Dee Nishimine, D.D.S., Inc.
Sophia Y. Tseng, D.M.D.
Periodontics & Dental Implants
Call: (559)229-6557

What is Periodontal (Gum) Disease?

The term “periodontal”means “around the tooth.”  Periodontal disease (also known as periodontitis and gum disease) is a common inflammatory condition which affects the supporting and surrounding soft tissues of the tooth; also the jawbone itself when in advanced stages.

Periodontal Disease (PD) is most often preceded by gingivitis which is a bacterial infection of the gum tissue.  A bacterial infection affects the gums when the toxins contained in plaque begin to irritate and inflame the gum tissues.  Once this bacterial infection colonizes in the gum pockets between the teeth, it becomes much more difficult to remove and treat.  Periodontal Disease (PD) is a progressive condition that eventually leads to the destruction of the connective tissue and jawbone.  If left untreated, it can lead to shifting teeth, loose teeth and eventually tooth loss.

Periodontal Disease (PD) is the leading cause of tooth loss among adults in the United States of America and should always be promptly treated.  "An ounce of prevention is worth a pound of cure."  This is preventable and treatable and should be treated by Drs. Dennis Nishimine, Dee Nishimine & Sopia Tseng

Types of Periodontal Disease (PD)

When left untreated, gingivitis (mild gum inflammation) can spread to below the gum line.  When the gums become irritated by the toxins contained in bacterial plaque, a chronic inflammatory response causes the body to break down and destroy its own bone and soft tissue.  There may be little or no symptoms as Periodontal Disease (PD) causes the teeth to separate from the infected gum tissue.  Deepening pockets between the gums and teeth are generally indicative that soft tissue and bone is being destroyed by Periodontal Disease (PD).

Every patient should have a complete periodontal examination.  Proper OHI of brushing and flossing are the key to keeping and maintaining your natural teeth and dental implants.  You should be brushing 4-5 times per day and flossing  two times per day to remove the Bacterial Plaque.  Your smile is our greatest concern.

Here are some of the most common types of Periodontal Disease (PD):

  • Chronic periodontitis – Inflammation within supporting tissues cause deep pockets and gum recession.  It may appear the teeth are lengthening, but in actuality, the gums (gingiva) are receding.  This is the most common form of Periodontal Disease (PD) and is characterized by progressive loss of attachment, interspersed with periods of rapid progression.
  • Aggressive periodontitis – This form of gum disease occurs in an otherwise clinically healthy individual.  It is characterized by rapid loss of gum attachment, chronic bone destruction and familial aggregation.
  • Necrotizing periodontitis – This form of Periodontal Disease (PD) most often occurs in individuals suffering from systemic conditions such as HIV, immunosuppression and malnutrition.  Necrosis (tissue death) occurs in the periodontal ligament, alveolar bone and gingival tissues.
  • Periodontitis caused by systemic disease – This form of gum disease often begins at an early age.  Medical condition such as respiratory disease, diabetes and heart disease are common cofactors.

Treatment for Periodontal Disease (PD)

There are many surgical and nonsurgical treatments that Drs. Dennis Nishimine, Dee Nishimine & Sophia Tseng may choose to perform, depending upon the exact condition of the teeth, gums and jawbone.  A complete periodontal implant exam of the mouth will be done before any treatment is performed or recommended.

Here are some of the more common treatments for Periodontal Disease (PD) and the replacement of missing teeth:

    Oral Hygiene Instructions (OHI) - The removal of bacterial plaque is the key to success.  We will be   showing you how to be more effective with your toothbrushes, dental floss and other oral hygiene aides. This will be done at each visit.  Please bring your toothbrushes and oral hygiene aides to each dental appointment.   We want you to brush 4-5 times per day and floss 2 times per day.  "Cleanliness is next to Godliness."  Your two hands will determine the success of your therapy.  Please give this information to all of your family members and friends.  A program will be tailored for your needs.
  • Scaling and Root Planing (SRP) – In order to preserve the health of the gum tissue, the Bacteria Plaque and calculus (tartar) which initially caused the infection, must be removed.  The periodontal pockets will be cleaned. SRP's will be provided with ultrasonic scalers and curettes to remove the "diseased bark from the tree."  Several appointments will be provided and this may take up to 4-6 hours of therapy.   Antibiotics and prescription mouthwash may be utilized  to help alleviate the infection.  Your comfort is our prime concern and anesthetics and sedation may be utilized as needed.  
  • Pocket Reduction Surgery (PRS) – Pocket reduction surgery (also known as flap surgery) is a surgical treatment which can be performed to reduce the pocket depths between the teeth and gums. Ideally we would like the pocket depths to be less than 3mm.  We may reshape or recontour the jaw bone so that the pockets are easier to clean and maintain with OHI.  Surgery on the jawbone is another option which serves to eliminate indentations in the bone which foster the colonization of Bacteria Plaque. 
  • Guided Tissue Regeneration (GTR), Guided Bone Regeneration (GBR) – When the bone and gum tissues have been destroyed, regrowth can be actively encouraged using grafting procedures. Many forms of bone graft materials are available and we will discuss them at length with you.  A membrane may be inserted into the affected areas to cover up the bone graft material in the GTR/GBR  process.
  • Dental Implants – When teeth have been lost due to Periodontal Disease (PD), trauma or congenitally missing, the aesthetics and functionality of the mouth can be restored with dental implants.  GTR/GBR procedures may be required prior to the placement of a dental implant in order to strengthen and have adequate amount of bone.  The dental implant must be completely embedded in the bone.

Ask our team if you have questions or concerns about Periodontal Disease (PD) , periodontal treatment, or dental implants.  Contact us today!