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How Teeth Become Discolored

Periodontal disease

It’s hard to believe that in a 2002 poll of 1,000 Americans over the age of 35, it was determined that 60% of adults polled knew little or nothing about gum disease! A tragedy when you consider that gum disease is the leading factor in tooth loss, even healthy teeth.

Your teeth can appear to be healthy and disease free, when under the surface gum disease can stalwartly march on creating a condition that will ultimately lead to serious tooth loss. Bad breath is a “red flag” to help determine if this problem is prevalent in your mouth.

Healthy gum tissue forms a shallow groove at the point where the tooth meets the gum line. This disease occurs when the anaerobic, sulfur producing bacteria we discussed earlier, become trapped beneath the gum line.

This is a perfect breeding ground for the bacteria and they will settle in and take residence.

Not recognizing and dealing with the problem will result in serious dental problems up to and including loss of teeth and even underlying bone disease.

If you are diagnosed with serious periodontal disease, work to save your teeth needs to begin as soon as possible.

The first step that your dentist will take is probably what is called “scaling and root planing.” This is a non-surgical procedure to remove the deposits of plaque on the surface of the tooth including the root. Since periodontal disease rarely occurs in just one tooth, this will probably need to be done to all your teeth.

The dentist will scrap the surfaces of the tooth below the gum line to remove all traces of plaque clear down to the bottom of the pocket. He will then smooth the surface of the root to encourage healthy gum tissue to heal. This process also discourages plaque from reforming.

Depending on how involved your case might be, the dentist may prescribe medication to assist in healing or control pain and potential infection.

More diagnostics are required before a prognosis of your case of periodontal disease can be given. Each deposit of plaque creates its own “pocket” and the dentist needs to measure the depth of the pockets that were scaled during your first visit.

Often, the scaling procedure works well to eliminate the problem and you are free from further treatment other than normal examinations. At this point you would be well served by employing a daily regimen of preventative maintenance to insure the disease does not return.

However, if the diseased pockets are deep and extending into actual bone, you may need to have surgery in order to keep the teeth. If this is the case, your dentist will refer you to a periodontist, a doctor who specializes in periodontal disease.

The periodontist will use a surgical process to aggressively penetrate the diseased areas and ferret out the plaque and bacteria. The pockets where plaque resides must be sealed off so the environment does not invite a return of the disease.

In some cases bone surgery or bone grafts may be necessary to rebuild bone that was destroyed by the periodontal disease. If there was substantial tissue damage grafts may need to be used to replace the soft tissue. This procedure involves removing gum tissue from your palate to cover the areas where severe gingivitis has penetrated too far into the gum line.

Your dentist or oral surgeon may also recommend further treatment and/or medications. Here is a list of FDA approved products to help combat periodontal disease:

 

Name
What It Is
 
Why It’s Used
 
How It’s Used
Colgate Total
triclosan and fluoride toothpaste
Over-the-counter toothpaste containing the antibacterial triclosan   The antibacterial ingredient reduces plaque and resulting gingivitis. The fluoride protects against cavities   Used like a regular toothpaste
Peridex or generic
chlorhexidine mouth rinse
Prescription mouth rinse containing an anti-microbial called chlorhexidine   To control bacteria, resulting in less plaque and gingivitis   Used like a regular mouthwash
Periochip A tiny piece of gelatin filled with chlorhexidine   To control bacteria and reduce the size of periodontal pockets   Chip is placed in the pockets after root planing, where the medicine is slowly released over time
Atridox A gel that contains the antibiotic doxycycline   To control bacteria and reduce the size of periodontal pockets   Placed in pockets after scaling and root planing. Antibiotic is released slowly over a period of about seven days
Actisite Thread-like fiber that contains the antibiotic tetracycline   To control bacteria and reduce the size of periodontal pockets   These fibers are placed in the pockets. The medicine is released slowly over 10 days. The fibers are then removed
Arestin microspheres Tiny round particles that contain the antibiotic minocycline   To control bacteria and reduce the size of periodontal pockets   Microspheres placed into pockets after scaling and root planing. Particles release minocycline slowly over time
Periostat A low dose of the medication doxycycline that keeps destructive enzymes in check   To hold back the body’s enzyme response—if not controlled, certain enzymes can break down bone and connective tissue   This medication is in pill form. It is used in combination with scaling and root planing

 

                    

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