Goals of Periodontal Treatment

Gum disease is the main reason people need periodontal treatment. Other gum conditions also require treatment, however. Here is an overview of treatments for various conditions.

Gum (or periodontal) disease is caused by bacterial infections of the soft tissue and bone that support the teeth. The disease can cause tissue and bone to be destroyed. It can lead to tooth loss.

A combination of professional treatment and your efforts can stop gum disease from getting worse. These efforts can prevent further tissue destruction. Depending on the stage of gum disease, treatment ranges from a thorough cleaning to periodontal surgery.

Treatment at any stage of periodontal disease can make your gums healthier. Some people assume that losing teeth is a natural part of aging. This is not true. If you work with your dental professional to keep your gums healthy, you should be able to keep your teeth for a lifetime.

The main goals of periodontal treatment are to:

Eliminate the bacterial infections that cause gum disease

Control the inflammatory process that destroys the tissues anchoring the teeth to the jawbones

Create a healthy periodontal environment that is easy for you and your dental professional to maintain

The earliest stage of gum disease is gingivitis. This stage usually can be stopped before it causes significant destruction of soft tissue or bone. Your general dentist or dental hygienist can treat most cases of gingivitis. Treatment includes cleanings in the office. You also will get instruction on how to take good care of your teeth and gums at home.

In some people, gingivitis will develop to a more advanced stage of gum disease. At this point, the disease can destroy the structures that anchor the teeth to the jawbones. This more advanced stage is known as periodontitis. It usually requires more aggressive treatment than gingivitis. If you have periodontitis, your dentist probably will refer you to a periodontist (a gum specialist) for treatment.

Gums can recede, or shrink, even if there is no bacterial infection. One of the main causes of gum recession is improper brushing. Using a hard- or medium-bristled toothbrush can cause gums to wear away. Using too much force can also cause gums to recede over time.

As the gums recede, the roots of the teeth are exposed. This may cause the teeth to become sensitive to hot and cold temperatures. In addition, teeth with significant amounts of gum recession are more prone to developing root cavities.

Periodontists can treat recession by taking gum tissue from one part of your mouth and moving it to the area where the gums have receded. This is known as a soft tissue graft.

For some people, the problem isn't too little gum tissue, but too much. Some people naturally have what is known as a "gummy smile." Their teeth look very small and their gums seem very large. Some medicines also can cause an overgrowth of gum tissue. Examples include phenytoin (Dilantin and other brand names), cyclosporine (Neoral, Sandimmune) and nifedipine (Adalat, Cardizem). Periodontists can remove excess gum tissue. The procedure is called a gingivectomy.