Online Dental Education Library
Our team of dental specialists and staff strive to improve the overall health of our patients by focusing on preventing, diagnosing and treating conditions associated with your teeth and gums. Please use our dental library to learn more about dental problems and treatments available. If you have questions or need to schedule an appointment, contact us.
Periodontal Disease
When to See a Periodontist
Periodontal treatment may be sought in several ways. Your general dentist or a hygienist may recommend a consultation with a periodontist if they find signs of periodontal disease through the course of a checkup or other dental care appointment. You may also decide to see a periodontist on your own, as a referral is not necessary to be seen at our office.
In fact, if you experience any of these symptoms, we encourage you to schedule an appointment at our office without delay:
- Unexplained bleeding while performing regular cleaning or consuming food is the most common sign of a periodontal infection.
- Ongoing halitosis (bad breath), which continues despite rigorous oral cleaning, can point to periodontitis, gingivitis or the beginnings of a gum infection.
- Longer-looking and loose-feeling teeth can indicate recession of the gums and/or bone loss as a result of periodontal disease.
Patients with heart disease, diabetes, osteopenia or osteoporosis are often diagnosed with correlating periodontal infections. The bacterial infection can spread through the blood stream, affecting other areas of the body.
- Bleeding while brushing or eating normal foods
- Bad breath
- Loose teeth and gum recession
- Related health concerns
What is Periodontal Disease?
Periodontal disease is a chronic infection of the periodontal or gum tissue. This infection is caused by the presence of a bacterial film, which is called dental plaque, that forms on the teeth surfaces. Bacteria that found in dental plaque produce toxins which irritate the gums. They may cause them to turn red, swell and bleed easily. If this irritation is prolonged, the gums separate from the teeth, causing pockets (spaces) to form. Plaque can also harden into a rough, porous substance known as calculus (or tartar). This can occur both above and below the gum line.
As periodontal diseases progress, the supporting gum tissue and bone that holds teeth in place deteriorate. If left untreated, this leads to tooth loss. With periodontal disease, bleeding, redness and swelling do not have to be present. Further, pain is usually not associated with periodontal disease. This disease damages the teeth, gum and jawbone of more than 80% of Americans by age 45. Each case is looked at individually, because in addition to plaque there are co-factors such as genetics, smoking, and overall health, which contribute to disease severity. Once periodontal disease is detected, our goal as therapists is to provide information and treatment necessary to control/ or arrest the active infection, and help keep the disease in an inactive or controlled state.
However, don’t be fooled!
With periodontal disease, bleeding, redness and swelling do not have to be present. The periodontal disease symptoms of inflammation may only be evident with sub gingival probing. Further, pain is usually not associated with periodontal disease.
In many cases, problems with the bite or the alignment of the teeth can be corrected using today's advanced methods of dental and orthodontic treatment. Sometimes, however, skeletal and dental irregularities aren't so easy to remedy, even with the most up-to-date non-surgical techniques. That's when corrective jaw surgery (also called orthognathic surgery) may be recommended.
While it may sound like a complex and demanding treatment, jaw surgery isn't always so serious. It's often performed as a routine in-office procedure — for example, to extract impacted wisdom teeth (molars that don't fully protrude through the gums), or to place dental implants in the jaw. However, it can also be used to remedy severe orthodontic problems involving the relationship between the teeth and jaws, including the correction of underbites (the most frequent surgical correction) and congenital abnormalities (birth defects) related to jaw development. It can even help alleviate sleep apnea, a potentially life-threatening condition.
Who Can Benefit From Jaw (Orthognathic) Surgery
People who have problems related to the jaws, tooth alignment and facial asymmetries, which create difficulties chewing, talking, sleeping, or carrying on routine activities, may benefit from having orthognathic (jaw) surgery. These procedures can also be used to correct aesthetic issues, such as a protruding jaw, a congenital defect, or an unbalanced facial appearance.
After a thorough examination, it can be determined if you're a candidate for orthognathic surgery. In general, if orthodontic treatment can solve the problem, that's where you will start. Yet, while orthodontics can successfully align the teeth, it's sometimes the jaws themselves that need to be brought into line. In most cases, orthodontic appliances, such as braces and retainers, will be used before and after the surgical phase of treatment, to ensure that you end up with an effective — and aesthetically pleasing — result.
Conditions that can be successfully treated with corrective orthognathic surgery include the following:
- Open bite, protruding jaw or receding chin
- Congenital defects such as a cleft palate
- Malocclusions (bite problems) resulting from underbites or severe overbites
- Obstructive Sleep Apnea, when more conservative methods fail
- Difficulty swallowing, chewing, or biting food
- Chronic jaw or jaw joint (TMJ) pain and headache
- Unbalanced facial appearance from the front or side
- Inability to make the lips meet without straining
- Chronic mouth breathing and dry mouth
- Facial trauma
The Surgical Procedure
While every patient's needs are different, it's possible to outline some typical steps in the process. The first (and perhaps most important) component is consultation and planning among members of the dental team, including the restorative or general dentist, the orthodontist, and the oral surgeon. Your overall plan may involve orthodontic treatments along with surgical procedures. Using diagnostic images, 3-D models and advanced software, a step-by-step plan will be developed for the entire process. It's even possible in many cases to show you a picture of what you'll look like when your treatment is finished.
The surgery itself may occur in a hospital or an office setting, with the type of anesthesia that's most appropriate for the procedure, and for your comfort. Because the actual surgery is generally performed inside the mouth, it often leaves no visible traces. After the procedure, minor pain and swelling can be controlled by over-the-counter or prescription pain medication. A soft or liquid diet may be recommended for a period of time following the procedure.
Following surgery, your condition will be closely monitored — as will your progress through each phase of the treatment plan. When it's complete, you can enjoy the benefits of improved functionality and an enhanced appearance.
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