Periodontal gum disease involves tissue-destroying bacteria that grow in the human mouth. These bacteria are usually removed by brushing, but when dental health is neglected, the bacteria multiply. If left untreated, the gums recede, and the teeth are left without the necessary support. Dr. Kenneth Kornman, editor of the "Journal of Periodontology," reported at the American Dental Association Annual Session in 2008 that periodontal problems are linked to other diseases, including diabetes, heart disease and Alzheimer’s disease.
Early Treatments
Early symptoms of gum disease include gingivitis (a swelling of the gums) and tartar and plaque buildup. The swollen gums create a pocket around the tooth that allows a staging point for bacteria from the plaque to enter the lower layers of gums and erode support for the tooth. Dentists and dental hygienists use special tools to reach underneath the gums for scaling (also known as root planing) the plaque from the pockets and from the tooth. This process removes the bacteria and the risk of further gum damage.
Least Invasive Treatment
For patients who have put off dental cleanings, one office visit for scaling or planing may not be sufficient to remove the plaque and bacteria buildup. The patient will be required to have additional scaling done over several office visits. The American Academy of Periodontology (AAP) reports that new laser scaling and root planing has been shown to improve the efficiency of the procedures, so fewer visits may be required. The AAP also cites studies reporting that the pain and bleeding typically associated with the procedure are reduced with the laser treatments.
Minor Surgery
When gum damage has reached a level at which the tissue is reduced around the tooth and the tooth root is exposed, the minor surgery options include soft tissue grafts, ridge augmentation and regenerative tissue-stimulating protein insertion. Soft tissue grafts remove gum material from other sections of the mouth and replace tissue lost to the disease. Gum ridges are thicker forms of tissue that are located closer to the tooth root. Surgery is also used to replace the ridge, a base for the soft tissue. This replacement slows the advance of the disease and provides a new base for the soft gum material. Experimental oral surgery is an option that inserts proteins in an attempt to regrow the tissue lost due to the disease.
Major Surgery
When the gums have receded due to periodontal disease, the jawbone is exposed to the bacteria. The only option at this point is regenerative bone grafts to replace the jaw bone. This major surgery is done as a last-ditch effort to restore the jaw.
Implants
When the gum tissue has receded to the root level, the teeth become loose and either fall out or require removal. Oral surgery is an option that offers replacement of the tooth with a dental implant, provided the jawbone has not been damaged.
