Right on Time

Periodontist declares it’s never too late to treat gum disease.

One out of three people in the United States has periodontal disease, commonly known as gum disease. That’s 65 million Americans, or the populations of Texas and California combined. Many don’t know they have it because it’s a silent disease process. Gum disease has many symptoms, but they are typically subtle, especially in the disease’s early stages.

Lindsey Pikos Rosati, DDSc, MS, joins Coastal Jaw Surgery as a periodontist. She describes gum disease and its potential complications.

Dr. Rosati (left)educates on the importance of preventing and treating gum disease.

“A common symptom of gum disease is bleeding gums, so patients may notice a little blood mixed with their saliva when they brush or floss,” notes Lindsey Pikos Rosati, DDS, MS, a periodontist who recently joined Coastal Jaw Surgery at their Palm Harbor and Trinity locations. “The gums may also be red and/or swollen, which may or may not be painful.

“Some people notice an uneven appearance of their gums, with some teeth looking larger than others. That is generally because the crowns of the teeth appear to be different sizes due to gum recession. In some cases, people experience bad breath or a bad taste in their mouths as a result of gum disease. Some notice their teeth shifting, with spaces forming between the teeth that were not there previously.”

The initial stage of gum disease, gingivitis, is inflammation, or swelling, of the gingiva, the supporting gum structure surrounding the teeth. At this stage, there is no bone loss, so it can typically be reversed rather easily. Treatment of gingivitis is generally a heightened dental hygiene routine with a dentist’s or periodontist’s supervision.

“The problem with a constant state of inflammation is that over time, it leads to bone loss and eventually tooth loosening,” Dr. Rosati warns. “When there’s gum inflammation along with bone loss, it is called periodontitis. That is the full-blown gum disease process. There are different stages of periodontitis, and all of them are treatable.

“Once patients progress to periodontitis, it is extremely important that they get treated. The goal of treatment at this stage is to stop additional bone loss and tooth loosening, which can result in tooth loss.”

Traditional periodontal therapy includes deep cleaning, which reaches the plaque and bacteria lurking below the gumline that lead to inflammation. Also included is education on steps patients can take at home to help prevent recurrences and maintain their teeth into the future.

“Patients are then followed up by their dentist or periodontist every three months for a periodontal maintenance appointment,”  Dr. Rosati informs.

“The goal of these appointments is to maintain patients’ teeth and gums long-term. They also aim to create an environment that patients can clean on their own so they do not end up back in the dental chair for more treatment.

“Patients who are further along in the gum disease process may need additional interventions, which can involve minor surgery.”

Systemic Connection

Sometimes, patients with gum disease experience tooth sensitivity, often because their tooth roots are exposed by gums that are receding. Some people may not like the appearance of their smiles because they are “too gummy.” They may think there’s too much gum or not enough. Inadequate gums can be corrected using gum grafting.

“There are multiple ways to perform grafting to increase deficient gum tissue,” Dr. Rosati observes. “Most of the techniques we employ at Coastal Jaw Surgery are minimally invasive, which results in less pain, less downtime, fewer complications and a quicker recovery.

“No matter what technique we use to graft the gums, patients achieve the outcomes they desire: Their exposed roots are covered, they experience less sensitivity and they have better overall support for their teeth.”    

Relieving uncomfortable symptoms and avoiding tooth loss aren’t the only good reasons to treat periodontal disease and maintain healthy gums. It’s also important because gum disease has a critical systemic link, a connection to the health of the rest of the body.

“The constant state of inflammation present with gum disease increases inflammation in other parts of the body as well, which can lead to illness, even cancer,” Dr. Rosati elaborates. “Gum disease, diabetes and cardiovascular disease are three well-known links.

“For example, increased swelling of the gums in the mouth can result in swelling and inflammation of the heart, causing cardiovascular problems such as plaque build-up in the blood vessels. Plaque build-up can lead to heart attacks and other heart conditions.”

Gum disease has an effect on diabetes management as well.

“There have been many studies that show patients who treat their gum disease maintain better control of their diabetes,” Dr. Rosati reports. “Better diabetes control reduces the risk of diabetes complications affecting the eyes, feet, blood vessels and other areas of the body.

“It is important to dentists and especially to periodontists to educate patients on preventing and treating gum disease. To help prevent gum disease, patients should thoroughly brush their teeth at least twice a day with a fluoride toothpaste and floss daily. The good news about gum disease is it is never too late to treat it. Periodontal disease is treatable at any stage, so patients should not be fearful of seeing a dentist. They are never too far gone to achieve healthy gums.”

Implanted Stability

Dr. Rosati is now practicing periodontology at Coastal Jaw Surgery. She employs a full scope of treatment with an emphasis on periodontal therapy, periodontal plastic surgery and periodontal-orthodontic procedures. Dr. Rosati is also trained in all aspects of bone grafting and dental implant surgery.

“Dental implants are screw-like posts made of a titanium alloy that are surgically implanted within the bone of the patient’s jaw,”
Dr. Rosati describes. “They serve as the roots of replacement teeth where teeth are missing.

“Once the dental implants are placed within the jaw, they fuse with the bone over time and eventually become a solid unit with the bone. This provides incredible stability for the replacement teeth, which may be a crown for a single tooth, or a partial or full denture to replace multiple teeth.”

For Dr. Rosati to place dental implants, her patients must have enough bone in their jaws to accommodate them. If they lack sufficient bone, Dr. Rosati can perform bone grafting to grow additional bone in the jaw. The implants can then be successfully implanted and connected to the replacement teeth via an attachment piece called an abutment.

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