Periodontal disease manifests itself in many different ways, all of which require early intervention by a periodontist and other oral healthcare professionals. Early treatment will result in much better prognoses and treatment outcomes.
Gingivitis is the mildest and most common form of periodontal disease. It is characterized by gum inflammation without involvement of the supporting bone structures of the teeth. If treated at an early stage, gingivitis is totally reversible.
Gingivitis is treated by a combination of meticulous home care and professional cleaning. The dentist may perform root planing and deep scaling procedures to remove the plaque and calculus which are the causative factors of the inflammation.
Chronic periodontal disease, while it may effect younger people, occurs much more frequently in people over 40. Chronic periodontal disease is characterized by gingival inflammation and bone loss. Once bone is lost, it cannot be restored. Chronic periodontitis is not reversible.
The goal in treating chronic periodontitis is to halt the progression of the disease. This is accomplished using several different regimens. The first is the reinforcement of the patient's oral hygiene and home care. The periodontist will then remove the plaque and calculus that are causing the disease process to progress by using scaling and root planing procedures in combination with debriding the infected material that line the pocket formed between the teeth and the gums. The periodontist may also treat the pockets with antimicrobial agents. The periodontist may also perform surgical treatments such as pocket reduction surgery and tissue grafts to strengthen the bone and improve the aesthetic appearance of the oral cavity. In some cases, dental lasers may be used to treat the pockets and halt the progress of the disease.
Many systemic illnesses may cause or worsen the effects of periodontal disease. Among the most common of these are heart disease, diabetes and respiratory disease. In these cases, the patient may have aggressive periodontal disease even though they maintain excellent oral hygiene and little plaque and calculus is evident.
Initially, the medical condition which caused the onset of periodontal disease must be controlled. The periodontist can then treat the disease using all of the treatment possibilities mentioned above.
While rare, this form of periodontal disease is very aggressive. It generally effects people who suffer from HIV, immunosuppression, malnutrition, chronic stress or smokers. This aggressive form of the disease causes rapid bone loss and tissue necrosis (destruction).
Because it may be associated with HIV or another serious medical condition, the periodontist will work hand-in-hand with the treating physician to develop a treatment plan. Scaling, root planing, antibiotics, medicated mouth rinses and fungicidal medicines are all used to treat this form of the disease.