- Gum Disease- Gingivitis and Periodontitis
- Gum Therapy – Periodontitis
- Flouride Treatment
- Bad Breath Remedies
- Oral Cancer Screenings
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Gum Disease- Gingivitis and Periodontitis
Periodontal disease attacks the gums and the bone that support the teeth. It is the disease process that can ultimately cause loss of teeth by destroying the support for the teeth. It is caused by bacteria that are found in plaque, which is a sticky film that forms on your teeth consisting of some of the components of saliva, nutrients from food, and most important, bacteria. Even in a healthy mouth, there are literally billions of bacteria constantly forming biofilm on the surfaces of your teeth.
The longer plaque is allowed to stay on your teeth, the more difficult it becomes to remove. And at the same time, when it isn’t removed, the bacteria multiply, colonize and organize to become more and more destructive as other disease-producing species of bacteria join the colony. (Some of the bacteria in plaque also cause tooth decay.)
Eventually some of the plaque turns into calculus (tartar) which can no longer be removed with a tooth brush or floss and has to be removed by professional cleaning. If calculus remains on the teeth, it forms a habitat for bacteria almost like a microscopic coral reef that is even more conducive to further plaque colonization. And the vicious cycle spirals on as the gums are infected and detach from the teeth and b0ne is destroyed. By this time, there are usually signs of trouble, but no pain until the process is advanced. The signs are redness, swelling, and bleeding of the gums.
All of that sounds pretty bad, but there’s still more bad news (we’ll get to the good news below)…Four out of five people have periodontal disease and most don’t know it! Most people are not aware of it because as we’ve already said, it is usually painless in the early stages.
Through more recent research we’ve gotten more information about periodontal disease that is still worse. Not only is it the number one reason for tooth loss, we now know that there is a definite link between periodontal disease and other diseases such as, stroke, bacterial pneumonia, diabetes, cardiovascular disease, and increased risk during pregnancy. Research is showing that inflammation and bacteria associated with periodontal disease affects these systemic diseases and conditions. Smoking also increases the risk of periodontal disease.
All of that is not meant to scare you; it is meant to inform you of a serious risk, so you can make good decisions about your health. You can manage and control periodontal disease and reduce your risk of it becoming a detriment to your health. Good oral hygiene, a healthy diet and lifestyle, and regular dental visits–in other words what you already know you should be doing–can reduce your chance of developing periodontal disease.
One other thing: make sure those regular dental visits include a detailed evaluation of the condition of your gums. It’s called periodontal exam (see below) and it determines if you’ve had any detachment of your gums from your teeth and also records any bleeding that occurs with light touch.
Signs and symptoms of periodontal disease:
- Bleeding gums – Gums should never bleed, even when you brush vigorously or use dental floss. This is a sign of infection.
- Loose teeth – May be caused by bone loss or weakened periodontal fibers when the disease process is advanced (fibers that support the tooth to the bone).
- New spacing between teeth – Your teeth are held in place by the bone in your jaw. When you loose that support your teeth may start to drift as you put pressure on them during chewing or clenching your teeth. May indicate more advanced disease.
- Persistent bad breath – Caused by infection that can be present in the gums.
- Pus around the teeth and gums – A sign of severe infection.
- Receding gums – Loss of gum around a tooth which also means that there has been a loss of bone support.
- Red and puffy gums – Redness and swelling are more signs of infection.
- Tartar deposits – hardened deposits on your teeth indicate that plaque was allowed to stay on the teeth for a long time and contains highly infectious bacteria
Periodontal disease is diagnosed by your dentist or dental hygienist during a periodontal examination. This type of exam should always be part of your regular dental check-up.
A periodontal probe (small dental instrument) is used to gently measure the space between the tooth and the gums (the sulcus). The depth of a healthy sulcus measures three millimeters or less and does not bleed. The periodontal probe helps indicate if pockets are deeper than three millimeters. As periodontal disease progresses, the pockets usually get deeper.
Your dentist or hygienist will use pocket depths, amount of bleeding, inflammation, tooth mobility, etc., to make a diagnosis that will fall into a category below:
Gingivitis is the first stage of periodontal disease. Plaque and its toxic by-products irritate the gums, making them tender, inflamed, and likely to bleed.
Plaque hardens into calculus (tartar). As calculus and plaque continue to build up, the gums begin to detach or recede from the teeth. Deeper pockets form between the gums and teeth and become filled with bacteria. The gums become very irritated, inflamed, and bleed easily. Slight to moderate bone loss may be present.
The teeth lose more support as the gums, bone and the periodontal ligament that attaches the gums to the teeth continue to be destroyed. The infection becomes more severe and pus forms in the pockets. A side effect of the pus formation is often severe bad breath. Unless treated, the affected teeth will become loose and may be lost. Generalized moderate to severe bone loss may be present.
Periodontal treatment methods depend upon the type and severity of the disease. Your dentist and dental hygienist will evaluate for periodontal disease and recommend the appropriate treatment.
Periodontal disease progresses as the pockets get filled with bacteria, plaque, and tartar, causing irritation to the surrounding tissues. When these irritants remain in the pocket, they can cause damage to the gums and eventually, the bone that supports the teeth.
If the disease is caught in the early stages of gingivitis, and no damage has been done, improved home care and regular cleanings will be recommended. You will be given instructions on improving your daily oral hygiene habits.
If the disease has progressed to more advanced stages, treatment for periodontal disease called root debridement therapy, will be recommended. It is usually done one section of the mouth at a time while the area is numb. In this procedure, tartar, plaque, and toxins are removed from below the gum line and rough spots on root surfaces are made smooth, using both ultrasonic and hand instruments. A laser may also be used to eliminate bacteria in the pocket as well as remove unhealthy tissue. This procedure helps gum tissue to heal and pockets to shrink by reattaching to the tooth. Medications, special medicated mouth rinses, and an electric tooth brush may be recommended to help control infection and healing.
If the pockets do not heal after root debridement therapy, periodontal surgery (gum surgery) may be needed to reduce pocket depths, making teeth easier to clean. Surgical procedures are usually done by a Periodontist.