Periodontal Examination

During your checkup, Dr. Berdy will examine your mouth to assess the overall health and stability of your teeth, gums, and surrounding areas including the muscles supporting your teeth, jaw joints, and tongue. He will review your current x-rays and then present his findings to you. A screening for oral cancer can also be performed at this time.

When examining your mouth an instrument called a periodontal probe is used to assess the health and quality of your gums and tooth attachments. The periodontal probe is used to measure the pocket depth, or collar of gum tissue that surrounds the tooth. Normal pocket depths are in the range of 1-3mm.

A microscope evaluation using a phase contrast microscope may be done. This enables us to determine the types of bone destroying bacteria that may be present and the extent of your infection to the surrounding areas. A sampling of the bacteria in the area of an infection may be sent off for further analysis to aid in our determination of an appropriate periodontal therapy. A DNA analysis may also be done to assess susceptibility to periodontal diseases.

Dental Implant Evaluation

Dr. Berdy will take a 3-D image and mold of your mouth to get a clear view of your bone structure, allowing him to determine the best way to replace your missing tooth or teeth. When you are missing a tooth or teeth, you have four replacement options:

• Implant supported crown
• Bridge
• Partial denture
• No replacement

Dental implants are artificial tooth roots that can be used in both the upper and lower jaws. Implants are usually made of titanium or zirconium, both of which are well accepted by the human body. Once implants have fused to bone, they can then be used to support a single tooth, multiple teeth, or dentures.

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ARESTIN® Gum Infection Treatment

Periodontal Disease is a serious infection under your gumline.

ARESTIN® (minocycline hydrochloride) is an antibiotic that kills the bacteria that cause the infection.

1. It’s placed directly in the infected areas—or “pockets”—in your gums.
2. It’s applied right after Scaling and Root Planing, the dental procedure that disrupts stubborn plaque and bacteria below your gumline—where brushing and flossing can’t reach.

ARESTIN® starts working quickly, right at the source of infection, and keeps fighting bacteria long after you leave the dental office.1,2
ARESTIN® fights infection and inflammation for 30 days,2 and provides significantly better results than SRP alone for up to 90 days.

Scaling & Root Planing (Deep Cleaning)

Typically, the first non-surgical step in the treatment of Periodontal Disease involves a special cleaning known as scaling and root planing (SRP), or a “deep cleaning.” When pocket depths are 3mm or more, scaling and root planing can be used to treat periodontal disease by removing plaque and tartar buildup found below the gum line. A specialized instrument called a small scaler or an ultrasonic cleaner is used to carefully remove plaque and tartar down to the bottom of each periodontal pocket. Finally, the tooth’s root surfaces are then smoothed or planed, helping gum tissue to heal while shrinking periodontal pockets. This procedure makes it more difficult for the accumulation of plaque along the root surfaces. To alleviate any potential discomfort, a local anesthetic may be given at the beginning of the procedure.

Depending on the extent of periodontal disease present, treatment by scaling and root planing may be recommended for one or more sections (quadrants) of your mouth. In combination with a deep cleaning, a localized antibiotic such as ARESTIN® may be used to help control infection and promote healing. Once scaling and root planing has been completed, a follow up appointment is usually scheduled several weeks later to examine your gums to see how they have healed and how the periodontal pockets have decreased. Often, many patients do not require further active treatment for periodontal disease and just need proper preventative care.

• Maintaining good oral hygiene at home and continued follow up maintenance cleanings are essential to help prevent periodontal disease from becoming more serious or recurring.
• Periodontitis does not go away by itself- prevention and treatment in early stages is crucial to keeping a healthy smile

Gum Disease Prevention

Proper home care is the key…

A good oral hygiene routine practiced for a few minutes twice a day can help reduce your risk of developing periodontal diseases and tooth decay. When choosing Dental Care products, look for those that display the American Dental Association’s Seal of Acceptance. The Seal of Acceptance is your assurance the product meets the ADA’s criteria for safety and effectiveness for its intended use.

• Brush your teeth twice a day with a fluoride toothpaste. With thorough brushing, you can remove plaque from the inner, outer, and chewing surfaces of each tooth. Dr. Berdy or your Dental Hygienist can show you a proper brushing technique if you have any questions.
• Clean between teeth once a day with dental floss or another interdental cleaner to remove plaque and debris from areas your toothbrush can’t reach. Rubber tip stimulators are also great tools to aid in cleaning your gums.
• If you need extra help controlling gingivitis and plaque that forms above the gum line, your dentist may recommend using an ADA-accepted antimicrobial mouthrinse or other oral hygiene aids as an effective addition to your daily oral hygiene routine.
• Eat a balanced diet for good general health and limit snacks.
• Visit your dentist regularly. Professional cleanings are the only way to remove tartar, which traps bacteria along the gum line.

