Periodontics is a field of dentistry that specializes in the prevention, diagnosis, and treatment of disorders that affect the teeth's supporting tissues, such as the gums, alveolar bone, and periodontal ligament. Periodontal infections can cause tooth loss, poor oral health, and even systemic health problems if they are not treated.

At Valencia Advanced Dentistry at Copperhill Smiles, we provide a variety of services to help you achieve and maintain a healthy, attractive smile. Our Santa Clarita periodontists use innovative diagnostic tools, tailored treatment plans, and compassionate care to restore and protect the health of your gums and supporting tissues.

Causes of Periodontitis

The following are the most common causes of periodontitis:

Plaque of Bacteria

The main cause of periodontitis is dental plaque, a complex biofilm of bacteria, saliva, and food particles. Plaque buildup on the gum line and tooth surfaces causes the gingiva to become inflamed, which in turn causes the release of pro-inflammatory cytokines, tissue deterioration, and subsequent periodontal loss of tissue.

Poor Oral Hygiene

Plaque buildup and periodontal disease are triggered by poor oral hygiene habits, such as infrequent brushing, inappropriate flossing, and neglecting interdental cleaning. Inflammation, bleeding gingiva, and periodontal disease are caused by bacterial pathogens that multiply when plaque and calculus are not removed from the tooth surfaces.

Use of Tobacco

One of the main risk factors for periodontitis is tobacco use, which includes both smoking and smokeless tobacco products. Numerous harmful substances found in tobacco smoke weaken the immune system, reduce blood flow to the gingiva, and intensify inflammation in the tissues of the periodontal cavity. Compared to non-smokers, smokers have a higher risk of developing severe periodontitis, experiencing a greater loss of attachment, and exhibiting a lower response to periodontal therapy.

Genetic Factors

Genetics influences an individual's immunity response, inflammatory profile, and sensitivity to bacterial colonization, all of which are important factors in periodontitis risk. Gene variations in immune response, cytokine generation, and tissue remodeling may raise the chance of periodontal disease development. A significant indication of infection vulnerability is a family history of periodontitis.

Systemic Health Conditions

Periodontitis is more common in people with certain systemic health conditions, including diabetes, cardiovascular disease, and immunodeficiency disorders. In particular, diabetes aggravates inflammation, interferes with immunological response, and impairs glucose metabolism, all of which promote the development of periodontal disease. Other risk factors for both periodontitis and cardiovascular disease include endothelial dysfunction and inflammation, indicating a reciprocal connection between both illnesses.

Hormonal Changes

Hormonal changes, including those that happen after menopause, pregnancy, or adolescence, might affect the inflammatory response and make a person more vulnerable to periodontitis. Hormonal fluctuations can affect the overall composition of the oral microbiota, weaken the immune system, and worsen gingival inflammation. As a result, there is a higher chance of periodontal disease developing during these times.

Medications

Anticonvulsants, immunosuppressants, and calcium channel blockers are a few drugs that may negatively impact periodontal health. These drugs increase the risk of developing periodontitis by altering the oral microbiome, causing xerostomia (dry mouth), and gingival overgrowth. Individuals who use drugs known to impact periodontal tissues need to be monitored carefully.

Periodontal Diseases and Conditions

From moderate gingivitis, which is characterized by gum inflammation, to severe periodontitis, which results in the devastation of surrounding tissues and bone, there are various types of periodontal disorders.

Gingivitis

The first and mildest stage of periodontal disease is called gingivitis, and it is usually caused by dental plaque buildup along the gum line. When brushing or flossing, plaque—a sticky film made of bacteria, food particles, and saliva—can irritate the gums and cause swelling, redness, and bleeding. Although gingivitis can not cause permanent harm to the tooth-supporting tissues, if gingivitis is not treated, it can lead to more serious cases of periodontal disease.

