Periodontal Disease Treatment: Common Concerns and Solutions

Questions about periodontal disease treatment procedures?

Hello:
1.
Does periodontal disease spread quickly? I am currently receiving treatment at a medical center, but I have gone three times and am still in the scaling phase.
I am very afraid of losing all my teeth, as one or two teeth have already shown alveolar bone loss on X-rays.
2.
If only 1/4 of the alveolar bone remains, does that mean I definitely need to have the tooth extracted? However, the tooth doesn't seem to be very loose, which is strange.
Should I extract the tooth first or treat the periodontal disease first? The intern only mentioned that I need to have the tooth extracted but didn't explain the treatment process in detail.
3.
Is there a way to regenerate alveolar bone? Thank you very much.

julia WU, 30~39 year old female. Ask Date: 2006/05/18

Dr. Wu Jinjun reply Dentistry

Hello,
1.
Most periodontal diseases are chronic and do not progress rapidly, but there are still a small number that fall under acute progressive periodontitis, which is relatively rare.

2.
If only 1/4 of the alveolar bone remains, the decision to retain the tooth should be based on the condition of the tooth itself, and the likelihood of extraction is quite high.

3.
Whether the alveolar bone can regenerate depends on the severity of the bone destruction; adequate conditions must be met before regeneration membranes and bone grafts can be used to promote periodontal and alveolar regeneration.

Reply Date: 2006/05/18

More Info

Understanding periodontal disease and its treatment can be quite daunting, especially when faced with the potential loss of teeth and the complexities of dental procedures. Here, I will address your concerns regarding the progression of periodontal disease, the condition of your alveolar bone, and possible treatment options.

1. Progression of Periodontal Disease: Periodontal disease can indeed progress rapidly, especially if left untreated. Factors such as oral hygiene, smoking, diabetes, and genetic predisposition can influence the rate of progression. If you are currently undergoing treatment at a medical center and are still in the scaling phase, it is crucial to maintain good oral hygiene at home. Regular dental cleanings and follow-ups are essential to monitor the condition of your gums and teeth. The presence of bone loss, as indicated by X-rays, is a sign that the disease is affecting the supporting structures of your teeth. However, with proper treatment, it is possible to manage the disease and prevent further deterioration.

2. Alveolar Bone Condition: If your alveolar bone is down to 25% of its original height, it does raise concerns about the stability of your teeth. However, the fact that your teeth are not excessively mobile is a positive sign. In some cases, teeth can remain stable even with significant bone loss, but this is not always guaranteed. The decision to extract a tooth should be based on a comprehensive evaluation by your dental professional, considering factors such as the extent of periodontal disease, the overall health of the tooth, and your personal dental goals. It is often advisable to treat the periodontal disease first, as this may improve the health of the surrounding tissues and potentially save the tooth. Extraction may be necessary if the tooth is deemed non-restorable or if it poses a risk to your overall oral health.

3. Regeneration of Alveolar Bone: The regeneration of alveolar bone is a complex process. While it is challenging to regenerate lost bone, certain procedures can help stimulate bone growth. Guided tissue regeneration (GTR) and bone grafting are two techniques that may be employed to encourage the regeneration of bone around teeth affected by periodontal disease. These procedures involve placing a barrier membrane or graft material in the area of bone loss to promote healing and new bone formation. However, the success of these treatments depends on various factors, including the extent of bone loss, the presence of infection, and your overall health.

In conclusion, it is essential to have open communication with your dental care team regarding your treatment options. If you feel uncertain about the recommendations provided by your current practitioners, seeking a second opinion from a periodontist or a dental specialist may provide you with additional insights and options. Remember, maintaining excellent oral hygiene, attending regular dental appointments, and following your treatment plan are crucial steps in managing periodontal disease and preserving your teeth.

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