Understanding Gum Disease
Periodontal disease (commonly referred to as gum disease), affects millions of people worldwide, causing discomfort, tooth loss, and even systemic health issues if left untreated. Gum disease is a bacterial infection that affects the tissues surrounding and supporting the teeth.
The risk of gum disease increases with age. Nearly 46% of all adults, ages 30 and older, show some signs of gum disease. Even adults with good oral hygiene habits can be susceptible to developing gum disease as our dental anatomy, chemistry, diet, stress levels, medical conditions, substance use, and hygiene can affect our risk. Fortunately, gum disease doesn’t occur overnight and is preventable if treated early.
When we eat, microscopic bacteria create a thin layer of plaque on our teeth and gumline. If the plaque is not removed, it can mineralize into a hard coating on the teeth known as tartar. Tartar buildup causes inflammation of the gums (also known as gingivitis). If still untreated, gingivitis can progress into gum disease.
One of the most serious effects of gum disease is bone loss. Untreated gum disease causes irreversible deterioration of the bone structure which supports the teeth, leading to tooth loss. While some bone can be regenerated through medical procedures and supplements, it is difficult and has limitations.
Once a patient has progressed into gum disease, traditional treatment often involves a combination of professional dental cleanings, scaling and root planing (deep cleaning), antibiotics, and in severe cases, surgical procedures such as gum and bone grafts. Gum disease isn’t something that one can be “cured” of. Even after successful treatment, it can return without proper hygiene and care. If gum disease continues for an extended period, the patient will likely require significant dental treatment to restore their oral health and function.
Full Teeth Restoration and Gum Disease
Many patients that have had prolonged gum disease are great candidates for full mouth restorative treatment such as the 3 on 6™ and All-on-4. These treatment options provide great benefits to patients with gum disease including preventing bone loss and fighting plaque buildup. With the expense of these treatments, patients might wonder how these treatment options will be affected by past or future gum disease.
Before treating a patient with any full mouth option, the dentist will make sure that any gum disease they are experiencing is under control. This may include a deep cleaning before surgery or the use of prescription mouthwash and antibiotics before and after treatment. The teeth contribute the most to retaining bacteria, and during surgery they are extracted and replaced with implants and bridges. Coming out of surgery, the largest contributor to gum disease will be removed and when the implants are fully osseointegrated after three months, no gum disease should be present.
3 on 6™ patients most often receive titanium implants and abutments and zirconia bridges. Zirconia is great at fighting plaque and patients have an easier time preventing tartar buildup. Both zirconia and titanium are impervious to infection and can’t be broken down by bacteria. The tissue surrounding the titanium components, however, is susceptible to plaque build-up and gum disease. To protect their implants, it is important for patients to develop and maintain good oral hygiene habits as directed by their dentist and hygienist. This often includes brushing and flossing twice a day, the use of a water flosser, mouthwash, and regular dental cleanings and checkups. The 3 on 6™ can be cleaned by a dentist or hygienist without removing it.
While the All-on-X can provide great outcomes, it can also present a greater challenge in fighting off gum disease. The bulk of the prosthetic makes cleaning it at home more difficult, increasing the chances for trapped food to develop bacteria and inflammation around the implants. It is recommended that All-on-X appliances are removed at least once per year for proper cleaning. Removing the prosthetic can be more time consuming and will often require connecting screws to be replaced, which can make these cleanings more expensive.
Conclusion
Gum disease is a prevalent oral health issue that nearly half of the adult population faces. While full mouth treatment will remove any active gum disease, it can return if the patient does not develop and maintain good oral hygiene habits. The check engine light of a car warns us to see a mechanic before an automotive problem worsens. Likewise, full mouth patients should see their dentist and hygienist regularly to ensure their implants are healthy and free from any signs of gum disease. Even with a history of gum disease, a full mouth treatment such as the 3 on 6™ can last a lifetime with proper care and maintenance.