The bacterial infection that develops into periodontal disease first attacks the soft tissues of your gums. However, as the disease advances, bacteria can also destroy the structures that support your teeth. If the infection reaches the roots of your molars or premolars, those teeth may loosen, become misaligned, or risk falling out. Learn how periodontists diagnose and treat periodontal disease when it reaches your back teeth and how you can prevent bone loss around tooth roots.
How Damage To Tooth Roots Is Diagnosed
The roots of molars and premolars (the teeth between your canines and the back molars) branch out in two or three directions, and the area of the teeth where the roots branch out is called a furcation. When periodontal disease reaches the furcation point, periodontists use a probe and X-ray imaging to identify defects at that vulnerable juncture.
Furcation defects are classified by the amount of bone loss detected. Although several classification systems exist, the most widely used one was developed by Irving Glickman:1
- Grade I – An early lesion with only slight bone loss in the furcation
- Grade II – There’s evidence of damaged bone, but some of the alveolar (jaw) bone and the periodontal ligament remain intact. A probe can achieve only partial penetration.
- Grade III – The probe can enter the furcation site with no obstruction, but it’s difficult to see without the use of X-rays because gum tissue gets in the way of the view.
- Grade IV – The inter-radicular bone (the alveolar bone between the roots of these back teeth) is completely destroyed, and the gum tissue has receded enough that an X-ray is not needed to see the opening.
How Does a Periodontist Treat Furcation Defects?
Periodontists need to treat furcation defects quickly to minimize bone loss around tooth roots and avoid the need to extract the tooth. The treatment method will depend on the extent of the furcation defect, but the overall goal is to clean the root area to remove bacterial plaque and tartar.
Scaling And Root Planing
The scaling and root planing process or “deep cleaning”, refers to two separate procedures that have many applications for treating early gum disease. Periodontists generally use scaling and root planing for patients with a Grade I furcation defect.
Using a manual tool or ultrasonic device, a periodontist will remove plaque and tartar from the root surface. Then, a similar tool will smooth out the root surfaces. Root smoothing helps to reduce gum tissue inflammation and allows gums to heal and reattach to the tooth.
For furcation defects beyond Grade I, studies have shown that with surgical access, scaling and root planning is more effective. 2
Regenerative Procedures
Patients with more severe furcation defects will likely need to regenerate bone tissue, gum tissue, or both.
For gum tissue regeneration, the periodontist will first fold back the tissue to clean it. Then, they will graft gum tissue from a portion of the patient’s mouth to the area, so that fresh and healthy tissue will grow there.
By grafting bone tissue onto the troubled area, the procedure stimulates bone growth. The material used in bone grafting will usually come from the patient’s own body, or a human donor.3
How Can You Prevent Bone Loss Around Tooth Roots?
A periodontist cannot treat all furcation defects successfully, which is particularly true if the defect has grown worse with time.
It’s essential to brush and floss your teeth at least twice a day to avoid tooth root bone loss. Plaque can form and build up on teeth and gums very quickly. And if plaque remains on your teeth for too long, you could set in motion a biological process that allows gum disease to develop. Regular periodontal maintenance appointments are also valuable for overall oral hygiene and health.
A Trusted Periodontist Helps Prevent Bone Loss Around Tooth Roots
At the first sign of gum disease, consult a periodontist. If your gums are puffy, red, painful to the touch, or you notice blood in the sink when you brush your teeth, make an appointment right away. The sooner a periodontist can diagnose gum disease, the more likely you’ll be able to save your teeth.
Dr. Thomas Zahavi leads the highly qualified periodontists, hygienists, and treatment assistants at Dental Implants & Periodontal Health of Rochester. When you visit our practice, you’ll receive an accurate diagnosis, honest feedback, and exceptional care from all of our skilled practitioners. Find out why so many in the Rochester area are loyal patients and recommend our services. Call us at 585.685.2005 or contact us here.
Sources:
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6162379/
[2] https://pubmed.ncbi.nlm.nih.gov/3517073/
[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3722694/
