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Periodontal disease Dentist Highlands Ranch
Periodontal disease in some form is very common in the population in general. Fortunately for most, early periodontal disease (gingivitis) is exceedingly treatable and reversible. The issue is when this disease is left untreated it becomes difficult to "manage" and control resulting in gum and bone loss. Highlands Ranch dentists Dr James DeLapp and Dr. H. Candace DeLapp general and cosmetic destists work with you on " mitigating" the effects of periodontal disease for their Dental Patients in the Highlands Ranch, Lone Tree Parker, Lone Tree, Castle Pines and the Greater Denver area.
Gingivitis: Is considered the earliest stage of the disease and as its name implies is mostly localized to the gums (gingivae). The gums may become infected with bacteria and one of the many responses is inflammation. The signs of inflammation are swollen gums, bleeding on brushing and flossing, as well as bad breathe. Healthy gums should never bleed when you brush and floss. Unfortunately, for some patients, their gums have bleed so long when theybrush and floss that they mistakenly believe that this is "normal" or unique to them. The category of gingivitis may be broken down into several "different" categories with each becoming more severe and its early treatment is paramount.
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Treatment of Gingivitis. The good new with gingivitis is that is it treatable and for the most part reversible. Its treatment involves:
- Diagnosis and recognition that it is an infectious disease!
- Properbrushing and flossing techniques
- .Professional dental cleaning to remove plaque and calculus by our office.
- Diet control-limiting the intake of sugars.
- Prescription medications and pregnancy may make control of gingivitis difficult.
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Pregnancy gingivitis. Women who are pregnant frequently suffer from bouts of pregnancy gingivitis. It is normal and expected for female hormone production to occur this change may not be compatible in its relationship with the gums. It is difficult to predict who will or won't be affected, but treatment involves meticulous detail to brushing and flossing. Dr. H. Candace DeLapp and Dr. James DeLapp "may," recommend more frequent cleanings by their hygienist during pregnancy to proactively mitigate the damage.
Periodontitis Periodontitis is a treatable but not a reversible dental disease. By definition periodontal disease includes the infectious disease process involved in gingivitis but the disease has progressed to the "underlying bone". It is classified into three main categories:
- Early or incipient
- Moderate
- Severe or advanced
As you can imagine, the most favorable prognosis would be early or incipient periodontitis and the least favorable severe or advanced. One of the diagnostic difficulties that patients encounter is... periodontal disease has few symptoms. In the chronic stage it "may" have no "pain" associated with its bone loss (a silent disease). Periodontal disease in each of these stages can only be diagnosed with a clinical examination and radiographs to determine its severity.
The Periodontal Probe. The periodontal probe is invaluable in determining all types of diseases of the gums and supporting structures. In "many" cases (with notable exceptions) periodontal probe readings from1-3mm are in the good range with readings in the 4-6mm a cause for concern, and over 7mm of great concern. Readings of 10-12mm "may," indicate dire consequences and "possible" loss of the tooth. The signs of bleeding upon probing and pus or other exudates are considered in the diagnosis. As an example, two pockets each measuring 5mm one which bleeds profusely with pus has a different disease prognosis than another 5mm pocket with no bleeding what -so- ever.
Tooth mobility and periodontal disease. Tooth mobility combined with periodontal probe depths, bleeding scores, and radiographic bone loss, are indicators as to the overall prognosis of the tooth/teeth. When a tooth compresses in the socket (class III mobility) its prognosis is "generally" very poor and certainly extraction may be a viable choice.
Treatment of Periodontal disease. Treatment of periodontal disease like diabetes may be an ongoing or lifetime activity depending upon your individual situation. As a general rule, periodontal disease is treated the following ways (with individual modifications).
- Diagnosis including exam and x-rays
- Home care instruction... brush... floss... oral irrigator... sonicare... etc.
- Root plaining curettage (deep cleaning with local anesthesia)
- Systemic antibiotics or medications (Peridex etc.)
- Local placement of medications (Arestin- minocycline HCl e.g.)
- Re-evaluation of phase I therapy
- Referral to a specialist for surgical intervention
- Extraction of teeth in severe cases.
Drugs that complicate periodontal disease. The most dental notable drug is Dilantin used in the treatment of seizure disorders. Dilantin hyperplasia is due to the interaction of the drug with plaque and calculus. The gum tissue grows up over the crowns of the teeth and in its severe state surgical intervention is needed to reshape/resize the gums exposing the crowns of the teeth. Drugs that cause dry mouth also can contribute to gingival inflammation and the progression to periodontal disease.
Loss of tooth/teeth Loss of tooth/teeth may be treated in many different ways. These include but are not limited to:
- No treatment; leave the space alone (generally not recommended).
- Partial or removable denture.
- Fixed or cemented bridge.
- Implant(s).
- Full or complete denture with or without implants to help stabilize the denture.
Summary: Obviously there are entire 800-page textbooks devoted to the subject of periodontal disease so a complete description of its significance is impossible. What the doctors hope you get out of reading this section is that the symptoms of periodontal disease may fool many patients. Pain or discomfort, which is seen in so many diseases, is not a chief presenting complaint by "many" patients. Like certain cancers... periodontal disease may progress symptom- free until teeth are compromised. Timely detection is the key to mitigating its effectson treatment. Our largest problems quite frankly involve patients who smoke and drink sodas high is sugar and caffeine. Patients who through our best efforts lose some or all of their teeth fall into this category. Our best advise in to stop smoking and discontine caffeine. Dr James DeLapp and Dr. H. Candace DeLapp are Highlands Ranch family dentists also serving dental patients in Parker, Lone Tree, Castle Pines and the Greater Denver area. Please feel free to call at (303) 694-9740
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