Periodontal disease may start in the gums’ superficial layers, but it’s not likely to stay there. As the disease moves deeper it can wreak havoc on tooth roots and bone as well as gum tissue attachments. Teeth with multiple roots are in particular peril because of the “forks” called furcations that form where the roots separate from each other. Infected furcations can be very difficult to treat.

We primarily treat gum disease by removing its main source, a thin film of bacteria and food particles called dental plaque that builds up on teeth. To remove it we most often use special hand tools or ultrasonic equipment to vibrate it loose. As the plaque and tartar diminish, the infection begins to wane.

But we can’t be completely successful in stopping the disease if any lingering plaque deposits remain. This especially includes furcations where the infection can cause significant damage to the roots. Although cleaning furcations of plaque can be difficult, it’s not impossible with the aforementioned tools and antimicrobial substances to disinfect the area.

The real problem, though, is access—effectively getting to the furcations to treat them. We may need to perform a surgical procedure called flap surgery where we create a hinged flap in the gum tissue to move it aside and access the root area beneath. Afterward we replace the flap and suture the tissue back in place.

In some cases, the infection may have already caused significant damage to the tissue and underlying bone. We may therefore need to graft gum or bone tissues to these damaged areas to stimulate re-growth. We may also need to surgically reshape the gum attachments around a tooth to make it easier in the future to access and clean the area.

These additional treatments around furcations can be very involved and labor-intensive. That’s why the best outcomes occur if we’re able to start treatment in the early stages of an infection. So, if you notice red, swollen or bleeding gums contact your dentist as soon as possible. Treating gum disease as early as possible will help ensure your tooth roots won’t suffer extensive damage.

If you would like more information on treating gum disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “What are Furcations? Branching Tooth Roots can be Periodontal Nightmares.”

Periodontal (gum) disease causes more than simple gum swelling—this bacterial infection can harm and destroy your teeth’s supporting structures, including the bone. Its aggressiveness sometimes requires equally aggressive treatment.

Gum disease usually begins with dental plaque, a thin film of bacteria and food particles on tooth and gum surfaces. Without proper oral hygiene plaque builds up with large populations of bacteria that can trigger an infection.

The growth of this disease is often “silent,” meaning it may initially show no symptoms. If it does, it will normally be reddened, swollen and/or bleeding gums, and sometimes pain. A loose tooth is often a late sign the disease has severely damaged the gum ligaments and supporting bone, making tooth loss a distinct possibility.

If you’re diagnosed with gum disease, there is one primary treatment strategy—remove all detected plaque and calculus (tartar) from tooth and gum surfaces. This can take several sessions because as the gums begin responding to treatment and are less inflamed, more plaque and calculus may be discovered.

Plaque removal can involve various techniques depending on the depth of the infection within the gums. For surfaces above or just below the gum line, we often use a technique called scaling: manually removing plaque and calculus with specialized instruments called scalers. If the infection has progressed well below the gum line we may also use root planing, a technique for “shaving” plaque from root surfaces.

Once infection reaches these deeper levels it’s often difficult to access. Getting to it may require a surgical procedure known as flap surgery. We make incisions in the gums to form what looks like the flap of an envelope. By retracting this “flap” we can then access the root area of the tooth. After thoroughly cleansing the area of infection, we can do regenerative procedures to regain lost attachment. Then we suture the flap of gum tissue back into place.

Whatever its stage of development, it’s important to begin treatment of gum disease as soon as it’s detected. The earlier we can arrest its spread, the less likely we’ll need to employ these more invasive procedures. If you see any signs of gum disease as mentioned before, contact us as soon as possible for a full examination.

If you would like more information on preventing and treating gum disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Treating Difficult Areas of Periodontal Disease.”

Are bleeding gums something you should be concerned about? Dear Doctor magazine recently posed that question to Dr. Travis Stork, an emergency room physician and host of the syndicated TV show The Doctors. He answered with two questions of his own: “If you started bleeding from your eyeball, would you seek medical attention?” Needless to say, most everyone would. “So,” he asked, “why is it that when we bleed all the time when we floss that we think it’s no big deal?” As it turns out, that’s an excellent question — and one that’s often misunderstood.

First of all, let’s clarify what we mean by “bleeding all the time.” As many as 90 percent of people occasionally experience bleeding gums when they clean their teeth — particularly if they don’t do it often, or are just starting a flossing routine. But if your gums bleed regularly when you brush or floss, it almost certainly means there’s a problem. Many think bleeding gums is a sign they are brushing too hard; this is possible, but unlikely. It’s much more probable that irritated and bleeding gums are a sign of periodontal (gum) disease.

How common is this malady? According to the U.S. Centers for Disease Control, nearly half of all  Americans over age 30 have mild, moderate or severe gum disease — and that number increases to 70.1 percent for those over 65! Periodontal disease can occur when a bacteria-rich biofilm in the mouth (also called plaque) is allowed to build up on tooth and gum surfaces. Plaque causes the gums to become inflamed, as the immune system responds to the bacteria. Eventually, this can cause gum tissue to pull away from the teeth, forming bacteria-filled “pockets” under the gum surface. If left untreated, it can lead to more serious infection, and even tooth loss.

What should you do if your gums bleed regularly when brushing or flossing? The first step is to come in for a thorough examination. In combination with a regular oral exam (and possibly x-rays or other diagnostic tests), a simple (and painless) instrument called a periodontal probe can be used to determine how far any periodontal disease may have progressed. Armed with this information, we can determine the most effective way to fight the battle against gum disease.

Above all, don’t wait too long to come in for an exam! As Dr. Stork notes, bleeding gums are “a sign that things aren’t quite right.”  If you would like more information about bleeding gums, please contact us or schedule an appointment. You can read more in the Dear Doctor magazine article “Bleeding Gums.” You can read the entire interview with Dr. Travis Stork in Dear Doctor magazine.