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Periodontal Disease

Periodontal Disease

What is Periodontal Disease?

Periodontal disease is commonly called gum disease. It is the result of infections and inflammation of the gums and bone that surround and support the teeth. In its early form, it is called gingivitis, when the gums become swollen and red and may possibly bleed. As it progresses, it can become periodontitis, when the gums pull away from the tooth. Teeth may become loose and fall out and bone loss may occur.

What causes Periodontal Disease?

Bacteria in the mouth can infect the tissue surrounding the teeth, which can lead to periodontal disease. When bacteria stay on the teeth long enough, a colorless film called "plaque" will form. If not cleaned away, plaque eventually hardens and becomes tartar. Tartar build-up can spread below the gum line, making teeth harder to clean. Brushing and flossing help get rid of plaque. Only a professional cleaning by a dentist or dental hygienist can remove tartar.

There are several risk factors that can lead to periodontal disease, including:

  • Smoking: Smoking is one of the most significant risk factors associated with the development of gum disease. Additionally, smoking can lower the chances for successful treatment.
  • Hormonal changes in girls/women: These changes can make gums more sensitive and make it easier for gingivitis to develop.
  • Diabetes: People with diabetes are at higher risk for developing infections, including gum disease.
  • Other illnesses and their treatments: Diseases such as AIDS and its treatments can also negatively affect the health of gums, as can treatments for cancer.
  • Medications: Many prescription and over-the-counter medications can reduce the flow of saliva, which has a protective effect on the mouth. Without enough saliva, the mouth is vulnerable to infections such as gum disease. Some medicines can cause abnormal overgrowth of the gum tissue, making it difficult to keep teeth and gums clean.
  • Genetic susceptibility: Some people are more prone to severe gum disease than others.
  • Poor oral hygiene
  • Crooked teeth
  • Fillings or bridges that have become defective

How does Periodontal Disease affect me?

Most people don't show signs of gum disease until they are in their 30 or 40s and men are more likely to develop it than women. Although teenagers rarely develop periodontitis, they can develop gingivitis, the milder form of gum disease. Most commonly, gum disease develops when plaque is allowed to build up along and under the gum line.

Here are some symptoms that may indicate gum disease:

  • Bad breath that won't go away
  • Red or swollen gums
  • Tender or bleeding gums
  • Painful chewing
  • Loose teeth
  • Sensitive teeth
  • Gums that have pulled away from the teeth

What can I do about Periodontal Disease?

The best thing to do is to avoid the possibility of periodontal disease as much as possible.

  • Brush your teeth twice a day (with fluoride toothpaste).
  • Floss regularly to remove plaque from between teeth. Use dental floss or a device such as a special brush or wooden or plastic pick recommended by a dental professional.
  • Visit the dentist routinely for a check-up and professional cleaning.
  • Don't smoke

If you experience any of the gum disease symptoms, mention it to your dental professional. At your dental visit the dentist or hygienist should:

  • Ask about your medical history to identify underlying conditions or risk factors (such as smoking) that may contribute to gum disease.
  • Examine your gums and note any signs of inflammation.
  • Use a tiny ruler called a "probe" to check for and measure any pockets. In a healthy mouth, the depth of these pockets is usually between 1 and 3 millimeters. This test for pocket depth is usually painless.

The dentist or hygienist may also:

  • Take an x-ray to see whether there is any bone loss.
  • Refer you to a periodontist. Periodontists are experts in the diagnosis and treatment of gum disease and may provide you with treatment options that are not offered by your dentist.

How is gum disease treated?

The main goal of treatment is to control the infection. The number and types of treatment will vary, depending on the extent of the gum disease. Any type of treatment requires that the patient keep up good daily care at home. The dentist may also suggest changing certain behaviors, such as quitting smoking, as a way to improve treatment outcome.

Other treatments include deep cleaning, called scaling and root planning. The dentist, periodontist, or dental hygienist removes the plaque through a deep-cleaning method called scaling and root planing. Scaling means scraping off the tartar from above and below the gum line. Root planing gets rid of rough spots on the tooth root where the germs gather, and helps remove bacteria that contribute to the disease.

Medications may be used with treatment that includes scaling and root planning, but they cannot always take the place of surgery. Depending on how far the disease has progressed, the dentist or periodontist may still suggest surgical treatment.

Some surgical treatments for periodontal disease include:

Flap Surgery: Surgery might be necessary if inflammation and deep pockets remain following treatment with deep cleaning and medications. A dentist or periodontist may perform flap surgery to remove tartar deposits in deep pockets or to reduce the periodontal pocket and make it easier for the patient, dentist, and hygienist to keep the area clean. This common surgery involves lifting back the gums and removing the tartar. The gums are then sutured back in place so that the tissue fits snugly around the tooth again. After surgery the gums will heal and fit more tightly around the tooth. This sometimes results in the teeth appearing longer.

Bone and Tissue Grafts: In addition to flap surgery, your periodontist or dentist may suggest procedures to help regenerate any bone or gum tissue lost to periodontitis. Bone grafting, in which natural or synthetic bone is placed in the area of bone loss, can help promote bone growth.

Gum disease can possibly have an effect on the rest of your body as well. People with gum disease may be more likely to develop heart disease or have difficulty controlling blood sugar. Some studies showed women with gum disease were more likely than those with healthy gums to deliver preterm, low birth weight babies.

Information sources:

Centers for Disease Control and Prevention

National Institute of Dental and Craniofacial Research