Periodontal Disease

Periodontal Disease Specialist in Louisville, KY

Periodontal Disease Dentist in Jeffersontown

First Choice Dental Center is your home for overcoming periodontal disease in Jeffersontown and Louisville. Dr. Holly Votteler and her dental team are committed to custom treatment based on patients’ needs as well as their continued oral health.


When you visit our office, you can depend on our team to create the smile you’ve always wanted, while keeping your comfort and wishes in mind.

Four out of five people have periodontal disease and don’t know it! Most people are not aware of it because the disease is usually painless in the early stages. 


The word periodontal means “around the tooth”. Periodontal disease attacks the gums and the bone that support the teeth. Plaque is a sticky film of food debris, bacteria, and saliva. If plaque is not removed, it turns into calculus (tartar). When plaque and calculus are not removed, they begin to destroy the gums and bone. Periodontal disease is characterized by red, swollen, and bleeding gums.


Not only is it the number one reason for tooth loss, research suggests that there may be a link between periodontal disease and other diseases such as, stroke, bacterial pneumonia, diabetes, cardiovascular disease, and increased risk during pregnancy. Researchers are determining if inflammation and bacteria associated with periodontal disease affects these systemic diseases and conditions. Smoking also increases the risk of periodontal disease.


Good oral hygiene, a balanced diet, and regular dental visits can help reduce your risk of developing periodontal disease.

Signs and symptoms of periodontal disease

If you experience any of these signs and symptoms, it is important that you schedule an appointment with a periodontist without delay:

  • Bleeding while eating or brushing – Unexplained bleeding while consuming food or during the course of daily cleaning is one of the most common signs of periodontal infection.
  • Bad breath – Continued halitosis (bad breath) which persists even when a rigorous oral hygiene program is in place, can be indicative of periodontitis, gingivitis or the beginnings of an infection in the gum tissues.
  • Loose teeth and gum recession – Longer looking teeth can signal recession of the gums and bone loss due to periodontal disease. As this disease progresses and attacks the jawbone, (the anchor holding the teeth in place) the teeth may become loose or be lost altogether.
  • Gangrene in the tissues – Gangrene is hard to self diagnose but the general dentist and periodontist will check for its presence in the soft tissues, alveolar bone and periodontal ligament.
  • Related health conditions – Heart disease, diabetes, osteopenia and osteoporosis are highly correlated with periodontitis and periodontal infections. The bacteria infection can spread through the blood stream and affect other parts of the body.

Mouth Disease Diagnosis and Treatment

Before initiating any dental treatment, the periodontist must extensively examine the gums, jawbone and general condition of the teeth. When gingivitis or periodontal disease is officially diagnosed, the periodontist has a number of surgical and non surgical options available to treat the underlying infection, halt the recession of the soft tissue, and restructure or replace teeth which may be missing.

  • Gingivitis/mild periodontal disease – When the gum pockets exceed 4mm in depth, the periodontist or hygienist may perform scaling and root planing to remove debris from the pockets and allow them to heal. Education and advice will be provided on an effective cleaning regime thereafter.
  • Moderate periodontal disease – If the gum pockets reach 4-6mm in length, a more extensive scaling and root planing cleaning might be required. This cleaning is usually performed under local anesthetic.
  • Advanced periodontal disease – Gum pockets in excess of 6-7mm are usually accompanied by bone loss and gum recession. Scaling and root planing will always be performed as the initial nonsurgical treatment. In addition to tose nonsurgical treatments, the periodontist may recommend surgical treatment to reduce pocket depth.
  • Tooth loss – Where one or several teeth are missing due to periodontal disease, dental implants are an effective option. If the bone is strong enough to provide a suitable anchor for the prosthetic tooth, the implant can be placed. However, if the bone is severely eroded, bone grafts may be performed by the periodontist to provide a suitable anchor for the new tooth/teeth.
Contact First Choice Dental Center in Jeffersontown Louisville if you have any questions about diagnosing and treating periodontal disease. 

Learn More About It

As patients’ dental goals are unique, so are the treatment plans we create for them. Our team takes the time to listen to your concerns and expectations to develop a strategy for a more beautiful smile, whether you want overall better health, bright new teeth, or both.

