The nature of periodontal disease (gum disease) can at times be a mystery to people but its really quite simple:
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•It is caused by the bacteria that we all have and produce in our mouths.
•Some of these groups of bacteria (there are several kinds) are stronger and more destructive that others.
•Like all other diseases of the body, some people have stronger resistance to these bacteria than others (For example, why can one person smoke their entire life and never get sick yet another develop lung cancer via second hand smoke).
•As with other disease entities like high blood pressure and diabetes, there is no cure. There are however effective, long-term treatments (such as scaling, root planing, and periodontal maintenance therapy) that can maintain a state of health, even though the cause of the disease may still be present.
•Your gums can look and feel quite normal yet pockets of periodontal infection can still be present. Gum disease most often is not painful. |
What is Gum Disease?
Gum disease, or periodontal disease is a chronic inflammation and infection of the gums and surrounding tissue. It is the major cause of about 70 percent of adult tooth loss, affecting three out of four people at some point in their life. Periodontal diseases include Gingivitis and periodontitis. Gingivitis is a milder form affecting only the gum tissue, while periodontitis affects the gums and surrounding ligaments and bone.
What Causes Gum Disease?
Bacterial plaque – a sticky, colorless film that constantly forms on the teeth – is recognized as the primary cause of gum disease. If plaque isn’t removed each day by brushing and flossing, it hardens into a rough, porous substance called calculus (also known as tartar). Toxins produced and released by bacteria in plaque irritate the gums. These toxins cause the breakdown of the fibers that hold the gums tightly to the teeth, creating periodontal pockets that fill with even more toxins and bacteria. As the disease progresses, pockets extend deeper, and the bacteria moves down until the bone that holds the tooth in place is destroyed. The tooth eventually will fall out or require extraction.
Risks and Prevention
Although bacterial plaque buildup is the main cause of periodontal disease, several other factors, including other diseases, medications, oral habits, and personal bacterial resistance, can also be contributing factors. These are factors that can increase your risk of gum disease or make it worse once the infection has set in.
Genetics
Researchers believe up to 30% of the population may have a genetic susceptibility to periodontal disease. Having a genetic susceptibility, however, doesn’t mean gum disease is inevitable. Even people who are highly prone to periodontal disease because of their genetic make-up can prevent or control the disease with good oral care.
Smoking and Tobacco Use
Smoking increases the risk of periodontal disease and the longer, and more one smokes, the higher the risk. If periodontal disease is present, smoking makes it more severe. Smoking is the main cause of periodontal disease that is resistant to treatment. Smokers tend to collect more tartar on their teeth, develop deeper periodontal pockets once they have gum disease and are likely to lose more bone as the disease progresses. Unlike many other factors that affect the health of your gums, you have control over this one. Quitting smoking can play a major role in bringing periodontal disease under control.
Misaligned or crowded teeth, braces or bridgework
Anything that makes it more difficult to brush or floss your teeth is likely to enhance plaque and tartar formation above and below the gum line, which increases your chance of developing gum disease. We can show you the best ways to clean your teeth, especially in hard-to-clean circumstances. For example, there are special tools and ways of threading floss to clean around bridgework or slide under braces. And if overcrowded or crooked teeth are a problem, we might recommend orthodontics to straighten out your smile and give you a better chance of preventing disease.
Grinding, gritting or clenching of teeth
These habits won’t cause periodontal disease, but they can lead to more severe disease if inflammation is already present. The excessive force exerted on the teeth by these habits appears to speed up the breakdown of the periodontal ligament and bone. In many cases, patients can learn to stop this habit during the day by recognizing it is happening and then relaxing. At night these efforts don’t work. We may recommend creating a custom night guard to reduce the pressure from grinding.
Stress
Stress can worsen periodontal disease and make it harder to treat. Stress weakens your body’s immune system, which makes it harder for your body to fight off infection, including periodontal disease.
Fluctuating hormones
Whenever hormones fluctuate in the body, changes can occur in the mouth. Puberty and pregnancy can temporarily increase the risk and severity of gum disease, as can menopause.
Medications
Several types of medications can cause dry mouth, that can lead to periodontal disease. Please tell us if you are taking medications.
Diseases
Although the exact mechanisms aren’t totally understood, certain diseases increase susceptibility to periodontal diseases. For example, people with diabetes are more likely to get periodontitis, than people without diabetes and it’s likely to be more severe. Other diseases, such as leukemia, inflammatory bowel disease and HIV infection, also can increase the risk. Having one of these diseases will make control of periodontal disease more difficult. Being aware of these additional risks and difficulties will allow us to fine tune your gum therapy, and offer guidance to maintain your periodontal health.
Poor nutrition
Nutrition is important for overall good health, including a working immune system and healthy gums and mouth.