Chronic Periodontitis

The most prevalent type of periodontal disease, known as chronic periodontitis, is defined by the gradual deterioration of the bone and periodontal tissues surrounding the teeth. It is brought on by extended contact with bacterial plaque and can be caused by several factors, including smoking, poor oral hygiene, genetics, systemic health issues, and lifestyle choices. The signs of chronic periodontitis are gum recession, pocket formation (the spaces between the teeth and gums), tooth mobility, and eventual tooth loss if not treated.

Aggressive Periodontitis

A relatively rare but more severe form of periodontal disease called aggressive periodontitis is distinguished by a rapid loss of bone and tissue. It usually affects younger people and could be linked to certain strains of bacteria or genetic predispositions. Prompt and intensive therapy is necessary to stop further damage from occurring in cases of advanced periodontitis, which can result in severe tooth loss..

Periodontal Abscess

An infection of the periodontal pocket can be the cause of a localized collection of pus within the periodontal tissues known as a periodontal abscess. Severe pain, swelling, redness, and pus discharge from the gums are common indications and symptoms. Periodontal abscesses need to be treated immediately to relieve symptoms, drain the abscess, and stop the infection from spreading.

Necrotizing Periodontal Diseases

A category of severe inflammatory illnesses known as necrotizing periodontal diseases is characterized by gum ulcers and tissue necrosis (death). Systemic factors like immunosuppression, hunger, stress, and poor dental hygiene are frequently linked to these disorders. The signs of necrotizing periodontal diseases can include intense pain, bad breath, bleeding gums on their own, and gum ulcers.

Diagnosis and Assessment in Periodontics

Periodontal diagnosis includes:

Clinical Examination

The periodontist can assess the general health of the periodontium and spot disease indicators through clinical examination. During the examination, the periodontist evaluates several factors, such as:

  • Gingival Appearance — Inflammatory indicators, such as redness, swelling, and bleeding when prodded, are examined for in the gingiva's color, shape, and consistency.
  • Periodontal Pocket Depth — To evaluate the level of attachment loss and establish the severity of periodontal disease, the periodontal pockets' depth is measured using a periodontal probe.
  • Attachment Level — The amount of attachment loss and degree of periodontal damage are assessed by measuring the distance between the base of the periodontal pocket and the cementoenamel junction (CEJ).
  • Tooth Mobility — The degree of periodontal support and the likelihood of tooth loss are assessed based on the mobility of the teeth.
  • Furcation Involvement — To gauge the extent of periodontal disease, furcation defects—a sign of bone loss between the roots of teeth that have several roots—are evident.

Assessing additional variables like tooth morphology, occlusal connections, accumulation of plaque and calculus, and the presence of dental restorations or prostheses may also be part of the clinical examination.

Radiographic Imaging

In addition to detecting indications of bone loss that are not visible through clinical examination alone, radiographic imaging offers significant details about the underlying architecture of the bones. In periodontics, radiography methods that are frequently employed include:

  • Periapical Radiographs — A periodontist can evaluate the existence and degree of bone loss, furcation involvement, and periapical pathology using periapical radiographs, which offer precise images of individual teeth and their supporting structures.
  • Bitewing Radiography — Bitewing radiographs help assess the levels of interproximal bone and identify early indications of periodontal disease, such as calculus deposits and horizontal bone loss.
  • Panoramic radiographs — Offering a comprehensive view of the complete dentition and surrounding structures, panoramic radiographs make it easier to evaluate the global architecture of bone, the location of teeth, and the presence of pathology.
  • Cone Beam Computed Tomography (CBCT) — In complex situations, CBCT imaging provides a complete evaluation of the bone morphology, furcation defects, root anatomy, and the level of bone loss. It does this by providing a three-dimensional picture of the periodontium.

The results of the clinical examination and radiography are combined to provide a thorough picture of the patient's periodontal condition and to inform treatment decisions.

