage when you're at risk of losing teeth. Ultimately, generally speaking, periodontitis is inflammation and infection of the gums that's causing the breakdown of the supporting structures of the teeth, including the gums and the bone. X-rays would show actual loss of bone.
Causes of periodontal disease
Generally speaking, the cause of periodontal disease is bacteria. Not everybody has the bad bacteria that cause periodontitis, but many people do. Some people have larger quantities, so they'll struggle more to keep it under control. Ultimately, we can teach you to control the bacteria, and if you've controlled the bacteria effectively, you can control the disease. You're never cured of the disease; you always have the bacteria. The long-term strategy is to develop a system and a method, both in the office and at home, that allows you to control the bacteria effectively so that you don't lose your teeth.
What are the symptoms of periodontal disease?
Periodontal disease often doesn't have symptoms. If you do have symptoms, you may notice a dull ache. Some people feel like there's pressure, but most people don't feel any symptoms at all. They might notice bleeding, swollen gums, or the dark buildup of tartar on their teeth. Most people will notice the aesthetic degradation, like your smile just doesn't look as good as it used to. Now, you have dark stuff on your teeth, the gums are swollen, and maybe your gums have receded too because of the loss of bone. That's typically how you would notice that you have gum disease if you're not a regular dental patient.
If you're a regular dental patient, you would just come in for a checkup, and a regular evaluation would help us determine that you have an active gum infection that you didn't even know existed. It really is the silent killer of the bone around your teeth, and that's the other reason for important dental checkups that are very regular.
What other conditions are connected to periodontal disease?
There is so much science out there now that connects periodontal disease to other systemic diseases like diabetes, early delivery or premature delivery of babies, coronary artery disease, and damaged heart valves due to the buildup of bacteria that can only originate in the mouth, circulating to the heart, and joint problems. There's just a long list of serious medical problems.
As we get older, there's a big focus on how we can feel healthier, have less pain, and avoid dying from one of the four major killers. Having a healthy mouth, making sure you don't have gum disease, and if you do, having it treated and controlled, is crucial so that these bacteria are not getting into your bloodstream, which is how all the other problems happen. It's very important to have regular checkups to rule out the possibility that you might have gum disease.
Can periodontal disease be cured?
The quick answer is no. It's not about curing the disease; it's about controlling the bacteria that cause the disease. We do make efforts to kill as many of the bacteria as we can when we incorporate a laser during the treatment and other things. These are all factors that control the bacteria, but bacteria are constantly multiplying and growing. We want to control them, understanding that it'll be a lifelong commitment to controlling the bacteria so that you can save your teeth. It's definitely possible.
We have patients that we get on the right protocol, and they follow the plan effectively. It's very simple; you just have to be willing to try some new things and make it part of your daily routine. Then, commit to regular checkups so we can make sure it's under control. We can help you save your teeth, and you can have beautiful teeth your whole life. It's not something you have to worry about once you have a system.
What treatment options are available for fighting periodontal disease?
There are several these days, most of which are very effective, but it starts with the basics of what we call a deep cleaning. It's a gum infection treatment that is a more involved cleaning that goes deeper than you would have if you had a healthy mouth. We've got to get to the bottom of the pocket to get the bacteria out, and we need to first do that mechanically. We also incorporate the laser. Once we get all the buildup out of the pocket, we use a laser to kill as much of the bacteria as possible. That helps to get a much more rapid healing result.
Some offices will apply antibiotics into the pocket. It's a powdered antibiotic or it can be placed as a chip that's placed in the pocket, with slow release over usually about 10 days. That's another effective strategy. It's not usually necessary to do both that and the laser, so one of the two; they're both effective.
Then, regular visits every three months to see your doctor and your hygienist to make sure that the treatment's working and that you're making constant improvement until we have a stable mouth with healthy gums that don't bleed, then we maintain that. We're also checking for all the home care compliance and making sure you're doing a good job with home care, and if we can help point you in a better direction, then we like to do that too.
Does it hurt to have periodontal treatment?
If you have a gum infection, does it hurt to have it treated? That varies significantly from one patient to another, but ultimately, we don't treat patients if we know they're hurting. Most people with gum infection have very sensitive gums. We've got a number of ways to numb the gums to make sure the treatment is comfortable. We do not work on patients if we have any knowledge that they're hurting. We always want the patient to know they're in control, and it should be painless. Most of the time, the numbing that we do in our office is a very non-invasive gel numbing gel that we put down in the pocket. In mild to moderate cases, it works very well. We know people don't like shots, so if we can help get you comfortable without a shot, then that's what we want to do.
In certain more advanced cases where we know the disease is just too advanced for that to work, there is a limit to how well the topical medicines can work. Then we're going to apply some topical, followed by a shot, and then the shot's going to numb the gum. Even with the shots, we take great care to make sure they're as comfortable as possible. I get a lot of compliments on my shots that they don't hurt at all, and patients are surprised it's even happened already. Sometimes it's a little uncomfortable, but we try to minimize patient discomfort whenever possible.
I hope I've been able to answer some of your questions about periodontal disease, what it is, and how it can be treated. If you have any more questions, I'd love to talk to you more. Please contact my office if you'd like an evaluation or treatment. Call us at (972) 992-5223 or schedule below. See you soon.