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Deteriorating oral health can be a vicious cycle. And once you’re stuck in that cyclical pattern, it’s difficult to escape without the help of a trained professional like Dr. Anne Nicholas.

Here’s how the cycle of gum disease progresses toward bone loss and the need for osseous surgery:

Poor oral hygiene results in the formation of plaque, which soon hardens to become tartar. As plaque and tartar remain on the teeth, inflammation of the gums begins, and this is called gingivitis — a mild form of gum disease. If gingivitis is left untreated, it persists and the disease worsens, advancing to periodontitis, which is when the gums pull away from the teeth.

The resultant space or “pockets” that appear between the gum tissue and teeth become infected, as plaque spreads and continues to develop beneath the gum line. The combination of the body’s response to the infection — as well as the bacterial toxins — begins to break down the bone and connective tissue that hold the teeth in place.

As the bone wears down and deteriorates, it often results in uneven or rough areas where bacteria accumulate and contribute to the disease. Cleaning these areas sufficiently through good oral hygiene practices is very difficult and unlikely.

One nonsurgical periodontal treatment that is attempted at this point is scaling and root planing, which is the process of removing tartar from above and below the gum line. Scaling and root planing is more commonly known as “deep cleaning.” To be clear, scaling is the process of removing tartar from the surface of the teeth; whereas, root planing is a smoothing of the tooth root surfaces.

We’re happy to inform you that our very own Dr. Nicholas is not merely a dentist; she’s also an expert periodontist who’s widely known and respected in her field. A periodontist is a highly trained dentist who specializes in the prevention, diagnosis and treatment of periodontal disease. (Periodontists like Dr. Nicholas also specialize in the placement of dental implants.)

You should know if scaling and root planing is performed by a gifted periodontist like Dr. Nicholas, the patient’s chances of needing surgery are reduced. Unfortunately, sometimes patients will ironically throw their money away by trying to save few dollars with a bargain dentist who lacks genuine expertise, leaving them in the expensive predicament of still requiring surgical treatment after all.

Don’t waste your time and money; instead, get your deep cleaning taken care of by Dr. Nicholas, a talented periodontist who has achieved the highest level of training in her field.

We want you to understand, however, that surgery is sometimes required, no matter what. If scaling and root planing and good oral hygiene are insufficient for reducing the depths of these pockets, the patient will be unable to clean and maintain his or her dental health, and the destructive cycle of gum disease will be well under way.

At this point, your dentist may recommend a regenerative procedure called osseous surgery, which is a surgical periodontal treatment for periodontitis. In simplest terms, osseous surgery is bone surgery that reshapes the bone which holds one or more teeth in place. It is performed on the jawbone and its overlying tissue.

More specifically, osseous surgery is designed to reduce pocket depths between the gum tissue and the tooth and to promote gum tissue attachment. To achieve this effect, your dentist will remove the bacterial accumulation and toxins from the surface of the tooth root. Next the bony structure around the tooth is contoured, placing the gum line close to the bone line once again. Osseous surgery is frequently the answer for treating bone loss around multiple teeth.

We must emphasize the serious nature of the degenerative effects of periodontitis. It is an inflammatory gum disease that affects the soft and hard structures that support the teeth. And if periodontitis continues to progress, it will eventually lead to the bones, gums and tissues that support your teeth being destroyed, which means the ultimate loss of the teeth.

So, if you notice that you have swollen and bleeding gums or loose teeth, these symptoms may be warning signs of periodontal disease. Come and visit our office right away so we can assess your oral health, and stop the destructive cycle of periodontal disease.

For more information about osseous surgery and other periodontal treatments, contact Dr. Anne Nicholas at the Palm Desert Center for Advanced Periodontics, Cosmetic, Sedation and Implant Dentistry. She can be reached by phone at 760-851-0314 or at her office in Palm Desert, California.