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What is Periodontal (Gum) Disease?

The term “periodontal”means “around the tooth.”  Periodontal disease (also known as periodontitis and gum disease) is a common inflammatory condition which affects the supporting and surrounding soft tissues of the tooth; also the jawbone itself when in its most advanced stages.

Periodontal disease is most often preceded by gingivitis which is a bacterial infection of the gum tissue.  A bacterial infection affects the gums when the toxins contained in plaque begin to irritate and inflame the gum tissues.  Once this bacterial infection colonizes in the gum pockets between the teeth, it becomes much more difficult to remove and treat.  Periodontal disease is a progressive condition that eventually leads to the destruction of the connective tissue and jawbone.  If left untreated, it can lead to shifting teeth, loose teeth and eventually tooth loss.

Periodontal disease is the leading cause of tooth loss among adults in the developed world and should always be promptly treated.

Types of Periodontal Disease

When left untreated, gingivitis (mild gum inflammation) can spread to below the gum line.  When the gums become irritated by the toxins contained in plaque, a chronic inflammatory response causes the body to break down and destroy its own bone and soft tissue.  There may be little or no symptoms as periodontal disease causes the teeth to separate from the infected gum tissue.  Deepening pockets between the gums and teeth are generally indicative that soft tissue and bone is being destroyed by periodontal disease.

Here are some of the most common types of periodontal disease:

  • Chronic periodontitis – Inflammation within supporting tissues cause deep pockets and gum recession.  It may appear the teeth are lengthening, but in actuality, the gums (gingiva) are receding.  This is the most common form of periodontal disease and is characterized by progressive loss of attachment, interspersed with periods of rapid progression.

  • Aggressive periodontitis – This form of gum disease occurs in an otherwise clinically healthy individual.  It is characterized by rapid loss of gum attachment, chronic bone destruction and familial aggregation.

  • Necrotizing periodontitis – This form of periodontal disease most often occurs in individuals suffering from systemic conditions such as HIV, immunosuppression and malnutrition.  Necrosis (tissue death) occurs in the periodontal ligament, alveolar bone and gingival tissues.

  • Periodontitis caused by systemic disease – This form of gum disease often begins at an early age.  Medical condition such as respiratory disease, diabetes and heart disease are common cofactors.

Treatment for Periodontal Disease

There are many surgical and nonsurgical treatments the periodontist may choose to perform, depending upon the exact condition of the teeth, gums and jawbone.  A complete periodontal exam of the mouth will be done before any treatment is performed or recommended.

Here are some of the more common treatments for periodontal disease:

  • Scaling and root planing – In order to preserve the health of the gum tissue, the bacteria and calculus (tartar) which initially caused the infection, must be removed.  The gum pockets will be cleaned and treated with antibiotics as necessary to help alleviate the infection.  A prescription mouthwash may be incorporated into daily cleaning routines.

  • Tissue regeneration – When the bone and gum tissues have been destroyed, regrowth can be actively encouraged using grafting procedures.  A membrane may be inserted into the affected areas to assist in the regeneration process.

  • Pocket elimination surgery – Pocket elimination surgery (also known as flap surgery) is a surgical treatment which can be performed to reduce the pocket size between the teeth and gums.  Surgery on the jawbone is another option which serves to eliminate indentations in the bone which foster the colonization of bacteria.

  • Dental implants – When teeth have been lost due to periodontal disease, the aesthetics and functionality of the mouth can be restored by implanting prosthetic teeth into the jawbone.  Tissue regeneration procedures may be required prior to the placement of a dental implant in order to strengthen the bone.

Ask your dentist if you have questions or concerns about periodontal disease, periodontal treatment, or dental implants.

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Dear Dr. Muduli ,

I want to take this opportunity to thank you for the excellent care and attention given to me during my office visit. I really appreciate your kind consideration and review of my medical condition. The time taken to explain to me the various options and your expert opinion is greatly appreciated. You have demonstrated to me your wisdom and knowledge of the profession. Once again, thanks for helping me and giving me high quality care and attention.

Peter

Dear Dr. Muduli,
I will write to you with warm and sincere thanks for extracting my wisdom teeth. I must say that you exemplify a superior level of professionalism, proficiency and confidence when you work. I was initially very apprehensive at the start of the procedure. However you and your staff were able to relax and provide me reassurance. You performed outstandingly and for that I am very grateful.
Please know that I will proudly recommend you to anyone that I should encounter who may require your services. You exhibit truly iconic poise and are a model to be replicated. Despite this, I do sincerely hope I never have to see you again. Once more, my deepest thanks and best regards.

Christopher

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“The quintessential professional in his field; Dr. Muduli's attention to detail, his superior skill, and unparalleled bedside manner make him a rare find in a competitive and sometimes confusing arena of Oral & Maxillofacial Surgery. My first experience with his professionalism and skill was when Dr. Muduli's comforting and professional approach put my son at ease while treating him for a difficult procedure to remove significantly impacted wisdom teeth. At the time his practice was local to me. The results were excellent. I was so pleased with how he cared for my son that when I needed extensive maxillofacial treatment I made the trip to his new office 23 miles from my home. A worthwhile trip I would readily do again. Bobby is a health professional I trust with my children and will gladly go out of my way in terms of travel for his services. I highly recommend him.” November 8, 2011

Francis

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