Question:
A friend (who is not a dentist), has been espousing the theory that
gum surgery only attacks the symptoms, not the cause, and therefore
the correct treatment for gum disease is antibiotics. It makes a certain
amount of sense since I have had gum surgery several times in the same
areas and obviously I still have the disease. Is his theory sound?
Answer:
Yes, but don't the antobiotics commonly used (don't remember the name)
cause discoloration of the teeth? Any dentist comments?
Try Sonicare and/or Sonex toothbrushes for your perio problems.
Periodontal disease is caused by bacteria and bacterial by-products that
attach themselves around the teeth and under the gums. To treat gum
disease it is necessary to physically remove these deposits so healing
can occur. That is the general rational for surgery. Some recent
research shows that antibiotic therapy (both local and systemic) may
help keep the disease from recurring. The bottom line though is keeping
the areas around the teeth as free from plaque as possible- that means
flossing.
Well, tetracycline can cause tooth staining if it's used on younger
people when the crowns of the teeth are forming. Generally (I can't
recall the exact time) most crowns are formed and erupted by age 12. The
antibiotic is notorious for causing yellowy brown streaks across teeth
showing at which phase of development the tooth was in when the
medication was taken. Most dentists try to avoid this problem. We also
avoid giving tetracycline to pregnant people too.
Too much fluoride ingestion can cause fluorosis (mottling) of teeth
with white to brown patches, making the teeth somewhat resistant to cavities
usually but weaker structurally. I don't think that a person can get
fluorosis after all of their teeth have formed and erupted.
I've heard of tetracycline applications given topically and
systemically to aid in gum disease. I believe that it is effective, but
still, it is again just treating the symptoms and not the cause which
is poor oral hygiene practices on part of the patient. People often get
to the point where they have moderate gum disease by not brushing,
flossing, going to the hygienist... and then they expect a miracle cure.
Unfortunately, by that time, the damage is somewhat permanent, and it is
often hard to change their oral hygiene practices. "Oh, I don't have
time to floss," is what I hear too too often. But they do have time to
swig a brusky and watch "Wheel of Fortune." :) Oh well, what can ya do?
There is also a product called "Chlorzoin" which is actually a
chlorhexidine (eg. Peridex) varnish that is meant to treat incipient
cavities and act as a preventative procedure. Our hygienist has commented
how well it seems to help the gums as a secondary benefit. In general, I
personally don't use tetracycline much, but I do stress tooth cleanings
and possibly gum surgery for more problematic cases.
The major cause of periodontal disease is indeed microbial in nature,
however systemic antibiotics (those taken by mouth and entered into the
blood stream) are of little use, as the offending microbes are outside the
"reach" of their effectiveness. Topical antibiotics are of some use, but
the problem is getting them under the gums where the problem is. And if
you can get them there (some espouse squirting them under the gums with
special syringes), then the problem is keeping them there long enough and
in high enough concentrations. Then, if you are successful in eradicating
the offensive organisms, without eliminating the pockets they have caused
you will soon enough be back where you started and have to begin again. If
your friend can solve these problems, I would expect he will be a wealthy
person! Gum surgery is a treatment to correct a problem created by these
evil bugs, and to (ideally) enable the patient to keep the teeth clean
enough to avoid future loss of gums and bone.
I can't believe the number of respondents to this question who
cannot seem to get the correct answer. Gum disease is not a disease, it
is a reaction of the immune system to the bacterial products, food
debris, etc..
An antibiotic mouth wash(like peridex) can help, but keeping a
mouth very clean does to.
The reason you're probably having continual perio surgery is that
you probably smoke, Nicotine effects the immune system and thus promotes
gum problems. By the way you should see what happens when an AIDS victim
is effected.
