Periodontal Care refers to the treatment of the gums and bone that are the supporting structure of the teeth.
At the dental office of Dr. Gerald Cohen, all patients’ periodontal needs are evaluated on an ongoing basis, and the appropriate therapy is then prescribed as needed.
Most initial periodontal care is started with recording the findings of a "gum" exam, and often patients receive scaling and root planing, which is a form of deep cleaning. This is often done with local anesthetic because we clean both above and below the gum-line.
- Gingivitis - Early stage gum disease where the gums become swollen, tender, and are likely to bleed. With proper oral hygiene and treatment from your dentist, gingivitis is reversible.
- Moderate Periodontitis - Moderate stage gum disease where the gums have deteriorated and begin to detach from the teeth. Periodontal gum pockets are deep enough to allows plaque to collect below the gum line. Bacterial in the pockets multiply rapidly. Tooth roots become susceptible to decay, and periodontal disease requires immediate treatment.
- Advanced Periodontitis - Advanced gum tissue and bone loss occur. Teeth become loose and may require extraction. Chewing and biting become painful and difficult. Untreated, patients risk the loss of teeth and serious health complications.
A gingival pocket as a 1–3 mm deep gap between the tooth and gums. In a gingival pocket, they is typically no permanent destruction of the gums or supporting alveolar bone. This early sign of disease is called gingivitis.
Symptoms may include:
- Swollen gums
- Bright red or purple gums
- Gums that are tender or painful to the touch
- Bleeding gums or bleeding after brushing
Gingivitis is reversible without dental surgical therapy.
A periodontal pocket is 4 mm or more deep between the tooth and gums where the the gingival tissue to the tooth have been irreversibly destroyed. The supporting alveolar bone may be also be degenerating based on the stage of the disease. This stage of gum disease is called periodontitis.
Symptoms may additional include:
- Receding gums
- Loose teeth
Periodontitis requires dental surgical therapy.
Non Surgical Treatment
Scaling and Root Planing
The initial stage of periodontal treatment is a thorough cleaning to remove plaque and tartar deposits beneath the gum line.
Antibiotics or irrigation with antimicrobials (chemical agents or mouth rinses) may be recommended to help control the growth of bacteria that create toxins and cause periodontitis. In some cases, Dr. Cohen may place an antibiotic in the periodontal pockets after scaling and root planing. This may be done to control infection and to encourage normal healing.
When deeper pockets between teeth and gums are present, it is difficult to thoroughly remove plaque and tartar. Consequently, periodontal surgery may be needed to restore periodontal health.
Traditionally, gum disease is treated by eliminating the gum pockets by trimming away the infected gum tissue and by re-contouring the uneven bone tissue. Although this is still an effective way of treating gum disease, new and more sophisticated procedures are used routinely today.
Oral Plastic Surgery
Dr. Cohen can perform periodontal plastic surgical procedures to replace the missing gum tissue with grafting procedures.
This surgical procedure "regenerates" the previously lost gum and bone tissue. Most techniques utilize membranes, which are inserted over the bone defects. Some of these membranes are bio-absorbable and some require removal. Other regenerative procedures involve the use of bio-active gels.