Friday, November 1, 2019

Re-Growing Lost Gum Tissue & Other Repair Techniques for Gum Loss



South Charlotte Dentistry sees many cases of periodontal disease, ranging from early mild stages to late severe stages, but mainly those moderate cases of gum degeneration. Our patients, alongside half of all American adults, are eager to find out about how or if they can re-grow lost gum tissue, or otherwise repair gum loss. South Charlotte Dentistry delivers the latest news on exciting findings in the dentistry field, and discusses gum repair techniques available to our patients to ensure that they have the best information available for advocating for a healthy, happy smile.

In March 2019, the American Chemical Society journal, Nano released an article titled, "New technique could help regrow tissue lost to periodontal disease." This report discussed exciting new findings where researchers have found that the development of a membrane can help periodontal tissue regenerate when implanted into the gums of rats.

What are the takeaways from this study?


Scientists have been trying to regrow lost gum tissue and bone from periodontal disease for ages. They tried implanting pieces of polymers (a small piece of mesh-like material) at the root of the tooth, in the aims of generating new gum and bone cells.

So what was the issue? A second surgery was required to remove the polymeric membrane that could get in the way of the healing process. When scientists developed more biodegradable membranes, they didn't work as well for re-growing that periodontal tissue.

The current study featured a new, nano-fibrous membrane of poly(ε-caprolactone), a biocompatible polymer. This was coated in polydopamine (PDA), which is a synthetic polymer with sticky consistency that can attach to wet surfaces. When this new membrane was implanted into the gums of rats with periodontal defects, bones at those defected sites regenerated to normal levels within weeks, and the membranes degraded. Researchers are now working to add more components to the membrane that further aid healing and prevent infection.
 

Why is this study so important?

We're not just nerding out at South Charlotte Dentistry, honest! As periodontal disease is associated with age, and Americans are living longer and keeping more of their natural teeth, more and more adults are suffering from the effects of the disease. This means that for our practice and for dental practices everywhere, periodontal disease will become a more prominent issue for the overall health of our population.

What is periodontal disease?

Periodontal, or gum disease, is an inflammatory condition of the gum and bone support (periodontal tissues) surrounding the teeth, in which the gums, ligaments, and bone become infected. This damages the soft tissue and the bone that supports your tooth. "Periodontitis" literally means "inflammation around the tooth."

On a scale of common to rare, where does periodontal disease fall?

Periodontal disease is very common. In fact, the US sees more than 3 million cases per year. According to the US Centers for Disease Control and Prevention, about half of all Americans will have periodontal disease during their lifetime.

A study titled "Prevalence of Periodontitis in Adults in the United States: 2009 and 2010" estimates that 64.7 million American adults (42.7% of the adult population, or one out of every two adults aged 30 and over) have mild to moderate or severe periodontitis. Of that 42.7 %, 30% have moderate periodontitis, with 8.7% being mild, and 8.5% severe. Among adults aged 65 years and older, the rates of periodontitis increase to 70.1%.

What is the main cause of periodontal disease?

Periodontal disease occurs when bacteria and plaque build-up around the tooth, and as a result, the immune system launches into action against it.

How do I know if I have periodontal disease, and how do dentists diagnose periodontal disease?

An annually comprehensive periodontal evaluation is the best way to identify the disease.
This happens once a year during one of your scheduled dental cleanings. A dental professional will examine each tooth above and below the gum line. You may not have realized this was happening beforehand, but the hygienist or dentist will use a periodontal probe (a tool with a ball end, a colored band at 3.5-5.5mm, and another colored band at 8.5-11.5mm) and call out a number between 0 and 4 for each tooth, measuring how deep the gum line is. This is the standard clinical examination of the periodontium or gums.

What are the symptoms of periodontal disease?

  • inflamed or swollen gums, and recurrent swelling in the gums
  • bright red, sometimes purple gums
  • pain when the gums are touched
  • receding gums, which make the teeth look longer
  • extra spaces appearing between the teeth
  • pus between the teeth and gums
  • bleeding when brushing teeth or flossing
  • a metallic taste in the mouth
  • halitosis, or bad breath
  • loose teeth

Who is at risk?

Those who have a more weakened immune system or partake in the following risk factors are more susceptible to periodontal disease:
  • Smokers
  • Females undergoing hormonal changes (i.e. from puberty, pregnancy, or menopause)
  • Diabetic people
  • People with AIDS
  • Cancer patients, or those undergoing cancer treatment
  • People medicated with drugs such as antihypertensive, vasodilating agents, or immunotherapy, that reduce saliva and increase chances of gum disease
  • People genetically predisposed to gum disease

What are the treatment options?

