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   Simon W Rosenberg, DMD

Prosthodontics and Cosmetic Dentistry
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Here is a very good, more scientific presentation on Periodontal Disease

by Rolf Attstrom and Anders Nattestad
from dental schools in Sweden and Denmark.

Periodontal Disease

The most common infection in the World

Rolf Attstrom and Anders Nattestad

The Department of Periodontology, Centre for Oral Health Sciences, Lund University, Malmo, Sweden,
and the Department of Oral and Maxillofacial Surgery, School of Dentistry, Copenhagen University, Copenhagen Denmark

Periodontal disease is an infection which develop over time in most adults and in a few young individuals. The disease is caused by the normal microbial flora of the mouth. These bacteria form deposits on the teeth at and below the gingival margin. The common term for these bacterial accumulations is Dental Plaque which over time mineralize and turned into Calculus. Initially the disease engage the superficial parts of the tissues and then by time spread into the deeper structures of the tooth attachment apparatus. In the early phases, before any irreversible effects have developed, the disease is termed Gingivitis. Not all teeth are equally attacked and at the same time in the same mouth there may be regions which suffer from gingivitis and from periodontitis respectively. The defense reaction in the gum tissues towards these microorganisms result in the destruction of the tooth attachment and in some cases to the loss of the tooth. Generally the destruction of the tissues is a slow process but occasionally rapid forms of the disease do occur.

The most obvious symptom noted by the patient is bleeding from the gum following tooth brushing. The dentist determines the presence of the periodontal disease by observing the tendency of the tissue to bleed upon gentle touching of the gum line and by registration of the s c probing depths of the periodontal pockets. Also xrays are used to determine the extent of the damages to the tooth attachment and the jaw bone. The treatment of periodontal disease include removal of the bacterial deposits and calculus. This treatment is a time consuming and technically demanding. When deep periodontal pockets remain following these procedures it is sometimes necessary to perform a surgical treatment.

The most significant part of the treatment consist of the efforts the patient has to undertake in her/his daily oral hygiene procedures. Therefore a very important part of the treatment is the instruction of the patient in efficient tooth cleaning. To visualize to the patient where the bacteria accumulate the teeth are stained with a disclosing solution. The oral hygiene aids necessary are a soft tooth brush with a comfortable handle, dental tape, interdental brushes or toothpicks for cleaning between the teeth. Which aid to use where should be told by a professional. Principally a cleaning technique shall be used which focus the efforts on the junction between the gumline and the teeth. Ask your dentist or dental hygienist which aid and what technique to use.

When periodontal disease has been treated its necessary to receive supportive treatment in the form of regular professional cleanings of the teeth and follow up inspection of the tissue condition. The interval between supportive treatments varies according to disease and patient characteristics. Active treatment, cooperation by the patient and supportive professional assistance in most cases lead to that periodontal disease is arrested and the teeth preserved lifelong.

If you have noticed bleeding from the gums in connection with tooth brushing contact your dentist for a check up. Unfortunately we do not answer e-mails with questions regarding diagnosis and treatment of periodontal disease. If you need a comprehensive approach to your dental problems, then our practice is just the place for you to start. We perform a complete periodontal examination on all of our new and recall periodic examination patients. We treat the levels of periodontal disease that is appropriate in our office and refer you to one of several periodontists in the area, if the level of periodontal care or the specific type of treatment (such as gingival grafting, intra-osseous surgery or bone grafting is needed by your periodontal condition.

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