Master, College of Conscious Sedation American Dental Society of Anesthesiology
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The Sweet Dreams Dental Team
Michael A. Starkey, DDS And Associates
The bad news about periodontal disease is that it cannot be eliminated. The good news is it can be successfully managed. Gingivitis is the early warning stage. Gingivitis can be reversed by simply eliminating the foreign particles that are irritating the gums. That means meticulous home care-which includes flossing, and seeing your dentist or hygienist for professional cleanings and alerts you to future problems so you can manage them before they become expensive to treat or become untreatable.
If your Gingivitis goes untreated your body's immune system will become more reactive and the attached gum tissue will break down and then the alveolar bone that holds teeth in place. That is irreversible gum disease. You cannot get your healthy gum and bone back. And the gum can no longer do its primary job of protecting your teeth and bone.
Over the years research has shown that gum disease affects more than your teeth and that gum disease is an inflammatory disease. Gum disease was in the long ago past ignored because it was not painful and did not bother the patient. Gum disease is a sort of silent disease but there are symptoms to be aware of which are listed below.
The good news is treatment of gum disease has become more conservative. That means doing less surgery and it mean taking out teeth that are irrational to save especially if dental implants can solve the problem. A patient cannot clean deep periodontal pockets; these pockets need to be managed by the dentist or periodontist. Instead of maintaining pockets or having the patient suffer through traumatizing expensive periodontal surgery the patient may elect to extract certain bad teeth and replace with implants, or perhaps it is possible to manage the gum disease non surgically with root planing and scaling and more frequent cleanings combined with improved medications that are taken orally or applied to the infected areas. Bone grafting is much more successful in reducing periodontal pockets than it was 20 years ago.
There is a new power brush that just came out by Oral B that has greatly improved patient's home care and reduced gum disease in recent studies.
I am forwarding information about gum disease and prevention from OralMD.com
It does an excellent job of explaining gum disease treatment and prevention.
The offer a naturopathic way of managing and preventing gum disease which may be of interest to those of you who prefer such method and OralMD web site is interesting and educational at the same time. I have no financial interest in any products that might be listed on our web site.
First and easiest and cheapest is PREVENTION!
Did you know that preventing periodontitis is the primary concern of your dental hygienist? There is a reason that she is always nagging her patients to brush and floss each day. Periodontitis begins as gingivitis, and if the symptoms aren’t addressed early on they can easily result in damaging consequences. In order to prevent periodontitis you must have exceptional oral hygiene, and reassess what you are already doing to ensure you’re doing it the right way. Here we will review everything your hygienist wants you to know about preventing the invasive dental disease known as periodontitis:
Use a soft-bristled toothbrush angled 45 degrees toward your gums, focusing on just two teeth at a time. Apply very gentle pressure and make short strokes back and forth, removing the debris near the surface of the gumlines.
Consider an electric toothbrush, as those are typically more effective in removing plaque biofilm and can greatly improve your chance of preventing gum infections like periodontitis.
Flossing – Don’t Ignore it
Flossing, not brushing, removes bacteria between the teeth and under the gumlines – where periodontitis starts to begin. Neglecting to floss at least once per day can allow bacteria to settle in and calcify, harboring disease conditions. Once calcified, bacteria cannot be brushed or flossed off and must be removed by a dental professional. To floss effectively, wrap your floss tightly around the tooth and slide up and down under the gums as far as it will go when gentle pressure is applied. Bleeding is a sign of infection so don’t let that stop you. Healthy gums do not bleed, and it may take flossing daily for up to two weeks before areas of gum infection stop bleeding.
Consider a water flosser such as a WaterPik. These devices are easy to use and can access areas deeper below the gums where flossing cannot.
Routine Preventive Care
Visiting your hygienist on a recurrent schedule allows her to screen for areas of disease as well as remove any bacterial deposits. Even allowing small areas of tartar (calcified bacteria) to remain on the teeth when you skip a cleaning can allow an area to harbor ideal conditions for periodontitis.
Nutritional and holistic supplements can increase your body’s immune health and reduce the risk of developing more advanced stages of periodontitis. Essential oils and supplementing with things like CoQ10 can greatly decrease your chance of developing advanced periodontitis.
Choose Your Oral Hygiene Products Wisely
Conventional wisdom tells us to brush with fluoride toothpaste and rinse with alcohol-containing mouthwash. But research has shown that there are real potential dangers in using these substances – [click here to read more – “The 6 Hidden Dangers in Toothpaste.” For optimal oral health and hygiene it is best to use [100% pure and natural botanical ingredients] whenever possible when brushing and rinsing.