Good oral hygiene is part of both treatment and prevention. For moderate and severe cases of periodontitis, medicated mouthwashes and medications can be used to treat periodontitis, including:
  • Prescription antimicrobial mouth rinse, such as chlorhexidine
  • Antiseptic chip
  • Antibiotic gel
  • Antibiotic microspheres
  • Enzyme suppressant
  • Oral antibiotics
Periodontal scaling is a nonsurgical procedure to treat your teeth and gums against plaque, bacteria, and tartar deposits. The dental professional targets the area below the gum line and along the roots using an ultrasonic scaling device and/or manual instruments to gently remove plaque and tartar. Scaling can also involve delivering an antimicrobial agent into the pocket to treat and reduce bacteria.
Next, root planing goes deeper to remove cementum and surface dentin, smoothing out affected root areas in order to decrease gum tissue inflammation and allow your gums to reattach to your teeth. A properly planed root surface helps fight against bacteria, tartar, and plaque when they want to relocate under your gum line, and promotes root healing.

When good oral hygiene and non-surgical treatments aren't effective, sometimes surgery may be necessary. Those options can include:
  • Flap surgery to lift and remove deep pockets, and remove tartar
  • Bone and tissue grafts to regenerate bone or gum tissue that has been destroyed, using new natural or synthetic bone, which promotes growth
  • Guided tissue regeneration (GTR), which as we mentioned before, uses barrier membranes to direct the growth of new bone and gum tissues to regenerate tissue and repair defects from periodontitis
Success in a periodontal treatment really can depend on how advanced the periodontal disease is, how well the patient adheres to a proper oral hygiene program, and other health and activity factors (i.e. smoking, or other preexisting conditions).

What happens if periodontal disease goes untreated? Can periodontitis kill you?

Because periodontitis is a chronic inflammatory disease, it has been associated with other chronic inflammatory diseases, such as diabetes and cardiovascular disease.

Is there a home remedy?

Sure there is! It may not be what you are picturing, it is not all that glamorous, and it definitely doesn't involve fancy polymers inserted in your teeth. Here it is:
  • Brush your teeth with a suitable toothbrush and fluoride toothpaste at least twice daily for at least two minutes, carefully cleaning the chewing surfaces, sides of the teeth, and all of the hard-to-reach places (including—very gently!—on the gum line) around your mouth
  • Consider using a manual or electric toothbrush with soft bristles, and replace this toothbrush every 3 to 4 months
  • Do not share toothbrushes—bacteria can pass from person to person
  • Floss every day! Consider using an interdental brush to clean gaps around the teeth and those small spots where a toothbrush cannot reach. Dental floss is great for small gaps, but a dental brush is really useful for larger spaces in your mouth
  • Uneven surfaces are more susceptible to periodontal disease, so take extra care in cleaning around closely-packed teeth, crooked teeth, crowns, dentures, fillings, etc.
  • Use an antibacterial mouthwash to help prevent bacteria from growing and reduce inflammatory reaction in the mouth. Plus, you'll be taking that extra step to freshen your breath after brushing and flossing!

What are the stages of periodontal disease?


There are two stages. First, gingivitis occurs. Gingivitis is basically gum inflammation, whereas periodontitis refers to gum disease, or the destruction of tissue and bone.

Gingivitis occurs when bacterial plaque builds upon the surface of the tooth and causes the gums to become red, inflamed, and susceptible to bleeding. With gingivitis, there is no irreversible damage occurring to the bone or tissue, just irritated and bothersome gums.

As gingivitis progresses, it leads to periodontitis. This is when the gum and bone pull away from the teeth and form large, deep pockets where debris and bacteria can collect. Bacteria between the gum and teeth leads to an infection, as the plaque is now below the gum line. But, it isn't just the plaque and bacterial toxins destroying bone and tissue—it's your immune system. Your immune system's response to the infection in the pockets is to fight the infection, all leading to the destruction of gum and bone.

What can periodontitis lead to?

Periodontitis can lead to serious medical issues and even death. For example, when someone with periodontitis chews or brushes their teeth, bacteria can potentially enter the bloodstream, which increases the clotting risk and risk of stroke. Healthy teeth and gums can also decrease the chances of cardiovascular disease, diabetes, preterm pregnancies, prostate cancer, and breast cancer.

Will I lose my teeth if I have periodontal disease?

Not in a mild or moderate case, but left untreated, this chronic inflammatory disease badly affects the gum tissue and structures supporting the teeth, leading to eventual tooth loss.

Can South Charlotte Dentistry tell me more about gum loss and gum repair?

Absolutely! Our team is always here at South Charlotte Dentistry, located conveniently in the Ballantyne area of South Charlotte to help you with any questions you might have. You may also be interested in our limited-time New Patient Special that includes a comprehensive dental exam and full x-rays for only $69.00. Our existing patients can tell you all about our friendly and welcoming team that ensures a low-stress, but high-quality dental experience.

If you're looking for a highly rated, clean, and patient-centered dentist in the South Charlotte area, then look no further! South Charlotte Family and Cosmetic Dentistry will provide you the best dental care in South Charlotte—whether you're in the market for gum regrowth and repair, or just a simple dental cleaning!


-Tayler Green

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