Measurements of Periodontal Disease

Periodontal measures track the disease's evolution over time and provide an accurate assessment of the disease's severity. Typical periodontal measures consist of:

  • Probing Depth — Measured with a periodontal probe, probing depth reveals the depth of the periodontal pockets, which reflects the degree of periodontal disease severity and attachment loss.
  • Clinical Attachment Level (CAL) — CAL measures the separation between the base of the periodontal pocket and the CEJ, allowing for a more precise evaluation of periodontal disease and attachment loss.
  • Gingival Recession — The amount of gingival recession and the related aesthetic issues are indicated by measuring the apical displacement of the gingival margin from the CEJ.
  • Bleeding on Probing (BOP) — BOP evaluations reveal whether bleeding occurs from the periodontal pockets or gingival sulcus when gentle probing is done. This is a sign of active inflammation and disease activity.

To track treatment results, evaluate the course of the illness, and modify treatment plans as necessary, periodontal measurements are performed both at baseline and at subsequent follow-up appointments.

Non-Surgical Periodontal Treatment Process

One of the effective and least intrusive methods for treating periodontal disorders and maintaining dental health is non-surgical periodontal therapy. The procedure consists of:

Comprehensive Periodontal Evaluation

A thorough periodontal evaluation is the first step in the non-surgical periodontal therapy procedure. During this evaluation, the periodontist determines the patient's oral health state and the degree and type of periodontal disease. To identify evidence of bone loss and other pathology, this evaluation includes a detailed examination of the gingival tissues, measurement of periodontal pocket depths, assessment of attachment levels, and analysis of radiographic images

Removal of Bacterial Plaque and Calculus

Scaling is the process of removing calculus and bacterial plaque from the surfaces of teeth and roots. It is done with the use of specialized tools including hand and ultrasonic scalers. Using these instruments, plaque and calculus deposits are carefully removed from both above and below the gum line. Bacterial infections and toxins are removed by reaching into the periodontal pockets.

Root Planing

After scaling, root planing is done to clean the teeth's root surfaces and get rid of any leftover calculus, plaque, and contaminated cementum. Root planing facilitates the formation of a hygienic and biocompatible surface that promotes gingival tissue reattachment and periodontal healing. In addition to preventing bacterial colonization and assisting in the removal of bacterial endotoxins, this procedure lowers the likelihood of inflammation and disease recurrence..

Antimicrobial Therapy

To improve therapy results, antimicrobial therapy may occasionally be used for non-surgical periodontal treatment. Antimicrobials can be used locally or as a mouthwash containing chlorhexidine to lower the bacterial load, stop the growth of microorganisms, and encourage the repair of periodontal tissues. In cases of aggressive periodontitis or resistant periodontal disease, these medications can be particularly helpful in suppressing periodontal bacteria and preventing reinfection.

Common Surgical Periodontal Procedures

The following are common surgical treatments for periodontitis:

Flap Surgery

A common surgical technique used to access and clear deep periodontal pockets, remove diseased tissue, and enable complete root debridement is flap surgery, sometimes referred to as pocket reduction surgery. To expose the surrounding bone and tooth roots beneath, the periodontist makes a flap of gingival tissue during the surgery. After that, the root surfaces are carefully cleaned, and any imperfections are smoothed to encourage the gingival tissues to rejoin. After that, the flap is moved and sutured back into place, giving the patient a more hygienic and accessible environment.

Soft Tissue Grafting

Soft tissue grafting techniques are used to restore periodontal health, improve aesthetics, and augment missing or receding gingival tissues. Common soft tissue graft varieties consist of:

  • Connective tissue grafts — To cover exposed root surfaces and increase the volume of the associated gingiva, a tiny piece of tissue is taken from the palate or another donor site and transplanted to the recipient site.
  • Free gingival grafts — To broaden the connected gingiva and strengthen its resistance to recession and mechanical damage, a thin layer of epithelial tissue and the connective tissue underneath are transplanted.
  • Pedicle grafts — Pedicle grafts cover exposed root surfaces and thicken the gingival tissue by using close gingival tissue. The tissue flap keeps its blood supply from the surrounding area while being rotated or advanced to its intended site.

