Q: Who Can Benefit From Laser Periodontal Therapy?

A: Anyone who wants to treat their gum disease but does not want cut and stitch gum surgery.

Attention People with Gum disease

Leaving gum disease untreated is no fun. As gum disease gets worse people can notice a whole host on unpleasant things happening in their mouths. Early on most people only notice some bleeding on the toothbrush. This is gingivitis and it is the start of gum disease. HEALTHY GUMS SHOULD NEVER BLEED. Not when you brush, not when you floss, and not when you eat hard foods. If your gums bleed seek attention immediately!!

The mass of tissue in the mouth is equivalent to the skin on your arm that extends from the wrist to the elbow. If this area was red, swollen, and infected, you would visit the doctor. Gum disease is not a small infection. Its result, tooth loss, leads to a very different lifestyle—dentures. The changes in your appearance, breath, and ability to chew food are dramatic.

The scary thing is that some people with gum disease have no bleeding. Smokers rarely have bleeding gums and yet smoking makes a person much more susceptible to gum disease. Many times people with advanced gum disease no longer have bleeding gums either. This is because the problem is deep in the bone rather than being on the surface of the gums.

Gum disease starts in the gums and then spreads deeper into the bone. It causes destruction of the jaw bone that is holding in the teeth. This condition rarely hurts until the bone loss is very advanced. Most times this disease has no symptoms and needs to be diagnosed by a dentist. The dentist will measure the pockets or space between the tooth and the gum. Normally this space should measure 2-3mm. As bone loss progresses, the pockets get deeper. Once the pockets get into the 5-6mm or greater range there has been bone loss. People with recession of the gums exposing the roots also have bone loss.

Look what happens as gum disease progresses:

Progression of gum disease

Most times gum disease has no symptoms. Symptoms people may notice include with more advanced disease include:

• Bone loss
• Pyorrhea
• Loose Teeth
• Receding Gums causing longer looking teeth
• Shifting teeth
• Bad Breath from Gum Disease
• Red Swollen or Tender Gums
• Bleeding while brushing. Flossing or eating hard foods.
• Separating teeth
• Pus around the teeth
• A Change in the way your teeth fit together when you bite
• A Change in the fit of your partial denture.

For years and years the only way to effectively treat gum disease that spread to the bone was cut and stitch periodontal surgery.  In this procedure a scalpel is used to make  an incision to separate the gums from the tooth.  The next step is to use an instrument called a periosteal elevator to lift the gum away from the tooth and the bone.  This allows the periodontist to  remove the tartar from the roots of the teeth and then either cut away bone, or place a graft  in an attempt to correct the defects on the bone caused by the gum disease.  The goal is to clean the root surface and make the pocket shallow so that it can be kept clean.  Many patients object to this method for several reasons:

1. It is invasive. No one likes having their gums cut and stitched even for the greater good of keeping their teeth.
2. Complete therapy can take up to 8 or more 1 hour visits.
3. After the surgery there can be varying degrees of pain due to the invasive nature of the procedure. While this can be addressed with medication, it can still be painful.
4. After the surgery many patients complain of recession, longer teeth, roots that are exposed and sensitive to cold.
5. There can also be spaces between the teeth as the gum between the teeth recedes. Food can get lodged in these areas and can be annoying.
6. Cut and stitch periodontal therapy can be expensive.

Here is an example:

Picture before surgery of the upper front teeth.	Here is a picture of the back of the upper front teeth before surgery.

The gum is separated from the tooth and lifted off the bone. It is then stitched back in place.

Picture taken after healing. Notice how much gum tissue was lost between the teeth. These “dark triangles” are unaesthetic and can collect all sorts of food.

For years and years the only way to effectively treat gum disease that spread to the bone was cut and stitch periodontal surgery. In this procedure a scalpel is used to make an incision to separate the gums from the tooth. The next step is to use an instrument called a periosteal elevator to lift the gum away from the tooth and the bone. This allows the periodontist to remove the tartar from the roots of the teeth and then either cut away bone, or place a graft in an attempt to correct the defects on the bone caused by the gum disease. The goal is to clean the root surface and make the pocket shallow so that it can be kept clean. Many patients object to this method for several reasons:

Laser periodontal treatment is for anyone who wants to treat their gum disease but does not want surgery. The laser light does several things to restore health. The laser removes diseased tissues but leaves healthy tissue untouched. It loosens the tartar from the root of the tooth to make it easier to remove. Finally, the laser is used to make a fibrin clot that reconnects the gum to the tooth root.

The advantages of Laser Periodontal therapy compared to cut and stitch surgery are:

1. Virtually pain free afterwards.
2. Non invasive, no cutting and stitching of the gums
3. Nearly bloodless.
4. Treatment is fast. The laser is usually used for only 2-2hour visits.
5. The gums are not lifted off the tooth and bone. Much less invasive that cut and stitch gum surgery.
6. Recovery is rapid and even loose teeth can be saved.
7. Laser treatment is usually less expensive than comparable treatment with cut and stitch methods.