Caring for Cleveland's Gums

Periodontal Disease and Its Stages

Gingivitis is characterized by inflammation of the gums, which usually produces bleeding when brushing and flossing.
This is considered to be the first stage of periodontal disease. This is usually the only stage of Periodontal Disease that is fully reversible, as there is no destruction of underlying boney supportive structures. Therefore, treatment intervention at this stage is essential.

Diagnosis

A comprehensive examination is performed with the necessary digital radiographs (x-rays pictures) and a periodontal screening.

Treatment

• Oral hygiene instruction is provided to enable you to control the disease process
• An electric toothbrush may be prescribed and special oral hygiene instructions will be provided.
• A full mouth therapeutic scaling will be performed along with a medicated irrigation under the gum line to expedite the healing process.
• Home fluoride agents may be dispensed to protect your teeth and continue the treatment of your gums at home.
• Approximately four weeks later a second visit with the hygienist will generally be scheduled to reevaluate the conditions and polish your teeth. If the results of this visit are favorable a four-month recall interval may be scheduled to follow up on your progress.

Early Periodontitis

Early periodontitis, which is the progression of uncontrolled gingivitis, is characterized by inflammation of the gums and the beginning stages of bone loss.

The space naturally present between the teeth and gums, the collar around the tooth, begins to deepen from the normal pocket depths of 1-3mm to 4-5mm. This pocket allows for the collection of bacteria far below the gum line which cannot be reached by “normal brushing” and is thus not maintainable by home plaque control alone.

Treatment

Treatment of this disease is performed in multiple appointments.

A procedure of non-surgical periodontal therapy, sometimes referred to as scaling and root planning, is performed involving the removal of the hard and soft deposits from the teeth and smoothing the root surfaces.

The last appointment in a 4 to 6 week period of treatment visits is a re-evaluation appointment and prophylaxis during which the pocket depths are measured again. If there is a marked improvement, the teeth are polished and a fluoride treatment is provided. In the event ample healing has not taken place additional treatment recommendations will be discussed at that visit.

A power assisted toothbrush may be recommended.

A three-month maintenance system is strongly recommended.

Insurance benefits will vary depending upon your particular coverage.

Moderate Periodontitis

Moderate periodontitis is characterized by inflammation of gum tissues (red, swollen, bleeding) and deepening of the periodontal pockets. The structures that support the teeth in the bone are breaking down leading to tooth mobility. The pockets in these areas have deepened beyond 5 millimeters and allow accumulation of bacteria at levels far below the gum line. This is the most advanced stage of periodontal disease that can be treated non-surgically. Home plaque control cannot reach bacteria at this deep level.

Treatment

Treatment of this disease is performed in multiple appointments.

The mouth will be treated in sections at separate appointments. A procedure called scaling and root planning is performed on each diseased area. This involves removal of the hard and soft debris from the teeth and root surfaces and the treating of the bacterial colonies within the sulcus. The pockets are irrigated with a medicated rinse to flush out the residual bacteria and expedite the healing process. Antibiotics may also be placed sub-gingivally. This treatment requires local anesthesia and/or analgesia.

A powered toothbrush and or Water Pic may be recommended for home use.

Re-evaluation, prophylaxis and/or periodontal maintenance is performed after a 4 to 6 week period at which time the pocket depths are measured again. If there is marked improvement, the teeth are polished and a fluoride treatment may be recommended. In the event ample healing has not taken place, additional treatment recommendations will be discussed.

A THREE-MONTH MAINTENANCE SYSTEM IS STRONGLY RECOMMENDED.

Insurance benefits will vary depending upon your particular coverage.

Your periodontal health will be re-evaluated during the course of treatment and if significant infected sites still remain, additional treatment will be discussed. At the end of the program we will determine whether further treatment is necessary. Once the program is completed, it is absolutely necessary to maintain regular continuing care and health screening appointments to avoid repeated flare-ups.

If you notice any of the signs of Periodontal Disease:

• Bad breath that won't go away
• Red or swollen gums
• Tender or bleeding gums
• Painful chewing
• Loose teeth
• Sensitive teeth
• Receding Gums

Do Not Panic ! We can help you !

If you wish more information regarding Periodontal Disease or wish to find out how our highly trained staff might assist you please call us to schedule an evaluation and consultation. 440-461-8200. You may also email us though the “contact us” page on this website.