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How is periodontal disease (gum disease) treated?

Gum disease in diabetics should be aggressively treated because of the risk of early tooth loss. Brushing teeth at least twice daily and daily flossing is the cornerstone of management.

Dental professionals are trained to remove plaque and tartar build-up that the individual cannot accomplish by regular flossing and brushing. The procedure used to remove tartar above a gumline is called scaling and root planing. In the advanced stages of gum disease, dentists may choose to prescribe medications to decrease the amount of bone loss, especially in those with diabetes. Dentists can of course remove teeth that have deteriorated because of gum disease and present you with options for replacement.

Anti-bacterial toothpastes and mouthwashes can also help treat and prevent gum disease. Ask your dentist which toothpaste and mouthwash to use.

Some studies report that people with diabetes who maintain an effective level of plaque control and periodontal health have better blood sugar control. Regular visits to the dentist/hygienist will make a big difference in preventing and treating gum disease and its unwanted effects. Prophylactic antibiotics may be needed in patients with diabetes who require oral surgery.

Regular cleanings at your dentist's office and daily brushing and flossing can help treat early gum disease (gingivitis).

More severe gum disease may require:

  • Deep cleaning below the gum line.
  • Prescription mouth rinse or medicine.
  • Procedures to remove tartar deep under the gums.
  • Surgery to help heal bone or gums lost to periodontitis. Your dentist may use small bits of bone to fill places where bone has been lost, or your dentist may move tissue from one place in your mouth to cover exposed tooth roots.

If you smoke or use spit tobacco, quitting will help your gums heal after treatment.

Periodontal disease is an infection that affects the tissues and bone that support the teeth. Healthy gum tissue fits like a cuff around each tooth. When someone has periodontal disease, the gum tissue pulls away from the tooth. As the disease worsens, the tissue and bone that support the tooth are destroyed. Over time, teeth may loosen or need to be removed. Treating periodontal disease in the early stages can help prevent tooth loss.

It can be hard to know if you have periodontal disease since it often develops with no obvious symptoms. That's why good oral hygiene, regular dental checkups and periodontal exams are so important.

Periodontal disease is a serious infectious disease, which can lead to tooth loss if left untreated. Our goal is to achieve periodontal health in the least invasive and most cost-effective way.

The first line of treatment is non-surgical, through scaling and root planing, followed by adjunctive therapies, such as lasers, anti-microbial agent such as antibiotics and rinses and systemic medications to decrease the inflammatory process. Most patients do not require further treatment. However, if the disease persists, then surgical treatment is recommended, called pocket reduction surgery and regenerative (bone grafting) procedures.

For more information on the treatment of periodontal disease, visit the American Academy of Periodontology: http://www.perio.org/consumer/gum-disease.htm

Carol Jahn
Dentist

Treatment for periodontal disease varies by how severe it is. For people with some mild to moderate bone loss, a deep cleaning of teeth with local anesthesia by a dental hygienist maybe all that is required. For those with a more severe case, gum surgery by a periodontist may be necessary. In either case, follow-up care is imperative to keep the disease arrested. Meticulous daily care needs to include cleaning between teeth in addition to tooth brushing. Bone loss around the teeth make flossing less effective. Interproximal brushes or a water flosser is a better choice. As well, professional cleanings 3 to 4 times yearly are often necessary.

Periodontal disease can be treated by a dentist or a periodontist. Removal of plaque and calculus (tartar) and good oral hygiene practices of brushing and flossing the teeth are the goals of initial treatment. The teeth and the gums may need to be numbed so that the calculus can be removed from the teeth and roots of teeth. This procedure is called scaling and root planing. Many times, this procedure along with good oral hygiene at home is all that needs to be done. Advanced cases may require surgery or extraction of teeth. Your dentist can best advise you as what treatments would be best to treat your periodontal disease.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.