One of the most dangerous things about periodontal disease (the disease that causes gum and jaw bone loss) is that it typically is painless until it becomes severe. Periodontal disease has recently been found to occur in 1 of 2 adults over the age of 30. This incredible finding tells us that this disease occurs more often than diabetes. Unfortunately, a patient may not even know they have the problem since it usually does not hurt. Reviewing how the disease progresses will better help understand how it can be managed.
Periodontal Disease: A Brief Review
There are multiple forms of periodontal disease, but the most common types are gum inflammation, gum recession and jaw bone loss.
Gum and Bone Loss:
As plaque and bacteria accumulate around the gums, the body responds and sends extra blood to the area to help attack what it sees as an “infection”. You may notice that the gums become swollen and bleed easily when this occurs (Gingivitis). If left untreated, this gum problem can lead to the jaw bone around the teeth being lost (Periodontitis). This is also known as “deep pockets” in which a deep space develops below the gum line. To be clear, this space occurs as the bone under the gumline resorbs away. In most cases, the only symptom you may have is bleeding when you brush. It is important to realize that you can be losing the bone supporting your teeth and have absolutely no idea. Very frequently, I see patients who learn they have the disease for the very first time when they are complaining that their teeth are loose. At this point, the prognosis for saving the teeth are much less promising than if we had addressed the situation much sooner.
Another common form of the disease is gum loss (recession). Most times, this is mistakenly viewed as a cosmetic issue. THIS IS A BIG MISTAKE. Our teeth have two parts: a crown (the part you see when you smile) and the root (the part that is below the gum/bone which supports the tooth). As the gum is lost, the jaw bone beneath the gum line is exposed. The bone will not remain exposed and resorbs away leaving the root showing (this is why we see a longer looking tooth in the mirror). This process does not typically hurt. The only complaints patients often discuss is that their teeth look longer or they are more sensitive to hot and cold. Although these are problematic, they are minor compared to the fact that the supporting jaw bone is being lost. If the process is not stopped, ultimately the teeth will become loose and eventually be lost.
What Can Be Done?
The first and most important step is to be sure you have a complete periodontal evaluation. Fortunately, this is a painless evaluation which involves a review of a current set of dental x-rays and a thorough review of your mouth. Measurements are taken to determine if gum or jaw bone is being lost. It may be shocking to find that you are part of the 50% of the population to have periodontal disease.
The Good News:
Believe it or not, there are advanced treatment options available to help address many forms of the disease that are relatively pain free. In the past, many of the treatments for moderate to advanced levels of periodontal disease involved traditional surgery. Today, we have incredible options for issues such as gum recession and jaw bone loss that no longer require a scalpel, stiches or graft material. Therapies such as LANAP (Laser Therapy) and Pinhole Gum Rejuvenation are two such options which have demonstrated amazing success with tremendous patient satisfaction and minimal to no pain.
It is important to remember that every patient and situation is different. A complete evaluation is required to determine if you in fact have the disease and if you are a candidate for one of these (or other) advanced treatment options.
Lee R. Cohen, D.D.S., M.S., M.S.,
is a Dual Board Certified Periodontal and Dental Implant Surgeon. He is a graduate of Emory University and New York University College of Dentistry.
Dr. Cohen completed his surgical training at the University of Florida / Shands Hospital in Gainesville, Florida. He served as Chief Resident and currently holds a staff appointment as a Clinical Associate Professor in the Department of Periodontics and Dental Implantology. Dr. Cohen lectures, teaches and performs clinical research on topics related to his surgical specialty.
The focus of his interests are conservative approaches to treating gum, bone and tooth loss. He utilizes advanced techniques including the use of the Periolase Dental Laser (LANAP procedure) to help save teeth, dental implants, regenerate supporting bone and treat periodontal disease without the use of traditional surgical procedures. Additionally,
Dr. Cohen is certified in Pinhole Gum Rejuvenation, which is a scalpel and suture free procedure to treat gum recession with immediate results.
Dr. Cohen uses in-office, state of the art 3D CT imaging to develop the least invasive dental implant and bone regeneration treatment options. Dr. Cohen and his facility are state certified to perform both IV and Oral Sedation procedures. Botox® and Dermal Fillers are also utilized to enhance patients’ cosmetic outcomes.
Dr. Cohen formerly served on the Board of Trustees for the American Academy of Periodontology and the Florida Dental Association. He is past president of the Florida Association of Periodontists and the Atlantic Coast District Dental Association. Dr. Cohen is a member of the American College of Maxillofacial Implantology and the American Academy of Facial Esthetics. In addition, he has been awarded Fellowship in the American College of Dentists, International College of Dentists and the Pierre Fauchard Academy.
Palm Beach Center for Periodontics & Implant Dentistry