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Archive for periodontal pocket

Following tooth extraction which could be the result of periodontal disease, fracture roots, abscess formation etc. the bone and gum around the removed root starts to shrink away. Research has shown that up to 40-60% of the remaining bone shrinks away within 2-3years.
This leaves areas which areas which are unsightly because of the reduction of hard (bone) and soft tissue (gum) volume. This results in less than ideal final crown or bridgework in terms of size and shape compared to the adjacent natural teeth. We can offer rebuilding of this soft and hard tissue as we have had years of experience in providing these sorts of procedures.

gum grafting used to treat periodontal conditions

Gum grafting and bone graft treatment before dental implant placement

Should a patient request dental implants to replace these teeth than bone grafting may have to be done prior to any implants placed. The replaced teeth look odd as it maybe much longer and the gum around this tooth will also look sunken in. A procedure called ridge augmentation restores the natural hard and soft tissue profiles so that the replaced teeth look much more in harmony with the natural teeth. There are many different techniques of ridge augmentation and the actual procedure used will depend on the volume of tissue lost and also final restorative therapy to replace the missing teeth. This procedure can be carried out under local anaesthetic and depending on the size of the area to be filled can either be done with small bone graft or a soft tissue graft taken from the roof of mouth. You will be given a choice of materials to be used in the bone graft.

The bone graft can either be taken from the patient (back of mouth) or usually from an either animal source (Bovine Bio-Oss) or synthetic material (Straumann bone ceramic. The bone graft helps to provide a stable base for the dental implants and gum tissue by bonding with the natural bone over a period of several months. After it has matured then the bridgework or implant therapy can be carried out. The healing period can vary and the success rates are very high but smokers are advised to refrain from smoking for at least 1 week prior to the procedure and for 3 weeks afterward for the best results. In some more advanced cases both hard and soft tissue grafts are used together.

bone and soft tissue grafts for treating gum disease

The casues of periodontitis

To understand this we must look at what causes gum disease in the first place. The cause of gum disease (gingivitis and periodontitis) is bacteria (bacterial plaque) inside your mouth which has overgrown. This is known as the indigenous bacteria i.e. it comes from own body. Just like the bacteria which we have inside our gut. The treatment for plaque induced gum diseases is all aimed at reducing the bacteria above and below the gum. However, we cannot get rid of indigenous bacteria, as this resides in our own body. That’s why antibiotics have only a limited effect in reducing the symptoms and the effect does not last more than a few weeks.

periodontitis cure before treatment

Treatment for periodontitis : Surgery and non-surgical management

All of periodontal treatments are aimed at reducing plaque bacteria to such a level that it does not become harmful and cause any further problems. First line of periodontal therapy is called non surgical treatment. Firstly we need to reduce the plaque build up above the gum by improving brushing & flossing techniques. Then any hardened deposits of plaque bacteria (called calculus or tartar) are removed both above and below the gum line by the use of both hand and ultrasonic instruments. Finally any fine deposits of bacteria and calculus are removed from the root surface with the use of specialised hand instruments called gracey curettes. In addition any teeth/tooth which have moved out of position and cause any problems with the bite may be adjusted (occlusal adjustment).

Management of periodontitis

Reducing periodontal pocket depths and bleeding

A reassessment is carried out approximately two months later to check the success of the treatment. The vast majority of cases we have treated at the Birmingham Periodontal & Implant Centre show at least 90% improvement in reduction of pocket depths. Almost all of the bleeding gums should be eliminated and in most mild to moderate cases this should be all the treatment that is needed. At this visit if we still find problems, then there is the option to have gum surgery. Gum surgery enables the periodontist to see the actual roots and bone surrounding the roots and also to remove any plaque/calculus deposits and any infection. Secondly the gum could be lowered to completely reduce the periodontal pockets also.

The final phase of any periodontal treatment is called maintenance therapy. Here 3 monthly hygiene appointments are arranged and professional cleaning above and below the gum line is carried out. Periodontitis needs to be treated like other chronic diseases such as diabetes and high blood pressure which cannot be cured but can be controlled by medication. The medication for periodontitis is good home care and regular professional hygiene visits. With this regime one can expect to keep their teeth for hopefully rest of their life.

aggressive periodontitis before treatment

BEFORE
Severe Chronic Periodontitis together with drug induced gingival hyperplasia (Nefidipine). After liasing with the General Medical Practitioner to change medication, the patient underwent a full course of non-surgical therapy.
AFTER
After treatment the periodontal condition has been stabilised with just non-surgical therapy and has been maintained by excellent plaque control by the patient.

florida probe is a periodontal probe used to diagnose gum disease

periodontal probe used to diagnose gum disease

 

How is periodontal disease diagnosed? What are gum pockets?