Types of Periodontal Diseases

There are many types of Periodontal Diseases and they can affect individuals of all ages from children to seniors.

Gingivitisis is the mildest form of periodontal disease and causes the gums to become red, swollen, and bleed easily. There is little to no discomfort at this stage and it is reversible with professional treatment and good home oral care.

Chronic periodontitis results in inflammation within the supporting tissues of the teeth and progressive loss of tissue attachment and bone. Progression of attachment loss usually occurs slowly, but periods of rapid progression can occur. It is prevalent in adults, but can occur at any age and is the most frequently occurring form of periodontitis.

Aggressive periodontitis is a highly destructive form of periodontal disease that occurs in patients who are otherwise clinically healthy. This disease may occur in localized or generalized patterns and can include rapid loss of tissue attachment and destruction of bone.

Periodontitis as a manifestation of systemic diseases. This form of periodontitis is associated with one of several systemic diseases, such as diabetes. Patients who have rare but specified blood diseases or genetic disorders frequently show signs of periodontal diseases.

Necrotizing Periodontal Diseases are infections characterized by necrosis (death) of gingival tissues, periodontal ligament and alveolar bone. These lesions are most commonly associated with pain, bleeding, and a foul odor. Contributing factors can include emotional stress, tobacco use, and HIV infection.

What is periodontal disease?

Periodontal Diseases are chronic bacterial gum infections that affect the tissues and bone that support teeth and hold them in place.

Warning signs:

• Red, swollen, or tender gums
• Gums that bleed easily
• Persistent bad breath
• Loose or separating teeth
• A change in the way your teeth fit together when you bite

The word periodontal means “around the tooth” and healthy gum tissue fits like a cuff around each tooth. Where the gum line meets the tooth, it forms a slight v-shaped crevice known as a sulcus, the depth of which is typically around three millimeters or less in healthy teeth. However, as tissues become damaged due to periodontal disease, the sulcus develops into a pocket that is greater than three millimeters. A special probe is used to measure pocket depths during a Periodontal Examination. Enlarged pockets make it difficult to practice effective oral hygiene as they harbor and promote the growth of harmful bacteria. If these pockets are left untreated, periodontal diseases may eventually lead to tooth and bone loss.

What causes periodontal disease?

Countless bacteria fill the mouth and certain types produce toxins and enzymes that can irritate the gums and cause inflammation. As a result of this inflammation, which can sometimes be painless, damage can occur at the attachment of the gums and bone to the teeth. Plaque, the sticky, colorless film that constantly forms on the teeth and the surfaces lining the mouth, can harden into rough porous deposits called calculus, or tartar. By itself, tartar is not the main cause of periodontal disease, but the pores in tartar hold bacteria and harmful toxins, which are impossible to remove even with regular brushing and must be removed during a professional dental cleaning.

Are you at risk?

Several factors that increase the risk of periodontal disease:

• Smoking or chewing tobacco- Tobacco users are much more likely than nonusers to develop plaque and tartar on their teeth, have deeper pockets, and have greater loss of bone and tissue supporting teeth. Periodontal treatment is also less successful in patients who continue to smoke.
• Systemic diseases- Diabetes, blood cell disorders, HIV infections, and AIDS can lower the body’s natural ability to resist and fight infection, making periodontal diseases more severe
• Medications- Many drugs, such as steroids, oral contraceptives, or medications used to treat epilepsy, cancer, and blood pressure, can affect the gums or reduce saliva production. A lack of saliva can result in chronic dry mouth and cause gum irritation. Always advise your dentist of any medications you are currently taking and any changes in your health.
• Bridges that no longer fit properly, crooked, crowded teeth, or defective fillings may hold plaque in place and increase the risk of periodontal disease development.
• Hormone levels- Changes in hormone levels due to puberty, pregnancy, and oral contraceptives can cause increased sensitivity in gum tissue to toxins and enzymes and can accelerate growth of some bacteria.
• Genetics- Certain patients may be predisposed to a more aggressive, severe type of periodontitis due to genetics. A family history of tooth loss periodontal disease need to pay particular attention to the health of their gums.