Guided Tissue Regeneration (GTR)

A regenerative surgical approach called guided tissue regeneration promotes the regeneration of missing periodontal tissues, such as bone, cementum, and periodontal ligament. In GTR, a barrier membrane is positioned between the soft tissues and the defect site to stop epithelial growth and promote bone-forming and periodontal ligament cell repopulation. This method improves periodontal health and function by promoting the growth of new attachments and the regeneration of periodontal tissues.

Bone Grafting

To restore function and aesthetics in areas of bone loss, or to supplement insufficient alveolar bone and provide sufficient support for dental implants, bone grafting operations are utilized. Common bone transplant forms are:

  • Autogenous bone grafts — In autogenous bone grafts, the patient's bone is obtained, usually from intraoral donor areas like the tuberosity, chin, or ramus. To encourage bone growth and improve osseointegration, the extracted bone is subsequently positioned at the recipient site.
  • Allografts and xenografts —These are materials used for bone grafting that come from either human or animal sources. To eliminate immunogenic components and encourage bone regeneration at the recipient position, these graft materials undergo processing and sterilization.
  • Synthetic bone grafts — Made of biocompatible materials like calcium phosphate or hydroxyapatite, synthetic bone graft materials are intended to replicate the characteristics of natural bone. During the healing process, these graft components act as a scaffold to assist new bone growth and offer structural support.

At-Home Dental Care Practices to Minimize Periodontitis

To avoid and minimize periodontitis, a serious gum infection that destroys the bone supporting your teeth and affects soft tissue, you must practice good dental hygiene at home. To reduce periodontitis, try these at-home oral hygiene techniques:

Brushing Twice Daily

You ought to brush your teeth thoroughly twice a day—in the morning and right before bed—using fluoride toothpaste and a soft-bristled toothbrush. Brushing lowers your risk of gum disease by removing food particles, bacteria, and plaque from the surfaces of your teeth and the gum line. Make sure to clean all tooth surfaces thoroughly by using gentle brushing motions in circular motions.

Flossing Daily

Flossing is a crucial component of dental hygiene because it can help get rid of food particles and plaque that your toothbrush cannot reach in the spaces between your teeth and beneath the gum line. Use dental floss or interdental cleaners to completely clean the spaces between each tooth by flossing at least once a day. The accumulation of plaque and tartar, which can cause gum inflammation and periodontitis, can be avoided with proper flossing.

Using an Antimicrobial Mouthwash

Use an antimicrobial mouthwash as part of your daily oral hygiene regimen to help lessen plaque and bacteria. After brushing and flossing, rinse with mouthwash for 30 seconds to get to any spots that could be challenging to clean with a toothbrush or floss. When choosing mouthwash, look for components that are good in fighting gum disease, like essential oils or chlorhexidine.

Maintaining a Balanced Diet

Consume a well-balanced diet rich in fruits, vegetables, lean proteins, and whole grains to improve overall dental health and lower the risk of periodontitis. Eat fewer sweet and acidic foods and drinks because they can worsen tooth decay and plaque accumulation. Keeping your mouth hydrated, flushing away food particles and bacteria, and drinking lots of water throughout the day helps maintain a clean and healthy mouth.

Avoiding Tobacco Products

Smoking and consuming tobacco products are high-risk factors for gum disease and periodontitis. Smoking lowers blood flow to your gums, impairs your immune system, and raises your risk of gum infections. You can lower your chance of developing periodontal disease and greatly improve your oral health by quitting smoking and using tobacco products.

Find a Periodontist Near Me

If you suspect you have periodontitis or are experiencing gum disease symptoms, you need to act quickly to treat the problem and protect your gum and teeth from additional harm. Valencia Advanced Dentistry at Copperhill Smiles provides a variety of modern diagnostic technologies, including digital X-rays, to precisely diagnose your periodontal health and provide personalized treatment programs based on your specific needs. Our experienced Santa Clarita dentists and periodontists are dedicated to delivering comprehensive periodontal care to individuals of all ages. Contact us at 661-775-7717 today.