Periondontal disease is caused by some types of bacteria that dwell in plaque and tartar. These bacteria produce acid and toxins. These toxins and the acidic environment created by the bacteria eventually start causing bone loss and ligament support loss of the teeth. Also, the inflammation caused by the immune system to fight off the infection is an acidic environment so that also eventually contributes to bone loss. If not taken care of, the infection keeps spreading and can start causing tooth mobility and eventually tooth loss.
Some of the signs that can indicate someone has periodontal disease are the following:
– Gums that bleed while brushing and flossing
– Red, puffy gums, sometimes sensitive to touch
– Gums pulling away from the teeth (receding gumline)
– Generalized gum pain
– Teeth start looking longer
– Tooth mobility
– Tooth shifting positions
– Halitosis (bad breath)
Scaling and root planing is a term used for a type of gum treatment done to prevent further spread of periodontal disease. This form of gum treatment removes all of the infection above and below the gumline using special types of instruments. These instruments can easily access spaces between the tooth and gum to remove plaque and tartar which harbor infection causing bacteria.
Scaling and root planing removes all the infection, can reduce the pocket depths (space between gum and tooth: the shallower the pocket, the healthier the pocket), eliminate inflammation, prevent further bone loss and can help in the regeneration of the attachment between the teeth and gums.
Not only does scaling and root planning eliminate infection in the mouth but it helps prevent the spread of the infection throughout the body. Bacteria found in the mouth travel in the bloodstream throughout the body. People with periodontal disease have a higher risk of acquiring diabetes, strokes, heart attacks, preterm babies and rheumatoid arthritis, among other diseases.
The patient comes in for treatment for one side of the mouth, then another visit to treat the other side of the mouth. Then there’s is a subsequent visit in 4-6 weeks to re-evaluate the health of the gums where pocket depths are measured again and compared the pocket depths measured before treatment started. This will give us a good indication how much tissue has been regenerated and if there are still some areas of the mouth that need to be addressed. In some cases, antibiotic treatment is suggested to areas that might not have responded to the treatment as expected.
Once the treatment is finished the patient goes on a 3 month recall (cleaning and exam) schedule to closely monitor the oral health of the patient, his or her hygiene and if there are signs of periodontal disease creeping back under the gums.
If the patient does not improve oral hygiene habits, the infection usually comes back within a year to 2 years at which point the patient will need another scaling and root planing treatment. Therefore, daily, diligent oral hygiene habits are required for a lifetime.