What are the different categories of oral health?
What is the difference between each category?
A healthy periodontium (healthy gums) is one where the gums are pink and absent of inflammation (no bleeding gums) and where there is no supporting bone loss.
Gingivitis is inflammation of the gingiva (gums). The signs are similar to healthy gums, except there is some bleeding of the gums. The supporting structures are not affected.
Periodontitis is when the disease progresses from the gums to the supporting structures (bone, periodontal ligament). Bone loss is noted as well as gum recession. If periodontitis progresses quickly or chronically for a long time, tooth loss may occur due to the destruction of bone.
Although gingivitis does not always progress to periodontitis, if left untreated it can advance to periodontitis.
What causes Gingivitis/Periodontitis?
Secondary Causes/Risk Factors
- Heredity – Periodontitis runs in families
- Poor Oral Hygiene
- Systemic Conditions – Diabetes, Leukemia, HIV
- Smoking and Smokeless Tobacco Use
- Older age
- Medications – Decrease protective salivary flow
- Hormonal changes (pregnancy, puberty, menopause)
- Poor nutrition
- Substance abuse
- Improperly fitted dental fillings/crowns
- Tooth position when biting
Are there any complications associated with gingivitis/periodontitis?
There is some research that supports relationships between periodontitis and the following conditions:
- Cardiovascular Disease
- Premature or Low Birth Weight Babies
- Poorly-controlled Diabetes
- Rheumatoid Arthritis
What can be done to prevent gingivitis/periodontitis?
The main method of prevention is a good oral hygiene routine. This routine includes brushing at least twice per day and flossing once per day. An American Dental Association (ADA) recommended mouthwash (i.e. Listerine, Crest Pro-Health) is helpful with gingivitis as well.
In addition to good home oral hygiene, it is recommended to visit your dentist every 6 months for a professional cleaning and checkup.
What options are available if I am diagnosed with periodontitis?
In the initial exam, Dr. Holland will look at your medical/dental history, radiographs, and take diagnostic measurements to assess the cause of the problem. Many times it is multifactorial (having more than one cause), and we will work with you and your physician(s), if necessary, to control the causes.
Nonsurgical therapy, known as Scaling and Root Planing (SRP) or a “deep cleaning.” This procedure is used to clean below the gums to remove bacteria and tartar from the tooth as well as the roots. In some cases this procedure will restore the gums to health.
After SRP is completed another evaluation will be complete 4-6 wks later to assess if and how much improvement has taken place.
If there is still deep pocketing around some of the teeth, a surgical procedure may be recommended. There are 2 types of surgical procedures to correct the periodontal disease: Regenerative therapy or Resective therapy.
Dr. Holland will assess the predictability of regenerating some or all of the supporting tooth structure. If found to be predictable, either a bone graft, guided tissue regeneration, biologic growth factor, or combination of the above treatments will be used to regenerate your supporting tooth structure. Essentially, we are returning the underlying bone and supporting structures to the current tissue levels.
If regeneration is unpredictable, Dr. Holland may recommend resective therapy, which includes osseous surgery and/or an apically positioned flap. In these cases we reduce the gum pockets by taking the tissues down to the existing support structures. The outcome of this procedure is to maintain the levels of the support structures and prevent further progression of periodontal disease.
What can I do to ensure that the periodontitis does not return?
In all cases a stringent periodontal maintenance protocol is crucial to prevent periodontal disease from returning. This protocol usually includes cleanings and checkups every 3 months to keep the teeth and gums healthy. It also is imperative that a good home hygiene routine be implemented and maintained. Another component is reducing any risk factors that can contribute to periodontal disease.
In rare cases even if a strict regimen is followed, periodontal disease may return. At that time we would sharpen the focus on risk factors, systemic disease(s), and the immune response.
An important realization of periodontal disease is that it occurs because of a person’s susceptibility to the disease. Whether it is hygiene, the immune response, and/or risk factors that contribute to it, the disease must be kept in check to maintain healthy gums and prevent tooth loss. Once diagnosed, a person must continuously follow-up with maintenances and check-ups in order to have the best chance for oral health.
Dr. Holland is looking forward to beginning a relationship with you and is committed to providing a place for education, motivation, and first-class care for your needs.