Home| Dental Services|General and Preventative Dentistry|Periodontal Treatment Periodontal disease (gum disease) is the leading cause of tooth loss in adults. Our office will provide comprehensive, individualized care for your gums, so you can keep your smile for a lifetime. At your initial visit, one of our Bethesda dentists—Dr. Deborah Klotz or Dr. Robert Schlossberg—will evaluate your gum tissue and prescribe treatment. In addition, we will work with you to develop good home-care habits, so your gums and teeth will remain healthy. To learn more about gum disease and various treatment options that are available, we invite you to read through the sections provided below, or simply contact Bethesda Sedation Dentistry today to schedule an appointment. What Is Periodontal Disease? Gum Disease Statistics Gum Disease Causes Signs & Symptoms of Gum Disease Periodontal Disease Stages Diagnosis of Gum Disease Periodontal Disease Treatment What Is Periodontal Disease? Periodontal disease is an infection of the gums that, if left untreated, can destroy the soft tissue and bone supporting the teeth. Among many issues, this can lead to the gradual loosening of teeth—and eventually tooth loss. While poor oral wellness is the most obvious concern related to gum disease, it is important to understand that the potential consequences of this condition are not limited to the mouth. Medical research has long shown a notable link between oral and systemic disease, meaning periodontal issues are believed to be strongly connected to several other health concerns throughout the body. Some of the most serious of these afflictions include the development of high blood pressure, diabetes, stroke, and heart disease—making periodontal care and treatment critical for optimizing both oral and systemic health. Gum Disease Statistics 75% of all Americans over 35 have some form of gum disease. Only 50% of the population visits a dentist on a regular basis. Of that 50%, 80% have some degree of gum and bone disease. Gingivitis is the most common form of periodontal disease, affecting 90% of the population, including our local Bethesda area community. People with gum disease are twice as likely to have heart disease or type 2 diabetes. Gum disease has been shown to lead to low birth weight and premature birth weight babies. What Causes Gum Disease? Gum disease is caused by harmful bacteria residing in dental plaque—the sticky, colorless substance that accumulates on the teeth between brushing and interdental cleaning sessions. While plaque and bacteria can typically be managed by following a good oral hygiene regimen, failure to brush and cleanse interdentally correctly—as well as neglecting to visit the dentist at least twice annually for professional teeth cleanings—can lead to a gradual buildup on the teeth that eventually spreads to and below the gumline. Once underneath the gumline, plaque and bacteria are protected from brushing and interdental cleaning, allowing the plaque to grow and inflame the gums. As it progresses, this plaque growth and inflammation creates pockets between the teeth and gum tissue, providing an excellent environment for the damaging bacteria to rapidly multiply and harm supportive structures of the teeth. The longer this is allowed to occur without treatment, the more tissue and bone loss can be expected. In addition to poor oral hygiene, factors that can also contribute to the development and progression of periodontal disease include smoking, diabetes or other certain medical conditions, hormonal fluctuations, particular medications, and genetics. What Are Common Signs and Symptoms of Gum Disease? Gum disease is a silent condition, similar to high blood pressure, cholesterol, and diabetes. In the early stage of the disease, people rarely experience pain and may not be aware of the problem until it is too late. Common symptoms of gum disease include: Swollen or bleeding gums Halitosis (bad breath) Gum recession Loose teeth Pockets between teeth and gums If you experience any of these symptoms, contact Bethesda Sedation Dentistry immediately. What Are the Different Stages of Periodontal Disease? There are three stages of periodontal disease: gingivitis, periodontitis, and advanced periodontitis. Each of these is described below. Gingivitis – In this initial stage of periodontal disease, the gums are typically inflamed and tender, often bleeding when brushed and/or cleaned interdentally. Fortunately, damage caused by gingivitis can usually be reversed if detected and treated early enough, as supportive tissue and bone are generally not yet impacted. Periodontitis – In this second stage of periodontal disease, a pocket below the gumline has likely begun to form between the tooth (or teeth) and gum tissue. While treatment and proper oral hygiene can help restore gum health and help prevent future harm, the tissue and bone damage