Management of Periodontal Diseases/Hygiene

Did you know that 75% of all adult tooth loss is due to periodontal diseases?

When your gums and the bone anchoring your teeth are damaged by periodontal infection, there is less support for your teeth.  Just as metal can turn to rust over time, the bone supporting your teeth can deteriorate.  As this support disappears, your teeth first become loose and then may be lost.

When periodontal treatment is recommended by your dental health team (general dentist, hygienist, and periodontist), it is important that you get started immediately to stop the deterioration that has already begun.

If the infection is allowed to continue, the teeth that are lost will need to be replaced with more complex dental work.  Nothing is better than your own teeth and so prevention is the most cost effective and long-term solution.

Treatment of periodontal disease begins with a comprehensive periodontal examination, which includes diagnostic imaging, evaluation of the deep periodontal pocketing in the spaces between your teeth and gums, and a detailed discussion about your particular oral situation.

There are non-surgical and surgical solutions for periodontal disease.  In almost all cases, Dr. Fritz and Dr. Schuldt recommend non-surgical therapy for generalized periodontal disease of all stages and grades.

This process involves a “deep cleaning” with one of our registered dental hygienists over a series of appointments.  Our hygienists use a variety of specialized tools to remove the infection living in the pockets between your tooth, bone, and gum.  Some of these tools include a very large variety of hand-held manual instruments, a series of ultrasonic instruments (which work by way of water and vibration), and most recently introduced to our arsenal of instruments, guided biofilm therapy (GBT).

Studies in our office reveal that after undergoing non-surgical therapy, such as a deep cleaning with one of our registered dental hygienists, only 7% of patients require further surgical treatment to combat periodontal disease.

Periodontal disease, also known as gum disease or periodontal infection, is a chronic infection of the gums surrounding your teeth. It is caused by infectious bacteria that penetrate deep into the gums, leading to tissue inflammation. This infection begins to destroy the bone that supports your teeth, and if left untreated, it can result in tooth loss. 

Gingivitis is the inflammation of the gums, characterized by swollen, reddened gums that may bleed when brushed or flossed. Unlike periodontal disease, gingivitis does not involve any loss of bone around the teeth.

Periodontal disease is the natural progression from gingivitis. Both conditions are caused by a build-up of bacteria and plaque on the teeth and below the gum line. Poor brushing and flossing habits are the most common causes of these conditions.

Some environmental and genetic factors can increase the likelihood of developing periodontal disease. Uncontrolled diabetes and smoking are significant risk factors that also contribute to the development and progression of periodontal disease.

If periodontal disease goes untreated, the bacteria residing in the crevices between your tooth and gums will continue to proliferate. This biofilm-producing bacteria will dig deeper and deeper into the pockets causing bone loss. Without proper treatment of periodontal disease, your teeth will become loose and can even be lost.

Yes… and no.

Non-surgical periodontal therapy, sometimes referred to as a “deep cleaning” removes the disease causing bacteria and biofilm and effectively halts periodontal disease in its tracks.

However, once you have experienced bone loss due to periodontal disease, you will always have a reduced periodontium and therefore will require regular supportive periodontal therapy and maintenance visits with your hygienist and periodontist.

Periodontal disease is often called a silent assassin, because it can progress without causing pain.

However, some warning signs of periodontal disease include:

  • red, swollen, and inflammed gums
  • gums that bleed when brushed or flossed
  • loose or shifting teeth
  • persistent bad breath or bad taste in the mouth
  1. Quit Smoking: Smoking significantly increases your risk of gum disease and tooth loss.
  2. Control Diabetes: Uncontrolled diabetes can also put you at higher risk for gum disease and tooth loss.
  3. Regular Maintenance: Regular dental check-ups and professional cleanings are crucial for maintaining gum health.
  4. Oral Hygiene: Take good care of your teeth at home by brushing and flossing regularly.

By following these steps, you can significantly reduce your risk of developing gum disease and maintain better oral health.

Alternating your dental care between your general dentist and a periodontist ensures comprehensive oral health management. Here’s why:

  1. Specialized Gum Care: The primary role of a periodontist is to monitor the health of your gums and evaluate your homecare routine to control and treat gum disease. They are experts in managing periodontal issues and can provide specialized treatments that a general dentist may not offer.
  2. Restorative Care: Your general dentist is essentially a specialist in detecting cavitiws and restoring diseased teeth. He or she will pay special attention to your overall dental health, including preventive care, fillings, crowns, and other restorative procedures.

By seeing both specialists, you receive targeted care for all aspects of your oral health, ensuring both your gums and teeth are well-maintained and treated effectively.  This way you have the best of both worlds!

Yes, advanced periodontal disease has been linked to an increased risk of several serious health conditions, including heart disease, stroke, and diabetes. Research also indicates that treating periodontal disease can improve glucose control in diabetic patients.

No, periodontal disease is often considered a “silent” disease because it typically does not cause noticeable pain until it becomes advanced. This makes regular dental check-ups crucial for early detection. Radiographs and periodontal probing should be performed routinely to identify the disease early. Signs of periodontal disease include bleeding gums, shifting teeth, and bad breath.

Alternating your hygiene visits between your general dentist and Dr. Peter Fritz is an essential part of maintaining the investment you made in your oral health. If there is a discrepancy in fees, and our fees are higher than those of your general dentist (although in some cases, the general dentist’s fees may be higher than ours), it is due to several key factors:

Specialized Training: Every hygienist undergoes an additional year of specialized training in periodontal care at our clinic before they can see patients. This advanced training equips them to handle the most challenging periodontal cases with precision and expertise. Many of our hygienists have international experience, bringing a diverse and comprehensive perspective to their practice. Their exposure to various global techniques and standards enhances the quality of care they provide.

Advanced Technology and Instruments: We utilize state-of-the-art technology and instruments designed for superior periodontal maintenance, ensuring thorough and effective treatment.

Periodontist and Medical Director Supervision: Our hygienists are supervised by a periodontist and medical director to ensure optimal results and maintain the highest standards of care.

This comprehensive approach ensures that you receive the best possible care for your periodontal health, justifying any fee differences.

When should I visit a Periodontist?

Please take a few minutes to answer the questions on this Gum Disease Risk Assessment so that we can gauge your individual risk for gum disease and tailor our treatment recommendations to your specific needs. Take The Assessment

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Pocket depths of 6mm or more: Especially without significant calculus or plaque.
Vertical bone defects: Visible on radiographs.
Gum recession: 3mm or more, particularly if the area has less than 2mm of keratinized tissue.
Exposed roots or furcation involvement.
Patients with complex conditions: Such as coexisting periodontal disease and diabetes.
Peri-implant disease or periodontal abscess: Requires immediate referral.
Patients under 40 years old: With bone loss and pocket depths of 6mm or more.
Lack of improvement in pocket depths: Pocket depths remaining at 6mm or more, or generalized pocket depths of 5mm or more, persisting after 4-6 weeks post-Scaling and Root Planing (SRP).
Persistent inflammation: At any site despite initial treatment.
Refractory or recurrent disease: Cases where periodontal disease continues despite appropriate initial therapy.