If the Gum Disease is Irreversible it is known as
How to treat gum disease after it has advanced to periodontal disease.
Hw to manage gum disease once it becomes irreversible
Most periodontitis conditions are addressed through conventional treatment in your dental office. The more aggressive periodontitis treatment needed, the more expensive and invasive it can become. Addressing it early on with prophylactic appointments and great home care is the best way to avoid costly conventional dental treatment.
Seeing your dentist and hygienist every six months is the first step you should take in preventing periodontitis. During these routine-cleaning appointments they can remove any calculus deposits that harbor periodontitis-causing bacteria. They will also alert you to any areas of concern, allowing you to implement at-home steps to prevent the progression of the condition. A typical cleaning is under one hundred dollars, and usually covered 100% by most dental insurance plans.
If you are suffering from periodontitis symptoms due to inadequate care or lapse in care, your dentist may prescribe a medication to help alleviate the initial infection and aid in your at-home prevention routine. These medications may be in the form of a gel, rinse or orally-administered drug. Common medications used for periodontitis include:
Fluoride: Prescription fluoride can aid in eliminating initial periodontitis symptoms related to poor oral hygiene. (4) When thinking about using any fluoride product as part of an oral hygiene program or as treatment, be sure to read our free eye-opening report about fluoride, “Why the FDA Requires a Warning Label on Your Toothpaste.”
Chlorhexidine: This antiseptic mouth rinse is usually used for up to two weeks to alleviate inflammation and kill periodontitis disease bacteria that it comes into contact with. If used for more than two or three weeks it can cause significant dental stain.
Antibiotics: Most prescription antibiotics are reserved for more severe forms of periodontitis and are only used in conjunction with other conventional treatments. They can reduce bacterial levels, increasing your body’s response to the therapy. Common antibiotics for periodontitis include Periostat and Tetracycline.
Deep Cleanings/Scaling and Root Planing
Deep cleanings are the most commonly used conventional treatment in your dental office for addressing periodontitis. These treatments address one quadrant of your mouth at a time, and usually involve local anesthesia or desensitizing techniques. Your hygienist will use advanced instrumentation techniques to access disease debris deep below your gums in order to allow the area to heal. Costs are typically $200 to $300 per quadrant, nearing $1,000 for the complete mouth.
Periodontal maintenance visits are similar to routine cleaning appointments, but are more frequent and always follow deep cleaning appointments. Typically the fees are the same as prophylactic appointments, but you may be seen every three to four months until the symptoms improve, instead of every six months as with a preventive care cleaning.
Local Antibiotic Delivery
Following in-office therapy, your doctor may decide to place a local antibiotic in areas of more advanced disease. The medication is usually in the form of a capsule and the area should not be flossed for as long as two weeks to allow the delivery of the entire dose. This method is usually only used for a few areas where there is the most concern, and costs about $30-40 per site.
Examples of commonly used local antibiotic medications include:
Crown lengthening removes the diseased, detached gum tissue and creates a shallower gum “pocket” around your tooth, allowing you to keep it cleaner and free of disease-causing bacteria. Unfortunately it also exposes the roots of your teeth and isn’t really an aesthetically pleasing treatment, but in some cases it may be necessary if you are otherwise unable to keep the area clean. The cost is usually at least a few hundred dollars per tooth.
Gum Flap Surgery
If periodontitis disease conditions are so extreme that they have extended deeply below the gumlines, it may be necessary for a specialist to perform what is called flap surgery. The gums are retracted in order to access the bacteria buildup on the root of the tooth. This debris is removed and the gums are sutured back into place. Surgery costs can be up to several thousand dollars depending on how large of an area is affected.
Bone Of Gum Grafting
When bone or gum loss has been significant enough to risk the development of tooth mobility, gum or bone grafting may be needed. These are more invasive surgical procedures but they can aid in the structural stability of teeth that might be at risk for tooth loss. The fee can cost several hundred dollars and is priced per tooth.
Teeth that are misaligned are more prone to develop gum disease symptoms. Orthodontics can correct the position of the teeth and it has been proven to be part of a comprehensive approach to managing periodontal disease. (5) By moving the teeth into an appropriate position, they are easier to keep clean and reduce the risk of disease. Treatment usually averages a few thousand dollars.
Natural And Home Remedies
There are many ways to treat periodontitis symptoms on your own. Preventive natural and home remedies are actually some of the most significant periodontitis treatment when it comes to improving your oral health. Your dentist and hygienist can provide professional services at limited appointments in their office, but unless you are taking a proactive approach to your own health on a daily basis, you will not benefit as much. To truly improve your periodontitis you must make significant changes in the way you treat the condition at home.
