Periodontal treatment focuses on the treatment of inflammatory disease that destroys the gums and other supporting structures around the teeth. Untreated gum disease can eventually lead to tooth loss and other health problems.
Gingivitis is the mildest and most common form of periodontal disease. It causes the gums to become red, swollen, and bleed easily. There is usually little or no discomfort at this stage. Gingivitis is caused by inadequate oral hygiene, which allows plaque to accumulate around the teeth. It is reversible with professional treatment and good oral home care.
Factors that may contribute to gingivitis include: diabetes, smoking, aging, genetic predisposition, systemic diseases and conditions, stress, inadequate nutrition, puberty, hormonal fluctuations, pregnancy, substance abuse, HIV infection and certain medication use.
Untreated gingivitis can advance to periodontitis. Over time, plaque that is not removed from the teeth can spread, harden and build up below the gum line. Toxins produced by the bacteria in plaque irritate the gums, causing a chronic inflammatory response in which the body in essence turns on itself. The tissues and bone that support the teeth are broken down and destroyed. Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected.
As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. Often, this destructive process has very mild symptoms. Eventually, teeth can become loose and may fall out or have to be removed.
Treatment of periodontal or gum disease is most often accomplished through non-surgical procedures. This treatment may include a thorough dental cleaning, scaling and root planing, and home care instruction. Scaling and root planing is a careful cleaning of the root surfaces to remove plaque and tartar from deep gum pockets and to smooth the root to remove bacterial toxins.
Most dentists would agree that after scaling and root planing, many patients do not require any further treatment. However, the majority of patients will require ongoing maintenance therapy to sustain health. Non-surgical periodontal treatment does have its limitations. When it does not achieve periodontal health, referral to a gum specialist for additional treatment may be needed.