Health First

Rebecca_sized.pngAt Torrey Pines Dental Arts, we say, “Health First!” We love healthy, happy smiles! And, if you have any concerns about your smile, please inform us. But, our primary goal is that you are healthy for a lifetime. Recent studies prove the link between periodontal disease and heart attacks, strokes, diabetes, and other mouth-body connections. Millions of people have periodontal (gum) disease, including gingivitis and periodontitis. Periodontal disease is a serious infection that, left untreated, can lead to tooth loss and other more systemic health concerns.

Regular oral exams are excellent preventative tools, since they allow our dentists to detect and treat dental problems (such as periodontal disease, tooth decay, oral cancer, and ill-fitting dental appliances) early on before they turn into bigger problems. Since it is recommended that everyone have an oral exam once every six months, contact Torrey Pines Dental Arts to schedule your next exam. And, to make sure that you keep your teeth and gums healthy, we recommend individually tailored treatment plans.

How do we find and diagnose Periodontal Disease?

When you visit our office, the doctors and the hygienists will talk to you about Periodontal Disease.  We measure the space around every tooth once a year as a part of your dental hygiene visit.  From the measurements we take at that appointment, we will talk to you about the health of your mouth related to the criteria described below.  If you have some symptoms of Periodontal Disease, we will arrange a focused treatment plan to help you restore a healthy condition in your mouth. Registered_Dental_Hygienists_cropped_and_sized.pngOur practice is focused on education and prevention, which allows us to fix tiny problems before they become major, and help educate our patients so that they understand the risks of allowing Periodontal Disease to be left untreated.  our hygienists spend a lot of time with Oral Hygiene Instruction, because you may have a professional cleaning several times a year, but most days it will be you and your brush and the dental floss ... and patients who have better home care regimens tend to have better check-ups.  So if you need a quick 'brush up' on flossing technique, don't hesitate to ask us! Remember we want you to keep your smile healthy and happy for your lifetime!

Types of Gum Disease

Periodontal (gum) disease, including gingivitis and periodontitis, are serious infections that, left untreated, can lead to tooth loss. The word periodontal literally means “around the tooth.” Periodontal disease is a chronic bacterial infection that affects the gums and bone supporting the teeth. Periodontal disease can affect one tooth or many teeth. It begins when the bacteria in plaque (the sticky, colorless film that constantly forms on your teeth) causes the gums to become inflamed.
  • Gingivitis is the mildest form of periodontal disease. It causes the gums to become red, swollen and bleed easily. There is usually little or no discomfort at this stage. Gingivitis is often caused by inadequate oral hygiene. Gingivitis is reversible with professional treatment and good oral home care.

Untreated gingivitis can advance to periodontitis. With time, plaque can spread and grow below the gum line. Toxins produced by the bacteria in plaque irritate the gums. The toxins stimulate a chronic inflammatory response in which the body in essence turns on itself, and the tissues and bone that support the teeth are broken down and destroyed. Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. Often, this destructive process has very mild symptoms. Eventually, teeth can become loose and may have to be removed.

There are many forms of periodontitis. The most common ones include the following:

  • Aggressive periodontitis occurs in patients who are otherwise clinically healthy. Common features include rapid attachment loss and bone destruction and familial aggregation.
  • Chronic periodontitis results in inflammation within the supporting tissues of the teeth, progressive attachment and bone loss. This is the most frequently occurring form of periodontitis and is characterized by pocket formation and/or recession of the gingival. It is prevalent in adults, but can occur at any age. Progression of attachment loss usually occurs slowly, but periods of rapid progression can occur.
  • Periodontitis as a manifestation of systemic diseases often begins at a young age. Systemic conditions such as heart disease, respiratory disease and diabetes are associated with this form of periodontitis.

Periodontal Procedures

Following are some of the procedures that our periodontists use to treat patients diagnosed with a periodontal (gum) disease. The main cause of periodontal disease is bacteria in the form of a sticky, colorless plaque that constantly forms on your teeth; however, many other facts can cause periodontal (gum) disease or influence its progression.

Non-Surgical Treatments

The American Academy of Periodontology (AAP) treatment guidelines stress that periodontal health should be achieved in the least invasive and most cost-effective manner. This is often accomplished through non-surgical periodontal treatment, including scaling and root planning (a careful cleaning of the root surfaces to remove plaque and calculus (tartar) from deep periodontal pockets and to smooth the tooth root to remove bacterial toxins), followed by adjunctive therapy such as local delivery antimicrobials and host modulation, as needed on a case-by-base basis.

Most periodontists would agree that after scaling and root planning, many patients do not require any further active treatment, including surgical therapy. However, the majority of patients will require ongoing maintenance therapy to sustain health. Non-surgical therapy does have its limitations, however, and when it does not achieve periodontal health, surgery may be indicated to restore periodontal anatomy damaged by periodontal diseases and to facilitate oral hygiene practices.

Periodontal Surgery

If you’re diagnosed with periodontal disease, our periodontist may recommend periodontal surgery. Periodontal surgery is necessary when your periodontist determines that the tissue around your teeth is unhealthy and cannot be repaired with non-surgical treatment. Following are the four types of surgical treatments most commonly prescribed:

  • Pocket Reduction Procedures
  • Regenerative Procedures
  • Crown Lengthening
  • Soft Tissue Grafts

The Use of Lasers in Periodontal Therapy

Limited research suggests that the use of lasers as an adjunct to scaling and root planning (SRP), in our office we refer to this procedure as “deep cleaning”, may improve the effectiveness of this procedure. In addition, when the lasers are used properly during periodontal therapy, there can be less bleeding, swelling and discomfort to the patient during surgery.

Gum Disease Links to Heart Disease and Stroke

Heart Disease

Several theories exist to explain the link between periodontal disease and heart disease. One theory is that oral bacteria can affect the heart when they enter the blood stream, attaching to fatty plaques in the coronary arteries (heart blood vessels) and contributing to clot formation. Coronary artery disease is characterized by a thickening of the walls of the coronary arteries due to the buildup of fatty proteins. Blood clots can obstruct normal blood flow, restricting the amount of nutrients and oxygen required for the heart to function properly. This may lead to heart attacks.

Another possibility is that the inflammation caused by periodontal disease increases plaque build up, which may contribute to swelling of the arteries.

Researchers have found that people with periodontal disease are almost twice as likely to suffer from coronary artery disease s those without periodontal disease.

Periodontal disease can also exacerbate existing heart conditions. Patients at risk for infective endocarditis may require antibiotics prior to dental procedures. Our periodontist and cardiologist will be able to determine if your heart condition requires use of antibiotics prior to dental procedures.

Stroke

Additional studies have pointed to a relationship between periodontal disease and stroke. In one study that looked at the causal relationship of oral infection as a risk factor for stroke, people diagnosed with acute cerebrovascular ischemia were found more likely to have an oral infection when compared to those in the control group.