Periodontal disease is divided into two main categories.
- Gingivitis is the inflammation of the gums. Gingivitis is characterized by the presence of redness, swelling and bleeding of the gums. In some people, but not all, gingivitis progresses to periodontitis.
- Periodontal disease increases the risk of certain systemic diseases such as cardiovascular disease and respiratory infections. If you have dental implants, you can still have periodontal disease. The risk of periodontitis increases in smokers.
What Causes Periodontal Disease?
The microorganisms in the white sticky material (dental plaque) on your teeth (implants) and tongue are the cause of periodontal disease. Dental plaque forms continuously in your mouth, and if left undisturbed, it forms a protective barrier (matrix).
It is very important to understand that dental plaque is impermeable to your immune defense, antibiotics and mouthwashes. The only effective cleaning is the mechanical removal of the plaque by brushing and flossing. If the dental plaque is left undisturbed, it is mineralized by minerals in the saliva and forms calculus (tartar). Tartar cannot be removed by brushing and flossing and needs to be removed by professional dental cleaning.
Treatment of Periodontal Disease
The treatment of periodontal disease is much easier if it is caught early.
- Gingivitis is reversible with the removal of dental plaque or tartar.
- The treatment of periodontitis depends on the stage of the disease. If it is caught early, scaling and root planing (deep scaling) is usually enough to control the disease. In more advanced disease stages, surgery may be needed to eliminate the pockets and to correct the bone defects caused by the disease.
During your initial examination, your dentist will perform a thorough clinical and radiographic examination to determine the presence and severity of periodontal disease and discuss the treatment options with you.
The Timing of the Treatment
Periodontal disease increases the risk of severe oral complications after cancer therapy. It should be identified and treated before commencement of cancer therapy. Teeth with advanced periodontal disease may be extracted to prevent any source of infection. Extractions should be accomplished at least three weeks prior to initiation of cancer therapy to ensure adequate wound healing. In general, periodontal surgical procedures are avoided because of the requirement for prolonged healing and meticulous oral hygiene to achieve desired results.
After the recovery from the radiation and chemotherapy, non-surgical periodontal therapy is appropriate for retained teeth, usually with prophylactic antibiotic coverage. However, some of the effects of cancer therapy are permanent and susceptibility to complications may continue throughout your lifetime. Therefore, surgical procedures should also be avoided throughout your lifetime.
Good oral hygiene is essential to improve comfort and to reduce the risk of infection and must be maintained throughout your lifetime.