Non-Surgical Periodontal Treatment

Periodontal disease

Occurs when bacteria builds up on your teeth under the gums, causing your gums to become red and swollen. This condition, known as inflammation, if left untreated, eventually results in damage to the ligaments and bone which hold your teeth in place, forming pockets around your teeth. As the disease progresses and these pockets become deeper, your teeth can become loose and fall out. Dentists and registered dental hygienists can tell how severe a patient’s periodontitis is by measuring pocket depth and reviewing patient x-rays Arestin, which contains a potent but low-dose antibiotic (minocycline 1 mg) is administered locally, directly into the infected pockets between your teeth. A trained dental professional can administer Arestin after scaling and root planing, a common procedure used to treat periodontal disease. When used together with scaling and root planing, Arestin significantly reduces the depth of infected pockets and helps prevent disease progression. A combined therapy of Arestin plus scaling and root planing is more effective at fighting periodontal disease than scaling and root planing alone. Arestin has been shown to be particularly effective in the more difficult to treat patients, i.e. those that are at a higher periodontal risk such as smokers or people who have cardiovascular disease. Arestin was studied in more than 920 patients with adult periodontitis at 22 universities and dental schools across the country. These large clinical trials allowed for the collection of extensive data establishing the safety and efficacy of Arestin. Minimal side effects were reported and those that were reported were similar to placebo. In these trials Arestin did not alter taste, stain teeth, or cause upset stomach.

Periodontics Presentation

To provide you with a better understanding of periodontics, we have provided the following multimedia presentation. Many common questions pertaining to periodontics are discussed.

Periodontics Presentation

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Risks

Family History

Scientists have discovered that there is a genetic link to periodontal disease. If members of your family have had this disease, you should discuss it with your general dentist or periodontist.

Tobacco Use (smoking or chewing)

The chemicals in cigarette smoke have been shown to cause harm to the “helpful” bacteria that keep your gums strong. Cigarettes also lower HDL or your “good cholesterol,” which can lead to artery damage and decreased flow of nutrients to your gums. If you are a smoker, it’s probably a good idea to try and quit.

Diabetes

Diabetics are at higher risk for developing infections, including periodontal disease. These infections can impair the body’s ability to process and/or utilize insulin, which may cause your diabetes to be more difficult to control. Diabetes may also have an impact on the infections that cause gum disease.

Transmission

Research has shown that the bacteria that cause periodontal disease can be transmitted through intimate contact such as kissing, or sharing a toothbrush. If you have had a relationship with someone who has symptoms of gum disease, you should bring this to your dentist’s attention.

Stress

As you probably already know, stress is linked to many serious health conditions. What you may not know is that stress is also a risk factor for periodontal disease. Research demonstrates that stress can make it more difficult for the body to fight off infection, including periodontal diseases.

Medications

Oral contraceptives, antidepressants, and certain heart medicines can affect your oral health. Just as you notify your pharmacist and other health care providers about all medicines you are taking and any changes in your overall health, you should also inform your dental care provider.

Clenching or Grinding Your Teeth

Has anyone ever told you that you grind your teeth at night? Clenching or grinding your teeth can put excess force on the supporting periodontal tissues of the teeth and can speed up the rate at which they are destroyed.

Poor Nutrition

As you may already know, a diet low in important nutrients can compromise the body’s immune system and make it harder for the body to fight off infection. Because periodontal disease is a serious infection, poor nutrition can worsen the condition of your gums. If you find it difficult to maintain a well-balanced diet, a good nutritional supplement should be considered.

Cardiovascular Disease

Your teeth and gums are supplied with nutrients by your vascular system. Recent studies have shown periodontal disease may be both a cause and a symptom of cardiovascular disease.

Signs and Symptoms of Periodontal Disease

Periodontal disease often approaches silently…

Periodontal disease can begin to affect the health of your teeth long before you even notice symptoms.

Here are some signs to look for…

Causes

The body responds

Bacteria are certainly a cause of gum disease, and it is important to remove bacteria to improve gum health. Bacteria, however, are not the direct cause of gum and dental bone tissue damage and eventual tooth loss. Gum and bone tissue damage are actually caused by the body’s own defense against bacterial infection. How could this be? Well, as a natural infection-fighting mechanism, your body sends white blood cells to the infection site. One of the functions of the white blood cells is to release enzymes to facilitate the passage into the gum and bone tissue. Once there, the white blood cells will destroy the bacteria. In periodontitis, however, there is an overproduction of these enzymes by these cells — an overproduction that results in a greater destruction of the gum and bone tissue than the body can repair or replace. Therefore, treatment of periodontitis involves a two-pronged approach: reduce the bacteria in the tooth pockets (the space between the gum and tooth) with a deep cleaning (known as scaling and root planing) of the teeth, and reduce the activity of the enzymes released in the gum tissue with Periostat®. Extensive studies have shown that when used with scaling and root planing, Periostat® significantly improved the results of this deep cleaning procedure and helped to stop progression of the disease better than scaling and root planing alone.

