Periodontics in Portland, Oregon

Gum Disease

Periodontics
Periodontal or Gum disease involves inflammation and infection that destroys the tissues that support the teeth, including the gums, the periodontal ligaments, and the tooth sockets.

Symptoms

  • Bleeding gums (blood on toothbrush even with gentle brushing of the teeth)
  • Bright red or red-purple appearance to gums
  • Gums that are tender when touched, but otherwise painless
  • Mouth sores
  • Swollen gums
  • Shiny appearance to gums

Signs and tests

Our experienced Portland Dentist will examine your mouth and teeth and look for soft, swollen, red-purple gums. Deposits of plaque and tartar may be seen at the base of the teeth. The gums are usually painless or mildly tender.

No further testing is usually necessary, although dental x-rays and dental bone measurements may be done to determine whether the inflammation has spread to the supporting structures of the teeth.

Treatment

The goal is to reduce inflammation. The teeth are cleaned thoroughly by the dentist or dental hygienist. This may involve various instruments or devices to loosen and remove deposits from the teeth.

Careful oral hygiene is necessary after professional tooth cleaning. Our dentist or hygienist will show you how to brush and floss. Professional tooth cleaning in addition to brushing and flossing may be recommended twice per year or more frequently for severe cases. Antibacterial mouth rinses or other aids may be recommended in addition to frequent, careful, tooth brushing and flossing.

Repair of misaligned teeth or replacement of dental and orthodontic appliances may be recommended. Any other related illnesses or conditions should be treated.

Prevention

Good oral hygiene is the best prevention against gum disease because it removes the plaque that causes the disorder. The teeth should be brushed at least twice daily and flossed gently at least once per day. For people who are prone to gum disease, brushing and flossing may be recommended after every meal and at bedtime. Consult the dentist or dental hygienist for instructions on proper brushing and flossing techniques.

Special appliances or tools may be recommended by the dentist for use by people who are particularly prone to plaque deposits. The use of supplements does not replace thorough brushing and flossing. Appliances and tools may include special toothpicks, toothbrushes, water irrigation, or other devices.

Antiplaque or antitartar toothpastes or mouth rinses may be recommended by the dentist or dental hygienist.
Regular professional tooth cleaning is important to remove plaque that may develop even with careful brushing and flossing. Many dentists recommend having the teeth professionally cleaned at least every 6 months.

Soft Tissue Grafting

Grafting
Your gums may have receded for a variety of reasons, including aggressive tooth brushing or periodontal disease. You may not be in control of what caused the recession, but prior to treatment your periodontist can help you identify the factors contributing to the problem. Once these contributing factors are controlled, a soft tissue graft procedure will repair the defect and help to prevent additional recession and bone loss.

Soft tissue grafts can be used to cover roots or develop gum tissue where absent due to excessive gingival recession. During this procedure, your periodontist takes gum tissue from your palate or another donor source to cover the exposed root. This can be done for one tooth or several teeth to even your gum line and reduce sensitivity.

Root Planing

The various treatment programs offered in our practice are tailored to the level of periodontal (gum) disease as found in your mouth. Treatment programs include scaling which uses ultrasonic and hand instruments to remove calculus, plaque, and bacteria; curettage which scrapes any necrotic (dead) tissue and cleans the area or pocket, and root planing which smoothes and contours the root surface to remove the debris and cementum found in the periodontal pocket. Medications or a special mouth rinse to help control the growth of bacteria may be part of treatment. A topical or local anesthetic may be administered depending on the sensitivity of the area to be treated. The success of the treatment depends in part on your efforts to brush and floss daily (or as directed), receive regular cleanings as diagnosed by your doctor, follow a healthy diet, avoid tobacco products, and follow proper home care taught to you by this office.

Benefits: Regular, professional periodontal disease therapy will, (a) create a clean environment in which your gums can heal; (b) reduce the chances of further irritation and infection; (c) make it easier for you to keep your teeth clean; and (d) decrease the likelihood of losing teeth due to gum disease.

Risks: Your gums may bleed and swell and you may experience moderate discomfort for several hours after the anesthesia wears off. There may be slight discomfort for a few days following the procedure, which may be treated with an over the counter pain medication. You should notify the office if the condition persists beyond a few days. Rarely, treatment may cause an infection of the treated tissue in your mouth, which would then be treated with antibiotics. These methods alone may not completely reverse the effects of gum disease or prevent further problems.

Consequences if treatment is not completed as diagnosed: If no treatment were administered, or ongoing treatment were interrupted or discontinued, your periodontal condition would continue to advance and possibly worsen. This could lead to further inflammation and infection of gum tissues, tooth decay above and below the gum line, deterioration of bone surrounding the teeth and eventually loss of the teeth.

Alternatives to non-surgical periodontal therapy: Surgical methods may also be prescribed to help control your gum disease, but scaling and root planing, followed with appropriate evaluation, is a less invasive procedure and thus preferred as initial therapy.