Gum Disease Treatment & Prevention

I would like to discuss a topic that some patients can be neglecting,  gum disease or periodontal disease.  There are many 20,30,40 and even 50 year old patients that grew up with flouride and a strong push for prevention that do not have any fillings!!   Some of my older patients remember the days of seeing the dentist and having 10 cavities. We just don’t see that very often today and it’s predominantly due to the intake of flouride vitamins as a child , flouride toothpaste , and visiting the dentist every 6 months for cleanings and flouride treatments until your teen years .. it really makes a difference.

This is absolutely amazing for these patients, unfortunately sometimes it can lead to taking your gums for granted.  If you’re 33 years old and never had a cavity but your gums bleed this can be a cause for concern. Healthy gums do not bleed !!!   When patients say “ my gums always bleed “ we try to educate them that this is not a good or normal thing .. a diabetic that always has a glucose level of 350 is not healthy !! 

What can we do about this ?  The patient needs to do something, ideally every day to clean in between the teeth. This can be regular floss wrapped around our fingers or the little handles with floss.  There are also picks , brushes , rubber tips , or splurge for a water pik  ; bottom line we see patients 2-4 times a year for cleanings that’s over 360 times a year when it is you , alone in the bathroom.  Do something routinely with warm salt water rinsing afterwards and your gums should start to change.  When the gums get neglected, bacteria builds up causing an inflammatory response (red and puffy) and we need to mechanically get that bacteria out which is the floss, picks etc followed by the warm salt water to cut down the inflammation.  Similarly if you have a cut on your leg and you go swimming in the ocean , the cut “disappears”, this same affect will happen in your mouth.

Sorry , there is no pill you can take or some magic rinse that will replace the mechanical cleaning process.

There are times when the progression of the periodontal disease has gone beyond the soft tissue of the gums and starts to breakdown the bone underneath.  This usually causes deep pockets that trap plaque and bacteria and we have to get that out first before healing can occur.  This starts with deep scaling and root planning , “a cleaning on steroids”. The mouth is usually treated in sections right side then left side with local anesthetic so we can get the deep pockets cleaned without hurting you.  This treatment is usually performed by the hygienist or the dentist.  Occasionally, we have to get a gum specialist called a periodontist involved for further treatments. After all this , your gums are not fixed , they are now maintainable for the patient to brush and floss.

We have come full circle. See your dentist and hygienist regularly and make sure you are doing your home care every day , simply relying on us to make up for poor oral hygiene can lead to problems.  As one of my dental school professors at Tufts University would say … floss only the ones you want to keep

Peter M. Perera, D.M.D.