Can my diet affect my teeth?

A healthy diet helps your body stay in top physical condition. If you do not eat well-balanced meals every day, you may be missing important nutrients that your teeth and gums need to fight invading bacteria. Talk to your dentist or physician about how you can improve your diet for peak physical condition.

Should I go to the dentist?

If you are concerned that any of these factors could use improvement, call your general dentist or periodontist today for a checkup. Your health care provider will be better able to help you if you come to his or her office prepared with a list of things to discuss.

Periodontal Treatments for Periodontal Disease

Today there are several ways in which dentists and periodontists are helping patients overcome periodontal disease. Old and new therapies used together often help dental professionals address the various factors that contribute to periodontitis.

Gum Irrigation and Ultrasonic Therapy

  • Gum Irrigation: Dentists often use a strong stream of water to help wash plaque and bacteria off of teeth. This is done by directing the water so that it penetrates below the gum line. As the body responds to this pressure, the bond between tooth and gum is made more solid.
  • Ultrasonic Therapy: This procedure uses an instrument that directs ultrasonic vibrations through the gums and teeth. Similar to gum irrigation, this procedure strengthens tooth and gum stability and encourages your own immune cells to destroy harmful bacteria.

Scaling and Root Planing (SRP)

Scaling and root planing is a type of professional tooth cleaning. It removes plaque and tartar from the teeth and smoothes the root surfaces.

Why is Periostat® (doxycycline hyclate) prescribed for periodontitis?

Most treatments for adult periodontitis focus primarily on reducing the number of bacteria on the surface of your teeth. For example, your dental professional is likely to perform SRP (scaling and root planing) to help reduce surface bacteria. This is an important part of your treatment because periodontal disease begins with a bacterial infection on the tooth surface, and by reducing the number of bacteria, the symptoms of periodontitis (such as bleeding) can be reduced.

Research has shown that it is also important to suppress your body’s overproduction of gum- and tissue-destroying enzymes. This is where Periostat® comes in. It is the first medication that works by reducing the activity of the enzymes that destroy tooth and gum tissue.

Periostat® is available by prescription only from your dentist or periodontist and should be taken in conjunction with SRP delivered by your dental professional to reduce pocket depths and improve clinical attachment levels.

Don’t take Periostat® if you are pregnant or breast-feeding, as it may cause harm to your unborn child or infant. Don’t take Periostat® if you are allergic to tetracycline antibiotics. In clinical trials, adverse reactions to Periostat® were similar to reactions from taking a placebo.

Periostat® Dosage and Duration of Treatment

Periostat® is available as a tablet to be taken twice daily, about an hour before or two hours after meals. Periostat® should be taken with plenty of fluids. If you forget to take a dose, just take the normal dose of 1 tablet at the next scheduled time. Do not double up to make up for the missed tablet.

The duration of Periostat® therapy is different for each person and depends on the severity of your gum disease and the time needed for your body‘s healing process to take place. During your checkups, your dentist or periodontist will determine if you should stop therapy or continue to take Periostat® based on your response to treatment and the level of improvement of your gum disease.
In clinical studies, Periostat® was shown to be safe when taken for as long as 12 months. Typically, the drug is taken for periods of no less than 3 months. Your dentist or periodontist will tell you how long you should take Periostat®.

Periostat® is a unique dosage of a drug called doxycycline. The dosage of Periostat® differs from that of doxycycline used to treat infections. Exceeding the recommended dosage may result in an increased incidence of side effects, including development of resistant microorganisms.

Plan for Better Oral Health

At all times, follow instructions given to you by your dentist or periodontist. Make sure you keep appointments for treatments and checkups. Between visits, follow good dental hygiene as recommended by your dental professional. If Periostat® has been prescribed for you, make sure you take it as directed by your dentist or periodontist.

Antibacterial Therapy

It is well established that many cases of periodontal disease are caused by bacteria. That’s why antibiotic therapy is widely used today to help eliminate these harmful bacteria. This treatment includes oral medication, locally applied antibiotics, such as ATRIDOX® (doxycycline hyclate) 10%, and rinses that can help fight bacterial infection.

Gum Surgery

When periodontitis progresses deep enough in the gum and tooth, a specialist called a periodontal surgeon sometimes needs to perform surgery to repair the gum. He or she uses various surgical techniques to repair the damage. Surgery may be done on soft tissue or bone to help the healing process.

What Should I Ask My Dentist?

On your next visit to the dentist, let your dentist know that you care about the condition of your gums as well as your teeth. If it helps, write down the questions you want to ask. Remember, a healthy smile begins with healthy conversation.

Ask the following questions:

  1. Do my gums look healthy?
  2. Did my gums bleed during this exam?
  3. Have any spaces formed between my gums and my teeth?
  4. Are any of my permanent teeth loose or separating?
  5. Have there been any changes in the way my teeth fit when I bite?
  6. What steps can I take to achieve healthy gums?
  7. Should I schedule an appointment with a periodontist?