The professional cleaning consists of removing all bacterial deposits around the teeth and polishing the teeth. Depending on the progress of the periodontitis and the improvement of the gums, we can give you further instructions and perform additional cleaning during subsequent visits. The next step will be to remove all bacterial deposits and tartar lodged in the depth of the gum pockets, anchored to the surface of the roots

The professional cleaning consists of removing all bacterial deposits around the teeth and polishing the teeth. Depending on the progress of the periodontitis and the improvement of the gums, we can give you further instructions and perform additional cleaning during subsequent visits. The next step will be to remove all bacterial deposits and tartar lodged in the depth of the gum pockets, anchored to the surface of the roots

Antibiotics are sometimes prescribed to treat active or persistent gum infections that have not responded to oral hygiene measures.

A few weeks after the initial treatment, your periodontologist will do a complete evaluation of your gums to check the results of this first phase. He or she will use a special instrument, called a periodontal probe, to record the depth of the periodontal pockets and check for bleeding gums. If periodontal pockets are still present, he or she may suggest other treatment options, including surgical corrective therapy.

Sometimes a surgical procedure is necessary to remove plaque bacteria and deposits from under the gum, deep in the periodontal pockets and on the root surfaces. Since these areas are inaccessible to brushes and floss, inflammation will persist as long as bacteria can colonize them. Under local anesthesia, the gum is removed and the root surfaces are cleaned under direct vision to ensure that all bacteria are removed. Sometimes bone loss can be treated at the same time with a special regenerative treatment. At the end of the procedure, the gum is sutured back around the teeth.

The long-term success of periodontal treatment depends on both your oral hygiene efforts and the work of the office team in providing care and evaluating you periodically. Once the first phase of treatment is complete, your dentist will need to examine the condition of your gums at regular intervals to ensure that the inflammation has been stopped. The frequency of your follow-up appointments will depend on the severity of the disease and your individual risk of disease progression. In general, follow-up visits are scheduled every 3 to 6 months.
It is important to have regular follow-up appointments to ensure that the disease process does not start again, leading to further destruction of the gums and supporting bone. If there are early signs of the disease, your dentist will be able to identify and treat them at an early stage. He or she will also give you advice on how to change your oral hygiene practices to fight inflammation.

If you have high blood pressure, you should be aware of the effects that certain prescribed medications can have on the health of your gums. Knowing this can help you take steps to protect yourself from gum problems and tooth loss.

Although blood pressure medications may be responsible for changes in the size and shape of the gums, the presence of plaque around the teeth remains the most important cause of periodontitis, as the inflammatory changes are triggered by periodontal bacteria. In addition, gum overgrowth tends to be worse in sites where bacteria accumulate easily and usually begins between the teeth. This creates a vicious cycle, as the overgrown areas then become even more difficult to clean due to the extra gum tissue. Effective plaque removal is therefore the key to limiting excessive gum growth and preventing inflammation, tissue destruction and tooth loss.

Diabetes mellitus – a condition in which the body is unable to properly control its sugar levels – is an increasingly common disease in Western countries, affecting at least 5% of the population. This is an approximation, as it is estimated that only about half of the people with diabetes have been diagnosed. Overall, 80% of known diabetics are over the age of 40, with only 0.05% under the age of 15.
Dentists now know that untreated periodontal disease in diabetic patients progresses very rapidly, often resulting in early tooth loss. In addition, wound healing following tooth extractions is often very slow and ineffective in these individuals. Other problems that may be encountered are abscesses (painful infections), gingivitis with ulcers or sores, and cracks or fissures in the corners of the mouth. In addition, anti-diabetic medications can also cause the patient to have a very dry mouth, which increases the risk of tooth decay.
Patients with type 1 (primary, insulin-dependent) diabetes and patients with the more common type 2 (non-insulin-dependent) diabetes all have three times the risk of periodontitis than people without diabetes. These individuals are also at greater risk of suffering bone loss and experiencing an active and rapid form of the disease. In addition, the presence of unrecognized or untreated periodontitis increases the likelihood that their diabetes will be poorly controlled. Therefore, treating periodontal disease in diabetic patients is crucial, not only to preserve the teeth, but also to help prevent the potential complications of uncontrolled diabetes.
It is important – and encouraging – to realize that a patient with well-controlled diabetes has no greater risk of periodontal disease than a person without diabetes. Therefore, in patients with diabetes, it is essential to ensure that blood sugar levels are well controlled when dealing with periodontal disease, because the better controlled the diabetes, the more effective the periodontal treatment will be.

Before proceeding with an organ transplant, the mouth must be free of periodontal disease and tooth decay. Therefore, it is important to have your dentist examine you prior to surgery so that decisions can be made regarding any necessary treatment in conjunction with your transplant specialist.
After the transplant procedure, you will need to take long-term immunosuppressive therapy to prevent rejection of the organ, which will put you at increased risk for periodontal disease. One of the most commonly used immunosuppressive drugs is cyclosporine A. Blood pressure lowering drugs, such as calcium antagonists, are also often prescribed to transplant patients. In many people, these drugs cause thickening of the gums after a few months of treatment, called gingival hyperplasia, which is more likely to occur if inflammation is already present in the gums. Gingival hyperplasia develops mainly between the teeth as small swellings, but it can also develop into a more generalized bulging of the gums. The invaded gums partially cover the teeth and make it very difficult to remove plaque, which leads to the onset of inflammation.

Using phenytoin for epilepsy
If you need to take phenytoin to control your epilepsy, read on to learn how your medication may put you at risk for periodontal disease and what you can do about it.
Phenytoin is an anticonvulsant drug, which is sometimes used to treat epilepsy. In some people, it causes overgrowth of the gums, making it very difficult to clean the teeth. As a result, bacterial plaque builds up and causes inflammatory changes in the gums that lead to gingivitis and, potentially, periodontitis. Gum enlargement is more likely to occur if the patient has poor oral hygiene or if inflammatory changes are already present in the gums at the beginning of treatment.