Root Debridement

What is Periodontal Disease?

Periodontal disease (advanced gum disease) is a chronic inflammatory condition affecting the supporting structures of teeth, including gums, periodontal ligament, and alveolar bone.

It’s primarily caused by plaque accumulation that hardens into calculus (tartar) if not removed.

The disease progresses from gingivitis (gum inflammation) to periodontitis, which can lead to irreversible damage such as bone loss and tooth loss.

Symptoms of Periodontal Disease

Early Stage (Gingivitis):

Red, swollen, or tender gums
Bleeding during brushing or flossing
Persistent bad breath (halitosis)

Moderate to Advanced Stage (Periodontitis):

Receding gums or teeth appearing longer
Loose or shifting teeth
Pain while chewing
Pus between teeth and gums
Deep periodontal pockets
Bone loss

Causes of Periodontal Disease

The primary cause is poor oral hygiene, allowing plaque to accumulate. Other contributing factors include:

Lifestyle factors: Smoking, poor diet, stress
Systemic conditions: Diabetes, cardiovascular disease, autoimmune disorders
Hormonal changes: Pregnancy, puberty, menopause
Medications: Drugs reducing saliva flow (antihistamines, antidepressants)
Genetic predisposition: Family history

Diagnosis Methods

A dentist diagnoses periodontal disease through:

Clinical examination: Assessing gum health, measuring pocket depth, checking for bleeding
X-rays: Evaluating bone loss around teeth
Periodontal probing: Using a calibrated probe to measure periodontal pocket depth

Treatment Options

Treatment depends on severity:

Scaling and Polishing: For mild cases, removes plaque and calculus above and below gum line
Root Planing (Deep Cleaning): For moderate cases, smooths root surfaces to remove bacteria
Surgical Treatment: For severe cases, may include flap surgery, bone grafting, or guided tissue regeneration

Difference between scaling and root debridement

Scaling removes plaque and calculus from tooth surfaces.
Root debridement involves more thorough cleaning of root surfaces to remove bacterial toxins and infected tissue to promote healing and gum reattachment.

FAQs About Periodontal Disease

Can periodontal disease be prevented?

Yes, through:

Brushing twice daily with a soft-bristled toothbrush and fluoride toothpaste
Flossing daily to remove plaque between teeth
Regular dental check-ups every 6-12 months
Using antibacterial mouthwash to reduce bacteria
Avoiding smoking and managing conditions like diabetes

Is periodontal disease reversible?

Gingivitis is reversible with proper treatment and improved oral hygiene. However, periodontitis can only be managed to prevent further damage, as lost bone and tissue cannot fully regenerate.

How does periodontal disease affect overall health?

Periodontal disease is linked to:

Diabetes: Makes blood sugar control harder; diabetes increases infection risk
Cardiovascular disease: Bacteria can enter bloodstream, contributing to arterial plaque
Respiratory infections: Inhaling oral bacteria can lead to lung infections
Pregnancy complications: Associated with preterm birth and low birth weight

Is periodontal treatment painful?

Most treatments use local anesthesia to minimize discomfort. After treatment, patients may experience mild sensitivity, soreness, or swelling that typically subsides within days. Pain management medications can help.

Can I treat periodontal disease at home?

While good oral hygiene is essential, professional treatment is necessary for removing calculus from deep pockets. Home care alone cannot address advanced periodontal disease.

How long does periodontal treatment take?

Non-surgical treatments like scaling and root planing can be completed in 1-2 sessions.
Surgical treatments may require multiple visits.
Regular follow-ups are essential to monitor progress.

What happens if periodontal disease is left untreated?

Untreated disease can lead to:

Severe gum recession and bone loss
Tooth loosening and eventual tooth loss
Chronic pain and difficulty chewing
Increased risk of systemic health issues

Can smoking affect periodontal disease?

Yes, smoking is a major risk factor as it weakens the immune system, reduces blood flow to gums, impairs healing, and makes treatment less effective.

Are there non-surgical alternatives to periodontal surgery?

Yes, non-surgical treatments like scaling, root planing, and laser therapy can effectively manage mild to moderate periodontal disease. Advanced cases may still require surgery.

Can periodontal disease recur after treatment?

Yes, periodontal disease can recur if proper oral hygiene and regular dental visits are not maintained. Patients with a history of periodontal disease should be especially vigilant.

How does diabetes affect periodontal disease?

Diabetes increases risk by impairing blood flow, reducing the body’s ability to fight infections, and delaying healing. Conversely, periodontal disease can make it harder to control blood sugar levels.

Can periodontal disease cause tooth loss?

Yes, advanced periodontal disease can destroy the supporting structures of teeth, leading to tooth loosening and eventual loss.

What is the role of genetics in periodontal disease?

Genetics can influence susceptibility to periodontal disease. Certain genetic markers are associated with increased inflammation and higher risk of gum infections.

Can stress contribute to periodontal disease?

Yes, stress can weaken the immune system, increase inflammation, and reduce the body’s ability to fight infections. It may also lead to poor oral hygiene habits.