7. The Goals Of Periodontal Treatment In More Detail – Part 3

In topic # 7, the remain­ing goals of revers­ing the effects of past peri­odon­tal dis­ease as much as pos­si­ble and prepar­ing the mouth of other types of den­tal treat­ment includ­ing the team mem­bers’ roles in achiev­ing these goals will be discussed.

To reverse the effects of past peri­odon­tal dis­ease as much as pos­si­ble has sev­eral mean­ings. It means to remove the cause and con­tribut­ing risk fac­tors of peri­odon­tal dis­ease so that the body can heal itself as much as pos­si­ble, such as a bet­ter reat­tach­ment of the gums to the tooth roots and a decrease or elim­i­na­tion of inflam­ma­tion in the gums. It also means pre­vent­ing future gum and bone loss. In addi­tion it means, when pos­si­ble, to regen­er­ate lost bone and / or gum tissue.

It is the role of the den­tal team mem­bers to achieve this goal with the co-operation and com­pli­ance of the patient. This sup­port is needed from the patient to aid the den­tal team mem­bers. Exam­ples of sup­port include fol­low­ing instruc­tions given by the den­tal team mem­bers before or after a pro­ce­dure and chang­ing lifestyle habits as needed.

There are a vari­ety of den­tal treat­ment pro­ce­dures to accom­plish these goals. How­ever each pro­ce­dure has its indi­ca­tions, antic­i­pated results, aver­age dura­tion of results, lim­i­ta­tions, suc­cess rates and poten­tial risks or com­pli­ca­tions. There are no guar­an­tees; how­ever there are prob­a­bil­i­ties and risks, just like any other pro­ce­dures in den­tistry or med­i­cine. These pro­ce­dures will be dis­cussed in more detail in future articles.

Also there cases where the gum or bone loss is so advanced that treat­ment will not help or that treat­ment can only pro­long the life of the tooth in the mouth rather than assur­ing that the tooth will last the rest of the person’s life. It is best to avoid these sit­u­a­tions by detect­ing and treat­ing peri­odon­tal dis­ease or gin­givi­tis early. While not all areas of gin­givi­tis progress to peri­odon­tal dis­ease, many areas do and the risk of devel­op­ing future peri­odon­tal dis­ease increases when gin­givi­tis is present.

Another goal achieved by the den­tal team mem­bers is to pre­pare the mouth for other types of needed den­tal treat­ment so that the other types of den­tal treat­ment will last as long as pos­si­ble and will be of the high­est qual­ity pos­si­ble. Need­less to say, the co-operation and com­pli­ance of the patient is needed as well.

The gums and bone that sur­round the teeth are the sup­port and foun­da­tion of the teeth and any­thing placed on the teeth as well as the sup­port and foun­da­tion of implants and any­thing on implants that are used to replace lost teeth. Swollen inflamed bleed­ing gums with or with­out cal­cu­lus present has a neg­a­tive effect on many other types of den­tal treat­ment which no den­tist can overcome.

Some com­mon exam­ples of this neg­a­tive effect include the fol­low­ing. Bleed­ing from the gums affects the qual­ity and dura­tion of fill­ings, espe­cially white bonded fill­ings that end near the gum line. Bleed­ing from the gums affects the molds used to make crowns or bridges and often com­pro­mises the qual­ity and dura­tion of crowns or bridges on a long term basis. Bleed­ing from the gums makes bond­ing of ortho­don­tic bracket dif­fi­cult or not pos­si­ble or weak­ens the bond­ing so that the brack­ets come off pre­ma­turely. Too much bone loss around teeth may make the teeth not suit­able to sup­port bridges, there­fore elim­i­nat­ing one option to replace miss­ing teeth. Bleed­ing from the gums will com­pro­mise the results of cos­metic veneers on teeth.

In other words, the health­ier the gums and bone are around the teeth, the higher the prob­a­bil­ity that many types of den­tal treat­ment will be of higher qual­ity and last as long as pos­si­ble. Because of this fact, peri­odon­tal treat­ment, in many cases, must be done first or before many other types of den­tal treat­ment by the gen­eral den­tist or the periodontist.

In future top­ics, more aspects of gin­givi­tis, peri­odon­tal dis­ease or related top­ics will be discussed.