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Gum Disease: Causes and Treatment
Gingivitis: The earliest stage of gum disease is called gingivitis. Gingivitis is an inflammation of the gum tissues. Typically patients with gingivitis will experience some bleeding when brushing and/or flossing. Although the soft tissue supporting the teeth are unhealthy, patients with gingivitis typically have healthy bone support around the roots of the teeth.
Treatment for gingivitis includes a professional cleaning to remove hard deposits that cannot be removed by brushing and flossing alone. Home care is critically important in the reversal of gingivitis. Dr. Miller and his team will work with patients to demonstrate proper brushing and flossing techniques and will recommend and provide various adjuncts to help with home care.
Periodontal disease, sometimes called pyorrhea, can be classified into three stages based on disease advancement, area of the mouth affected, and whether the condition is acute or chronic. Periodontal disease can be localized to small areas or sections of the mouth, or generalized to the entire mouth. Periodontal disease can become acute sometimes causing pain and/or rapid bone loss. Early stage periodontal disease is denoted by all of the previously mentioned signs of gingivitis plus some bone loss. Early stage periodontal disease can typically be treated non-surgically with a procedure called scaling and root planning. Scaling and root planning is a way to remove the hard deposits of bacteria filled calculus and smooth the root surfaces to make it more difficult for new bacteria to adhere. Patients with early periodontal disease should be seen more frequently for cleanings to help disrupt biofilm formation and prevent disease progression. Unfortunately, periodontal disease is a progressive disease. Typically, bone cannot be regenerated to its original position once it is lost. Patients with moderate periodontal disease typically have 25-50% bone loss around teeth. Sometimes patients with moderate periodontitis can be treated with non-surgical scaling and root-planning alone; other times, optimal results cannot be obtained without the adjunct of surgery. A periodontist (gum specialist) is consulted when surgery is required, and care is then coordinated. Patients often want to know how surgery will help. The goals of surgery are not only to remove diseased soft tissue and calculus around the affected teeth, but also to contour the bone and gums around the teeth so that they can easily be cleaned and cared for at home.