Complete Periodontal Services

In this modern era, the most likely cause of tooth loss is periodontal disease. The preventive benefits of fluoride, space-age restorative materials and advances in endodontic therapy are helping millions of Americans retain teeth that might have been lost in earlier times.

Whereas, the comparatively “simple" problem of restoring teeth has become routine and predictable, treatment for the problems of gum inflammation and bone loss have not met with a similar degree of success. Granted, great strides have been made in periodontal therapy and the number of treatment alternatives has grown in both effectiveness and success. There still remains one fundamental problem that affects us all at varying degrees – infection of the tooth supporting tissues by perio pathogens. Everybody possesses some amount of disease causing bacteria. However, we all differ as to how our immune system suppresses or is overcome by these organisms. Furthermore, and perhaps more importantly, individuals vary greatly in how motivated and effective they are in controlling the root cause of disease (bacteria) via routine home care and professional intervention.

My personal observation, over 30 years of practice, is that the only real "cure" for periodontal disease is prevention – vigorous intervention at the earliest sign and symptoms of the problem. With this in mind, the practical treatment questions become, "How early, and how aggressive?" The back end of this issue is, "Once active therapy has been accomplished, how do you maintain the result?" We have all met people, or may even be one, where a series of progressive periodontal treatments, culminating in surgery, end up being repeated over the years. The truth is, periodontal disease has no "cure," but like other chronic diseases, it can be managed with varying degrees of success.

What are the techniques and goals of periodontal therapy?

As you may have read, periodontitis is a disease of bacteria-mediated inflammation resulting in the loss of the bone that supports the teeth. This irreversible bone loss results in "periodontal pockets" – areas around the tooth that stay chronically infected since they cannot be adequately debrided on a daily basis by routine brushing and flossing. The goal of all periodontal therapy is to reduce and, hopefully, eliminate all pathological pocketing, thus restoring the patient's ability for self-care.

The usual start of all periodontal therapy involves a procedure known as deep scaling and root planning. Typically this is accomplished under simple local anesthetic and differs from a routine cleaning in that: a routine cleaning, or "adult prophylaxis," is done on healthy tissue, and the purpose of scaling and root planning is to instrument as deeply into the pocket to remove bacteria, calculus (calcified bacteria) and bacterial-infected root structure as possible. The soft tissue management accomplished by scaling and root planning is both relatively painless and very effective. But this strategy does have some shortcomings:

  • First of all, the success of pocket reduction is directly related to the degree of pocketing being addressed. Deep pockets with irregular anatomy are more resistant to such management.
  • Secondly, scaling and root planning cannot eliminate or reduce the infection of the adjacent gingiva.

At Pleasantville Dental Associates, we deal with these shortcomings with both high-tech and low-tech solutions.

Addressing our second concern first, our high-tech solution comes right from Star Wars... We've got lasers! Over the past decade, we have routinely used the Nd-YAG laser to supplement and improve our scaling results. This wavelength of laser is thought to be particularly effective in disinfecting the gingival tissue which surrounds the affected teeth. But not only does it help to reduce the bacterial count in the surrounding tissue, but it also helps to control bleeding and improve visibility during the procedure. This is a win-win for doctor and patient alike.

But what if this is an advanced case?

Perio Protect® can tilt the equation in the patient's favor. This management strategy is painless, cost effective, preventively oriented and is the perfect adjunct no matter where the patient is in the cycle of disease. If your concern is periodontal disease, and you have the discipline to spend an extra 10 to 15 minutes per day wearing a comfortable mouthpiece containing a pleasant tasting gel to save your teeth, I would urge you to click this link to learn more about Perio Protect®.