PERIODONTITIS, an inflammatory disease of the teeth and gums, characterized by the loss of the soft connective tissue and surrounding alveolar bone, which support the teeth, is one of the most prevalent diseases in North America and

is also the most frequent reason for tooth loss in adults. Caused by a build-up of bacteria, which adheres to tooth and root surfaces, both common gingivitis (early- stage gum inflammation) and more advanced chronic periodontitis, are conditions that require recurring treatment. Fortunately, regular dental cleanings, which include the removal of this bacteria-based plaque and calculus (a.k.a., tartar), are one of the easiest ways to help prevent inflammation and/or periodontitis from taking hold.

The connection between oral and general health is becoming better understood and appreciated in medical communities. In fact, similarities between dental plaques and those found in cardiovascular and neurological conditions are also becoming apparent, which

is why it is so important to treat periodontitis promptly. Gingival
(or gum) inflammation is often difficult to manage because it can vary based on how an individual builds and retains plaque, their use of medications, and immunologic reactions, as well as any systemic diseases they may have. For example, diabetes affects both oral and systemic health, and certain medications, including those for high blood pressure, can affect the gums by causing severe inflammation and tissue overgrowth.

Periodontitis is a complex disease and eliminating it represents a great challenge for periodontists and dental hygienists. One reason, regular treatment is so important is that dental plaque along the gumline can reform just 72 hours after removal or cleaning. If it is allowed to grow, undisturbed, bacterial colonization quickly follows, and that can initiate an immunologic response in the body. On average, damaging results from this sort of “invasion” begin to occur on a cellular level after roughly three months. For this reason, patients who are predisposed to, or are already displaying a history of periodontal disease, are often asked to schedule cleanings every three months.

For most patients, however, regular, bi-annual treatments and cleanings—using manual and ultrasonic instruments to remove dental plaque above and below the gums—are sufficient to effectively keep periodontitis at bay. Eliminating plaque at
the gum-line and root planing (smoothing the exposed surface of the roots) significantly reduces inflammation, and can also help alter the subgingival flora, creating a less hospitable environment for bacteria to grow in the first place. Laser treatments offer a more rapid solution, removing inflamed tissue and sterilizing the periodontal pocket, with minimal bleeding. Last but not least, in order to maintain their oral health, patients must also establish good at-home care practices, and schedule routine maintenance visits.

One of the biggest challenges –

for dentists and dental hygienists in a periodontal practice is helping patients understand that treating periodontal disease requires their active involvement. Like many practices in this specialty, our office carefully monitors individual patients and customizes their treatment to maximize comfort and results. From experience, we know that tailoring preventive and maintenance strategies to each patient’s needs is important, as is educating them about home care, including proper techniques, what devices to use, etc. When patients work with their dentist to maintain good oral hygiene, they are helping to improve their overall health, and are less likely to lose their teeth. Remember, dental prevention is a proven money- and time-saving endeavor!

Dr. Frank Celenza is a uniquely dual-certified orthodontist and periodontist, who has maintained a practice on the Upper East Side for over thirty years. In addition to his practice, he is an internationally recognized professor, who holds faculty positions at several universities. Ioana Stoia is a registered dental hygienist who works with Dr. Celenza.

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