Periodontics involves the diagnosis, treatment and prevention of gum disease by a general dentist or a periodontist. A periodontist is a dentist who has had additional years of specialized training in periodontics at a post-doctoral educational program and is certified as such.

Periodontal Disease is a bacterial infection of the gums, bone and ligaments that support the teeth and anchor them in the jaw. The bacteria are normal inhabitants of the mouth and form a film of dental plaque and calculus (tartar), which stick to the teeth. The bacteria produce poisonous toxins, which stimulate the immune response to fight the infection. If the disease process is not stopped, the supporting structures of the teeth will continue to be destroyed. This eventually leads to tooth loss.

Periodontal disease can occur at any age. Over half of all people over the age of 18 have some form of the disease. After age 35, over 75% of all people are affected. Unfortunately, the disease process is usually asymptomatic and painless. The disease can be easily detected during regular dental examinations. The most common type of periodontal disease are GINGIVITIS and PERIODONTITIS
 

HEALTHY GUMS AND BONE

PERIODONTITIS is classified as being Mild, Moderate or Severe, depending upon the amount of destruction to the gums, ligaments and bone that surround teeth. As the disease progresses, gums separate from the teeth and form gum pockets. These pockets get deeper as more underlying bone is destroyed. Gum pockets will collect increasing amounts of bacterial plaque and calculus (tartar) as the disease process worsens. Teeth will loosen as more bone is lost.
 

SEVERE PERIODONTITIS

CONTRIBUTING FACTORS TO PERIODONTAL DISEASE

The response of the gums and bone to dental plaque may be modified by one or more of the following factors.

	Poorly fitting dental restorations
	Smoking
	Crowded teeth, improper bite alignment
	Clenching or grinding of teeth
	Hormonal changes, including pregnancy, menstruation and menopause
	Diet
	Systemic diseases, including blood disorders and diabetes
	Medications, including calcium channel blockers and anti-convulsants

WARNING SIGNS OF PERIODONTAL DISEASE

	Bleeding gums
	Tenderness, swelling, red colour
	Abscess (pus oozing from the gums)
	Foul Odour
	Loose teeth
	Pain

TREATMENT OF PERIODONTAL DISEASE

The main goal of periodontal treatment is eradication of the disease process from the gums, ligaments and bones that surround the teeth, and restoration of health that can be predictably maintained in the future.
 

PHASE I

Scaling and root planning are performed by either the dentist or oral hygienist to clean the tooth structure and remove bacterial plaque and calculus deposits (the source of the infection) from the gum pockets. This may be the only treatment necessary in cases of gingivitis and very mild periodontitis.

PHASE II

In cases, which demonstrate deeper gum pockets and underlying bone loss, it becomes necessary to eliminate the diseased gum pockets and bony destruction with osseous (bone) surgery. The gum is "flapped" and retracted away from the teeth to expose the underlying roots and bone deformities. The bone is contoured to approximate a normal physiologic profile, and the gum is sutured back to place. When the gum heals, normal probing depth is re-established between the gum and tooth (ideally 1-3mm). The attainment of minimal probing depth facilitates easy removal of plaque by patients at home and by hygienists during professional cleaning.
 

MAINTENANCE