Antibiotic Treatment

Periodontal disease is a progressive condition that leads to severe inflammation and tooth loss if left untreated.  Antibiotic treatments can be used in combination with scaling and root planing, curettage, surgery, or as a stand-alone treatment to help reduce bacteria before and/or after many common periodontal procedures.


Antibiotic treatments come in several different types, including oral forms and topical gels which are applied directly into the gum pockets.  Research has shown that in the case of acute periodontal infection, refractory periodontal disease, prepubertal periodontal disease and juvenile periodontal disease, antibiotic treatments have been incredibly effective.


Antibiotics can be prescribed at a low dose for longer term use or as a short term medication to deter bacteria from re-colonizing.


Oral Antibiotics

Oral antibiotics tend to affect the whole body and are less commonly prescribed than topical gel.  


Here are some specific details about several different types of oral antibiotics:

  • Tetracycline antibiotics – Antibiotics which include tetracycline hydrochloride, doxycycline, and minocycline are the primary drugs used in periodontal treatment.  They have antibacterial properties, reduce inflammation and block collagenase (a protein which destroys the connective tissue). 
  • Macrolide antibiotics – This group of antibiotics has proven effective at reducing inflammation and can also reduce bacterial growth associated with periodontitis. 
  • Metronidazole – This antibiotic is generally used in combination with amoxicillin or tetracycline to combat inflammation and bacterial growth in severe or chronic periodontitis.

Topical Gels and Strips

The biggest advantage of directly delivering antibiotics to the surface of the gums is not affecting the entire body.  Topical gels and direct delivery methods tend to be preferred over their oral counterparts and are extremely effective when used after scaling and root planing procedures. 


Here are some of the most commonly used direct delivery antibiotics:

  •  Atridox® – This doxycycline gel conforms to the contours of gum surfaces and solidifies over them. Over several days, this gel gradually releases the antibiotic medication. 
  • PerioChip® – This chip is placed into the actual gum pocket after a root planing procedure.  PerioChip® slowly releases Chlorhexidine, a powerful antibacterial antiseptic. PerioChip® reduces pocket depth in most periodontitis cases. 
  • Actisite® – This thin strip is similar to dental floss and contains tetracycline hydrochloride. The thread is temporarily placed between the tooth and gum to kill bacteria and reduce pocket depth.  Several threads are sometimes placed for around 10 days to enhance the antibiotic effect. 
  • Elyzol® – This metronidazole antibiotic comes in gel and strip form. It is unique because it is able to destroy parasites as well as oral bacteria. 
  • Arestin® – This Minocycline antibiotic comes in mini capsules which are delivered into the gums after scaling and root planing.

Noticeable periodontal improvements are usually seen after systemic or oral antibiotic treatment. We will incorporate antibiotic treatments as necessary for the healing of your periodontal condition.

Maintenance

It only takes twenty four hours for plaque that is not removed from your teeth to turn into calculus (tartar)!  Daily home cleaning helps control plaque and tartar formation, but those hard to reach areas will always need special attention.


Once your periodontal treatment has been completed, your dentist and dental hygienist will recommend that you have regular maintenance cleanings (periodontal cleanings), usually four times a year.  At these cleaning appointments, the pocket depths will be carefully checked to ensure that they are healthy.  Plaque and calculus that is difficult for you to remove on a daily basis will be removed from above and below the gum line.


In addition to your periodontal cleaning and evaluation, your appointment will usually include:

  • Examination of diagnostic x-rays (radiographs): Essential for detection of decay, tumors, cysts, and bone loss.X-rays also help determine tooth and root positions.
  • Examination of existing restorations: Check current fillings, crowns, etc.
  • Examination of tooth decay: Check all tooth surfaces for decay.
  • Oral cancer screening: Check the face, neck, lips, tongue, throat, cheek tissues, and gums for any signs of oral cancer.
  • Oral hygiene recommendations: Review and recommend oral hygiene aids as needed. (Electric toothbrushes, special periodontal brushes, fluorides, rinses, etc.)
  • Teeth polishing: Remove stain and plaque that is not otherwise removed during tooth brushing and scaling.

Good oral hygiene practices and periodontal cleanings are essential in maintaining dental health and keeping periodontal disease under control!

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