already caused is irreversible. Advanced Periodontitis – In this final stage of periodontal disease, gum tissue and bone is harmed to the point that teeth can significantly shift and/or loosen. These issues may have a major impact on bite alignment and the appearance of the smile, sometimes requiring tooth removal and replacement in addition to periodontal treatment to restore proper oral health, tooth function, and smile aesthetics. How Is Gum Disease Diagnosed? Periodontal disease can go on for years without pain or detection unless specific examination procedures are performed. Visual oral examination (even by a dentist) will not reliably detect periodontal disease until it has reached an advanced stage. Early detection and adequate diagnosis require precise measurements of pockets (the crevice between the tooth and gum) with a periodontal probe. At Bethesda Sedation Dentistry, effective prevention and treatment is available, but the damage caused as the disease progresses is irreversible. What Are My Treatment Options for Periodontal Disease? If our dentists find that you have gum disease, we can alleviate your symptoms and help prevent further infection. Depending on how far your periodontal disease has advanced, Dr. Deb or Dr. Rob will recommend non-surgical or surgical treatment, possibly with the adjunct of Diode laser gum therapy and/or Perio Protect®—all of which are highlighted below. Regardless of the particular technique(s) selected, you can expect customized, holistic co-therapy involving close collaboration between you, your dentist, and your hygienist. We believe in treating the entire individual—not just the mouth—and this evidence-based approach to periodontal care has yielded exceptional results from both a gum wellness and whole-health standpoint. Non-Surgical Periodontal Therapy When gum disease is in its earliest stages, our dentists may be able to utilize non-surgical methods to treat the condition. Non-surgical periodontal therapies include: Scaling – This procedure removes hardened plaque from below the gumline. Root Planing – This involves gently removing tartar and smoothing root surfaces to prevent plaque from sticking. Arestin – This antibiotic therapy fights disease-causing bacteria for up to 21 days. Periodontal Surgery For advanced stages of gum disease, we may utilize surgical methods to treat gum disease. Our dentists have undergone extensive training in oral surgery and can perform periodontal surgery in the safety and comfort of our Bethesda dental office. Typically, periodontal surgery involves four procedures. Depending on your unique case, your dentist may reduce the depth of periodontal pockets, regenerate bone or soft tissue, lengthen the crown of the tooth, and/or perform soft tissue grafts. Periodontal surgery will improve your chances of keeping your teeth throughout life. We offer several methods of sedation dentistry, so you can get the care you need while experiencing total comfort. Diode Laser Periodontal Therapy As an adjunct to non-surgical and surgical periodontal treatment, our dentists offer Diode laser therapy—a state-of-the-art technique designed to further cleanse the mouth of damaged tissue and harmful bacteria. With this advanced technology, Dr. Rob or Dr. Deb can selectively remove infected or diseased gum tissue from the pockets surrounding the teeth, as well as destroy the dangerous bacteria that can be difficult (if not impossible) to eliminate manually from nearby tissue/areas. As added benefits, Diode laser therapy can also help promote gum healing and may even mitigate the need for antibiotics as part of treatment. Perio Protect® Perio Protect® is an innovative therapy designed to inhibit the growth of harmful biofilm within periodontal pockets, ultimately helping prevent the progression of gum disease after initial treatment. This non-invasive system works by delivering a 1.7% hydrogen peroxide gel via a customized Perio Tray® that is to be worn for a few minutes every day. Thanks to its custom specifications, the tray offers a comfortable fit and tight seal that creates enough pressure to push the special gel formula deep into spaces between the teeth and gums that are not generally accessible by brushing, interdental cleaning, and mouth-washing. Once in the periodontal pockets, the gel is able to disrupt biofilm development and oxygenate gum tissue, promoting a healthy environment below the gumline. Perio Protect® can often be an excellent complement to therapies such as scaling and root planing, helping to keep gum disease under control for optimal long-term wellness while minimizing the need for antibiotic use and future periodontal surgery. Contact Bethesda Sedation Dentistry For more information about our periodontal disease and possible treatments, or if you are interested in scheduling an appointment at our practice, please feel free to contact us today.