Periodontics (Gum Therapy) treats bad breath, swollen and/or bleeding gums and a bad taste in the mouth that is caused by bacterial infection. A Periodontist is the dental specialist who typically treats gum disease. General dentists are legally allowed to perform all types of gum treatment. We prefer that our Periodontist treat the majority of gum disease and bad breath problems in our Gum Disease Treatment office.
Many patients are mistaken in their belief that dental cleanings are trivial and high volume managed care insurance offices are sufficient for this kind of work. The truth is the skills of individual hygienists vary as greatly as those of dentists and high volume offices will typically schedule patients in 15 – 30 minute time slots whereas premium practices will typically schedule patients for one hour. (Who has time to sterilize the room between patients??) If bacteria is left behind after a poorly performed cleaning then the ravages of tooth decay and gum disease may progress unnoticed by the naked eye. Patients may only begin to notice years after the damage has occurred. A Periodontist should be available to diagnose these problems early especially since most dentists fail to diagnose gum disease.
A combination of early gum disease diagnosis, early preventive therapy and bacterial cultures with species-specific antibiotic regimens should dramatically reduce the need for gum surgery in a premium, conservative periodontal practice. Our practice sends cultures to the Oral Microbiology Testing Lab at Temple University School of Dentistry. Our office is relatively rare in providing this service but the reader will agree after a review of the literature on the National Institute of Health’s U.S. Government website (www.NIH.gov). The results we obtain are quite significant.
If a patient still needs gum surgery then all the initial preventive care described above should dramatically reduce the amount of teeth involved.
There has been a lot of recent press regarding the relationship between periodontal and cardiovascular (heart) and other diseases. There is a lot of truth to this and is one reason why we have been obtaining periodontal bacterial cultures of our patients for 23 years. It is logical that the presence of chronic bacterial infection anywhere in your body is unhealthy; why leave it in your mouth? Again, refer to the NIH website to review ‘periodontal and cardiovascular disease’ for an unbiased, scientific opinion. Most patients in our office who demonstrate significant periodontal infection are referred to an internist and cardiologist for examination.
Mouthwashes
We offer thorough check-ups and analysis of the bacteria in your saliva for determining decay and periodontal risk.
Tooth decay and gum disease is caused by specific species of bacteria. These bacteria can be detected in your saliva through microscopic and DNA analyses. We can also test these bacteria for antibiotic resistance so that if antibiotics are appropriate for your therapy we can pick the most effective one and minimize your dosage.
Preventive dentistry is based upon sound diagnosis.
The species of bacteria that cause cavities and gum disease are different. Mechanical cleaning of your teeth with regular dental cleanings, flossing and brushing will help get rid of all the species of bacteria. Chemotherapy with mouthwashes, however, is specific to the species of bacteria we want to primarily eliminate. There are two types of mouthwashes: 1) those that are directed towards eliminating the bacteria associated with cavities and 2) those that are directed towards eliminating the bacteria associated with gum disease. These mouthwashes should be used twice a day, everyday, after flossing and brushing.
Any over the counter mouthwash with Fluoride is effective in reducing cavities. Some brand names include Act or Fluorigard but generic Fluoride mouthwashes will work as well. We typically recommend Fluoride mouthwashes for children under age 18 and adults who are experiencing a lot of new cavities.
There are only two mouthwashes, however, which have been scientifically proven to reduce the bacteria associated with gum disease: Peridex and Listerine. Peridex is an expensive ($18/bottle) prescription mouthwash that is significantly more effective than Listerine but has side effects, most notably tooth stains develop which can be removed by dental cleanings. We recommend Peridex for patients who have more advanced gum problems. Listerine (or Listerine Mint Flavor, or generic equivalents of Listerine) is the only other mouthwash on the market which is effective in fighting gum disease and is the product we recommend for most adults who are not experiencing a lot of new cavities. Other mouthwashes, e.g. Plax, Scope or generics, have not been shown to be clinically effective.