Common Questions about Gum Tissue and Bone Health
Gum tissue recession can occur for a number of reasons. Most commonly gum tissue recession starts when the gums are abraded and harmed by the use of a medium or stiff bristled tooth brush. Aggressive tooth brushing will cause the gum tissues to recede over time. People who clench or grind their teeth are also often predisposed to suffering from gum tissue recession due to the severe forces that can be placed on their teeth and supporting tissues. Another common predisposing factor for gum tissue recession is the thickness (often referred to as “biotype”) of the gum tissue itself. Typically, the thinner the tissue the more susceptible it is to recession and people with a family history of gum tissue recession may fall into this category. The root surfaces of our teeth are weak by comparison to the crown surfaces of our teeth and when exposed in the mouth they are more prone to decay, erosion and abrasion. Gum tissue recession can be treated by the addition of new gum tissue or by using artificial tissue that stimulates gum tissue growth. Guided tissue regeneration such as this is a great example of how modern dental materials and techniques can repair and prevent further progression of disease. If the patient is not a candidate for gum tissue grafting the root surfaces of teeth can also be artificially protected by the placement of fillings or crowns.
Periodontal disease ("gum disease”) is an infection of the gums with an accompanying loss of supporting jaw bone. A study titled Prevalence of Periodontitis in Adults in the United States: 2009 and 2010 estimates that 47.2 percent, or 64.7 million American adults, have mild, moderate or severe periodontitis, the more advanced form of periodontal disease. The good news is that periodontal disease can be diagnosed, treated, and for the most part controlled. In certain situations it can even be reversed and new bone and gum tissue can be developed. Periodontal treatment, which encompasses a wide spectrum of procedures, can make your mouth healthier and help preserve your teeth. Periodontal disease is a “silent” disease in that if often has only mild symptoms that people can tolerate until it has progressed to a point where the teeth can no longer be saved. Fortunately, with regular dental exams and dental cleanings periodontal disease can be diagnosed and treated to prevent premature tooth loss. Another significant component of periodontal disease is the role that it plays in a persons overall health. Research has shown that there is a correlation between uncontrolled periodontal disease and higher risk factors for cardiovascular disease and diabetes. Similarly, people with uncontrolled diabetes have a greater incidence of developing periodontal disease. This illustrates the importance of good oral health and how integral it is to whole body health.
This deep cleaning has two parts. Scaling is when your dentist removes all the plaque and tartar (hardened plaque) above and below the gumline, making sure to clean all the way down to the bottom of the pocket. Your dentist will then begin root planing, which is the smoothing out of your teeth roots to help your gums reattach to your teeth. Scaling and root planing may take more than one visit to complete and may require a local anesthetic.
For people that have been diagnosed with periodontal disease, standard dental cleanings are not effective as a measure of controlling the disease. Standard dental cleanings are used to clean the teeth surfaces that are above the gum tissues when the gums and underlying bone structures are healthy. When periodontal disease is present the hygienist or dentist must clean both above and below the gum tissues to help remove damaging bacteria and plaque that are responsible for the disease. This procedure is known as a “periodontal maintenance” and for most patients with diagnosed periodontal disease this procedure must be completed 3-4 times annually to help control the disease. Periodontal maintenance is performed following the completion of scaling and root planing. For most patients with periodontal disease this procedure will need to continue for their entire life in order for the best possible outcome as it relates to maintaining their natural teeth.
Many dental benefit plans will only cover the cost of 2 periodontal maintenance procedures each year, even though 4 periodontal maintenance procedures are necessary to control the disease. This is a great example of how dental benefit plans do not cater treatment to the individual but rather expect the individual subscriber (“you”) to conform to a standardized “norm”. Our office will always fight on your behalf to supply the dental benefit plan with the justification for the additional necessary procedures but this is never a guarantee unfortunately that they will pay. We consul patients that the additional out of pocket expense for completing these procedures far outweighs the cost of losing your teeth and then having to undergo more costly dental procedures such as the placement of dental implants. There is no true replacement for your natural teeth and it is impossible to quantify the value of your quality of life with and without your natural teeth.