During a consultation or routine check up the dentist inspects the colour and firmness of the gums. Teeth are tested for looseness. The bite is checked. At some point, a small measuring instrument the periodontal probe – is gently inserted between the tooth and gum to measure the depth of the gum pockets. Periodontal Pockets are spaces between the tooth and gum, the deeper the gum pocket the worse the problem. This “periodontal” exam should be done at frequent intervals for all adults, especially when there is a history of periodontal disease in the immediate family. X-rays should be taken at appropriate times to evaluate changes in the bone supporting the teeth

Broad definition of the stages of periodontal disease
*Warning Signs*

There are few if any early warning signs, but as the disease progresses, the signs and symptoms become more obvious.

  • Red swollen gums that may bleed easily
  • Persistent bad breath
  • Tall looking teeth (Recession)
  • Loose teeth (Mobility)

 

HEALTHY GUMS AND TEETH

periodontal chart healthy gumsimage of healthy gum diagnosis

  1. Coral pink gums
  2. Gums hug teeth tightly
  3. No bleeding
  4. Periodontal Pockets 1-3mm deep

FIRST STAGE DIAGNOSIS: GINGIVITIS

periodontal chart gingivitisimage of gingivitis diagnosis

  1. Gums become red/swollen that may bleed easily
  2. Warning – This stage is not always obvious
  3. Periodontal Pockets 1-4mm deep

SECOND STAGE DIAGNOSIS : EARLY PERIODONTITIS

periodontal chart early periodontitisimage of early periodontitis diagnosis

  1. Periodontal Pockets form as gums separate from teeth
  2. Periodontal Pockets 4-5mm deep

THIRD STAGE DIAGNOSIS : MODERATE PERIODONTITIS

periodontal chart moderate periodontitisimage of moderate periodontitis diagnosis

  1. Periodontal Pockets deepen as more bone supporting the tooth is lost
  2. Periodontal Pockets become difficult to clean as they deepen
  3. Periodontal Pockets 5-6mm deep

FOURTH STAGE DIAGNOSIS : SEVERE PERIODONTITIS

periodontal chart severe periodontitisimage of severe periodontitis diagnosis

  1. More than 50% of the bone supporting the tooth has been lost
  2. Teeth loosen or may need to be extracted
  3. Periodontal Pockets 6-10mm deep

patient education stages of gum disease

BPI Dental use the leading high tech Florida Probe system for diagnosis of gum disease and periodontal pocket depth

Dental research continues to solidify the link between periodontal (gum) disease and your overall health. Although periodontal disease is often difficult to detect in the early stages without a periodontal exam, it can be very easy and painless to treat. If not treated in a timely manner, periodontal disease has been associated with an increased risk of heart disease, stroke, diabetes, and low birth-weight babies.
We are excited to let our patients know that we utilize the Florida Probe® System as an advanced diagnostic tool for the tracking and monitoring of this disease. This system, which utilizes an automated, computerized probe, has proven to be more accurate and consistent than traditional methods of assessing periodontal disease and provides both you and the dental team with advanced information.

Software automatically tracks good and bad changes in your periodontal health over time and creates a printable periodontal chart that visually illustrates these changes to enhance understanding.

 

Florida Probe system also calculates your risk of periodontal infection

Their new Risk Assessment Screening tool calculates your risk of periodontal infection or re-infection based upon your specific risk factors, which include smoking habits, systemic health, oral hygiene, medications you may be taking, genetics, age and other contributing factors. You are assigned a high, medium, or low risk score based on combining these risk factors and your periodontal exam data to date.

You will leave with a clear picture of your gum health and a better understanding of your treatment options. Florida Probe®, helping to protect your beautiful smile for a lifetime!

sample image of periodontal chart

Do you have periodontal disease? The diagnosis?

If left untreated, periodontal disease can lead to bleeding, discomfort, receding gums and tooth loss. More that 50% of Americans over 30 have some gingivitis and more than 33% (35 million) have periodontitis. Periodontal disease affects 3 out of 4 people at some point in life. Dental research had linked periodontal disease to and increase rate of heart disease, stroke, diabetes, respiratory disease and pre-term and low birth weight babies. The Florida Probe has been designed has a high tech instrument used in the war against periodontal disease. Speak with your dentist about routine periodontal probing, maintenance of deep pockets and ways to improve your home care. Remember that early diagnosis is the key to maintaining your oral health and preventing serious systemic problems.

Extracts of this text have been adapted and used under copyright of Florida Probe Corporation. BPI Dental acknowledge and credit the author (s) of the original work which is used and / or appears in parts of this work. Link to source material http://www.floridaprobe.com