What is Periodontal (Gum) Disease?
Most people are aware of the most common kind of tooth decay that is treated by filling cavities with various materials. Another common dental problem that many people are not aware of is gum disease (or periodontal disease). Instead of attacking the tooth itself and causing cavities, acids produced by bacteria in the mouth infect the gums that surround the base of the tooth-attacking fibers and bone that hold the teeth in place. If untreated, this results in teeth becoming loose and eventually to their loss. In fact, gum disease is the leading cause of tooth loss in the United States affecting as many as 75% of the population.
Gum disease begins with a mild inflammation known as Gingivitis caused by an infection of the gum tissue. Unlike tooth decay, gum disease, at least in its early stages, is not accompanied by pain and therefore often remains undiagnosed. (This is one of the important reasons dentists recommend regular checks.) If untreated, the disease progresses forming pockets between the teeth and gum and also to receding gums giving the impression that the teeth are lengthening. Important early warning signs of progressive gum disease include bleeding when brushing, flossing, or eating as well as swelling, pain, loose teeth, halitosis, and pus between the teeth.
The treatment of gum disease will depend on its severity. If the disease has progressed beyond the early stage of gingivitis where regular cleaning may suffice, special periodontal deep cleaning will be necessary. This involves two procedures performed after numbing the affected areas. Scaling removes the toxic matter from above and below the gum line while Planing smooths and removes deposits on the root surfaces of the teeth. These procedures, together with a range of antibiotic treatments, promote the healing of gum tissue and shrinkage of the gum pockets. If these treatments are not sufficient or if the disease has progressed to a more severe stage with the destruction of gum tissue and bone, then surgical procedures may be necessary to promote their regeneration.
There are many causes of gum disease some of which are amenable to prevention such as good oral hygiene, a sensible diet with reduced sugar and starch, and regular dental visits to ensure that the disease is caught in its early stage where the effects can be completely reversed using mild forms of treatment. Other factors that may cause or exacerbate gum disease include stress, smoking, diabetes, grinding of teeth, and medication such as oral contraceptive pills, heart medication, anti-depressants, and steroids. Hormonal changes that occur during pregnancy and menopause can increase sensitivity to the gums leaving them more susceptible to gum disease. A number of medical conditions are associated with gum disease including oral cancers, heart disease and stroke, respiratory disease, osteoporosis, and AIDS. However, nearly a third of the population is genetically predisposed to gum disease increasing its probability sixfold. Even with the most rigorous oral hygiene, the best form of prevention is a regular check with a Dentist or Oral Hygienist.
Types of Periodontal Disease
When left untreated, gingivitis (mild gum inflammation) can spread to below the gum line. When the gums become irritated by the toxins contained in plaque, a chronic inflammatory response causes the body to break down and destroy its own bone and soft tissue. There may be little or no symptoms as periodontal disease causes the teeth to separate from the infected gum tissue. Deepening pockets between the gums and teeth are generally indicative that soft tissue and bone is being destroyed by periodontal disease.
Here are some of the most common types of periodontal disease:
- Chronic periodontitis – Inflammation within supporting tissues cause deep pockets and gum recession. It may appear the teeth are lengthening, but in actuality, the gums (gingiva) are receding. This is the most common form of periodontal disease and is characterized by progressive loss of attachment, interspersed with periods of rapid progression.
- Aggressive periodontitis – This form of gum disease occurs in an otherwise clinically healthy individual. It is characterized by rapid loss of gum attachment, chronic bone destruction and familial aggregation.
- Necrotizing periodontitis – This form of periodontal disease most often occurs in individuals suffering from systemic conditions such as HIV, immunosuppression and malnutrition. Necrosis (tissue death) occurs in the periodontal ligament, alveolar bone and gingival tissues.
- Periodontitis caused by systemic disease – This form of gum disease often begins at an early age. Medical condition such as respiratory disease, diabetes and heart disease are common cofactors.
Treatment for Periodontal Disease
There are many surgical and nonsurgical treatments the periodontist may choose to perform, depending upon the exact condition of the teeth, gums and jawbone. A complete periodontal exam of the mouth will be done before any treatment is performed or recommended.
Here are some of the more common treatments for periodontal disease:
- Scaling and root planing – In order to preserve the health of the gum tissue, the bacteria and calculus (tartar) which initially caused the infection, must be removed. The gum pockets will be cleaned and treated with antibiotics as necessary to help alleviate the infection. A prescription mouthwash may be incorporated into daily cleaning routines.
- Tissue regeneration – When the bone and gum tissues have been destroyed, regrowth can be actively encouraged using grafting procedures. A membrane may be inserted into the affected areas to assist in the regeneration process.
- Pocket elimination surgery – Pocket elimination surgery (also known as flap surgery) is a surgical treatment which can be performed to reduce the pocket size between the teeth and gums. Surgery on the jawbone is another option which serves to eliminate indentations in the bone which foster the colonization of bacteria.
- Dental implants – When teeth have been lost due to periodontal disease, the aesthetics and functionality of the mouth can be restored by implanting prosthetic teeth into the jawbone. Tissue regeneration procedures may be required prior to the placement of a dental implant in order to strengthen the bone.
Please contact our office if you have questions or concerns about periodontal disease, periodontal treatment, or dental implants.
Causes of Periodontal Disease
Types of Periodontal Disease
Signs & Symptoms of Periodontal Disease
Mouth – Body Connection
Periodontal Disease and Diabetes
Periodontal Disease, Heart Disease and Stroke
Periodontal Disease and Pregnancy
Periodontal Disease and Osteoporosis
Periodontal Disease and Respiratory Disease
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