Holistic Dental Options Could Save Your Teeth… and Your Money
Most holistic options for treating periodontitis are fairly inexpensive, which can save you hundreds if not thousands of dollars on professional treatments. However, not making a point to treat periodontitis on your own will ultimately result in the need for advanced professional intervention.
Home Remedy Options
If you’ve been looking for a periodontitis remedy, there are several methods that you can use conjunctively or alone to improve the health of your mouth
Advanced Hygiene Practices
Making significant changes in the way you brush your teeth does more than you think. Angle the brush 45 degrees toward the gumlines and brush in short back and forth strokes focusing on just two teeth at a time. Use only a soft-bristled brush and apply only enough pressure to cause a gentle blanching of the tissues. Brush other areas as well, including the tongue and cheeks to remove excess bacteria from the mouth.
Consider an electric toothbrush. Electric toothbrushes can remove a significantly larger amount of bacteria than manual toothbrushes. (5)
Floss every single day. Brushing alone does not remove periodontitis bacteria that rest between the teeth or deep below the gumlines. Wrap the floss in a “c” shape around each tooth and gently slide up and down under the gums several times.
Consider a water flosser or other irrigation device. Water flossers can remove plaque biofilm in concave areas of the tooth or deep below the gums (in cases of severe periodontitis) when normal flossing cannot. (7)
Antiseptic, over-the-counter mouthrinses can help decrease the amount of bleeding associated with periodontitis. However, avoid mouthrinses that contain alcohol, as it can dry out the mouth, which can lead to more bacterial growth in the long run. It is best to go with a 100% pure botanical mouthwash that kills the harmful bacteria that lead to gum problems.
Warm salt-water rinses are a good way to reduce swelling associated with oral irritation such as periodontitis.
Ibuprophen may be taken to alleviate any discomfort associated with inflammation, as it is an anti-inflammatory drug.
There are several types of natural supplements that have been shown to be effective in treating periodontitis symptoms. Not only are they easy to use, but also they are usually fairly inexpensive, especially compared to conventional treatment.
Vitamin And Nutritional Supplements
CoQ10 may be one of the most effective supplements available for the treatment of periodontitis. According to the Mayo Clinic, CoQ10 significantly aids in the reduction of gum disease symptoms.
Vitamin A is found in oils such as olive and sunflower oil. The nutrient promotes a healthy immune system and is shown to improve healing of oral infections when used as a supplement.
Vitamin C has long been known to promote immune health. Its use has been shown to improve the healing process of periodontitis symptoms.
Essential oils are useful for applying to the area of gum infection or simply adding to a glass of water to be used as mouthwash. They can dramatically affect your healing process when suffering from periodontitis and be a tremendous benefit when added into your normal oral care routine.
Essential oils that have a significant affect on periodontitis symptoms include examples such as:
Essential oils should be used according to directions and sparingly, so as not to accidentally use too much. Typically you can add one or two drops of the oil to your toothbrush and brush in the affected area or apply it with a cotton swab.
Here’s more essential oils benefits.
Recommended Lifestyle Changes
Having a healthy immune system makes a huge impact on your body’s ability to respond to periodontitis. Neglecting other health conditions such as obesity or diabetes may make it harder for you to address your periodontitis concerns and symptoms because your immune system is already strained. Here are some simple tips to help fight periodontitis in a truly holistic manner:
Work Out To Fight Plaque
Stimulating your cardiovascular system can prevent plaque biofilm from accumulating in large amounts throughout your cardiovascular system. That’s right – the plaque from your mouth can also enter into your arteries and heart!
Kick The Tobacco Habit
Nearly every patient with periodontitis who also smokes will never see an improvement in their condition. No matter how dedicated they are, smoking can counteract everything good that you do for your gums.
Eat A Balanced Diet
Fibrous fruits and vegetables stimulate gum tissue as you chew, while also providing essential nutrients to the rest of your system. They actually cleanse the teeth while you eat them! When your body has healthy nutrients going in, it makes it easier for you to fight infections as they occur.
Limit Sugar And Alcohol Intake
Sugars and refined sugars often found in processed food and alcoholic beverages create an acidic environment inside of the mouth and the rest of the body. Bacteria thrive in these areas and as they feed on the sugar the result is lots and lots of plaque biofilm (think “germ poop”). The more sugar you eat, whether it be through your coffee, juice, packaged food, alcoholic drink or other source, the more bacteria that you are going to produce in your mouth. The more bacteria you have, the easier it is for your periodontitis to advance.
How to manage and treat periodontal (gum) disease once it is irreversible
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