Symptoms of Gum Disease
Periodontal infection is usually painless until it reaches an advanced stage. However, there are some symptoms that can indicate the presence of periodontal infection. These include:
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•Red or swollen gums
•Bleeding when brushing (pink toothbrush) or at other times
•Aching, itchy, sore or tender gums
•Receding gums (teeth beginning to look longer)
•Bad breath •Any change in the way your teeth fit together when you bite
•Loose, separating or protruding teeth
•Spaces between teeth |
If you notice any of the above warning signs of periodontal infection, please contact us.
Can gum disease affect the rest of my body?
We now know that gum disease and the causative bacteria have a direct deleterious affect on our general health and other body systems. These include:
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Atherosclerosis and Heart Disease – Gum disease increases the risk of clogged arteries and heart disease, although the extent of this connection is unclear. Gum disease can also worsen existing heart disease.
Stroke – Gum disease increases the risk of the type of stroke that is caused by blocked arteries.
Diabetes – People with diabetes and periodontal disease are more likely to have trouble controlling their blood sugar than diabetics with healthy gums.
Premature Births – A woman who has gum diseases during pregnancy is more likely to deliver her baby too early and the infant may be more likely to be of low birth weight. One study showed that up to 18% of premature, low birth-weight babies might be linked to maternal gum disease.
Respiratory Disease – Gum disease may cause lung infections and worsen existing lung conditions when bacteria from the mouth reach the lungs. |
What does periodontal treatment involve?
In the early stages of gum disease, most treatment involves a special service called scaling and root planing. This involves removing the plaque, tartar, and infection from around the tooth to the depth of the pocket. Antibiotics or antimicrobials may be used to supplement the effects of scaling and root planing. In most cases of early gum disease, scaling and root planing and proper daily cleaning achieve a satisfactory result. More advanced cases may require surgical treatment, which involves cutting the gums and removing the hardened plaque build-up, and recontouring the damaged bone. The procedure is also designed to smooth root surfaces and reposition the gum tissue so it will be easier to keep clean.
How do you prevent gum disease?
Removing plaque through daily brushing, flossing and professional cleaning is the best way to minimize your risk. We can design a personalized program of home oral care to meet your needs.
Maintenance is Critical
Sticking to a regular oral hygiene regimen is crucial for patients who want to sustain the results of periodontal therapy. Patients should visit the dentist every three to four months (or more, depending on the patient) for spot scaling and root planing and an overall exam. In between visits, they should brush at least twice a day, floss daily and brush their tongue. Manual soft nylon bristle brushes are the most dependable and least expensive. Electric brushes are also a good option, but don’t reach any further into the pocket than manual brushes. Proxy brushes (small, narrow brushes) and other interdental cleaners are the best way to clean between the recesses in the teeth and should be used once a day. We believe the waterpic is also a wonderful adjunctive tool in keeping your mouth clean and your gum disease in check.
Definitions You Should Know:
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Plaque – A sticky film containing bacteria that forms on our teeth. If not removed each day it forms a fuzzy yellow appearance around the tooth, which hardens into calculus.
Calculus – the calcified form of dental plaque. Layers are added to calculus over time making it more and more destructive to the supporting bone and gums.
Perio probing / Probe scores – A probe is a very thin, rounded instrument that is marked in millimeter (mm) increments. The probe is gently inserted between your teeth and gums and is allowed to fall to the first point of resistance. A millimeter reading is then recorded. There are six recordings around each tooth. These recordings help us determine if you have gum disease and if so, to what extent. This also serves as a guide to allow us to provide the proper necessary therapy for you.
Pocket – A pocket is the depth of gum tissue around your tooth as measured by the probe. Low number probe scores mean the pocket is small and healthy. Larger probe readings mean the pocket is getting deeper and treatment may be warranted.
Periodontal maintenance – The time in between hygiene visits that we have determined best fits your needs. This is critical to maintaining a high level of dental care. We all have different abilities to carry on proper home care, different genetics and habits, and a different rate of plaque buildup and resistance to it. Some of us are lucky enough to have a cleaning twice a year and maintain optimal oral health. Others aren’t so lucky. Seeing our hygienist, Renée, three to four times a year can make a huge improvement on your dental and general health. We’ll let you know what we believe is the best maintenance schedule for you.
Scaling –
Scaling is a procedure that meticulously removes contamination toxins, micro-organisms, plaque and tartar that is rough and/or permeated by calculus from around, below and under the gum line down to the bottom of the pocket. This promotes a healing response from the gum tissue.
Root planning – This involves smoothing the root surfaces of your teeth with thin curettes so gum tissue can more firmly reattach to the tooth roots. The procedure makes it more difficult for plaque to accumulate along the root surfaces. |
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