What is Periodontal disease? How did I get it? Why do I need a deep cleaning?

Human tooth cross-section (3d model)
Human tooth cross-section (3d model)

Periodontal disease is an irreversible disease that can be treated and prevented and stopped from getting worst. It’s the destruction of tissue surrounding your teeth, that includes your bone and gum.

Now you may ask, how did this happen?

Usually Periodontal disease is the result of not having regular dental cleanings done frequently by a professional and not having adequate and effective oral hygiene at home. In some cases, genetics can play a role too. Its been shown that uncontrolled diabetes, and some other systemic conditions can promote Periodontal disease and vice-versa.

After eating or drinking, a biofilm of proteins adhere to the teeth surface, this later adds bacteria, creating a by-product called plaque. Plaque is very sticky and it’s a medium for bacteria to keep growing. Plaque can be removed with regular brushing and flossing at home, but if this is done inefficiently, it hardens into calculus. Once calculus has formed, it irritates the gums and some bleeding can be noticed during regular hygiene routine. The bacteria within the calculus and plaque will continue to grow and make its way under the gums. Now this is when a deep cleaning is needed. Calculus starts extending and forming under the gum, the bacteria carried within calculus will trigger an inmune process that will destroy the bone and the tissue, creating a gap between the teeth and the gum. As long as the calculus remains under the gum, bone will continue to disappear, therefore, your teeth will loose attachment and support. In the worst case scenario, teeth could start becoming loose and moving. When the bone and tissue starts breaking down due to calculus accumulation, there is no way back. It will not regrow to its original healthy condition.

Periodontal disease can be very aggressive and progress rapidly. Please note that regular dental cleanings do not remove calculus under the gum, you can have many dental cleanings, also referred to as “dental prophylaxis”, and your teeth will look clean and beautiful, but the problem is under the gums.   So a right approach and treatment plan is key.

How is periodontal disease treated?

Usually Deep cleanings are done by quadrant and it might take up to two visits to the clinic. Local anesthesia is used to numb the areas treated, then ultrasonic instrumentation and manual scaling is done to remove calculus, tooth by tooth in all surfaces. Once done, a localized antibiotic is applied to each tooth to kill the bacteria that is found on the tissue and the gap between the teeth and gum. This antibiotic will also diminish the gap where the calculus was found under the gum, making the area easier to keep clean. A follow up appointment of 6 weeks is recommended to assure a stable health status has been achieved.

Following a deep cleaning, patients need to have periodontal maintenance appointments every three to four months. This time, a regular dental cleaning will take place, but the bone and tissue will be assessed to keep track of the periodontal status. If dental cleanings are not done as often as recommended by your dental hygienist, most likely a deep cleaning  or more extensive surgical procedures will be needed again in the future. In some cases, depending on patient’s compliance following good oral health care at home, antibiotic might need to be re applied after a year to prevent the gap between the teeth and the gum from getting bigger and allowing calculus to form.

Research shows that bacteria within calculus will create tissue damage within 3 months of being present. Periodontal disease is also link to affect some systemic disease such as diabetes. Follow your dental professional recommendations and take care of your teeth to take care of your overall health.

If you have any  questions, do not wait…and contact us. We are here to help.

HQ Dontics Dental Centre. Brickell, Miami. USA

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