WHAT IS PERIODONTAL (GUM) DISEASE?
The term “periodontal”means “around the tooth.” Periodontal disease (also known as periodontitis and gum disease) is a common inflammatory condition which affects the supporting and surrounding soft tissues of the tooth; also the jawbone itself when in its most advanced stages.
Periodontal disease is most often preceded by gingivitis which is a bacterial infection of the gum tissue. Gingivitis occurs when there is a build-up of plaque and tartar along the gum line. A bacterial infection affects the gums when the toxins contained in plaque begin to irritate and inflame the gum tissues. Often the only sign (if any) is occasional bleeding when brushing. Once this bacterial infection colonizes in the gum pockets between the teeth, it becomes much more difficult to remove and treat. Periodontal disease is a progressive condition that eventually leads to the destruction of the connective tissue and jawbone. If left untreated, it can lead to shifting teeth, loose teeth and eventually tooth loss.
Periodontal disease is the leading cause of tooth loss among adults in the developed world and should always be promptly treated.
HOW DO I KNOW IF I HAVE GUM DISEASE?
Gum disease is often COMPLETELY PAINLESS, and sometimes the only warning signs may be bleeding gums, bad breath, receding gums or in more severe cases, teeth becoming loose. More often than not, patients have no idea there is even a problem!
SHOULD I BE CONCERNED?
If you suspect that you may have gum problems, the first step is to book in for a consultation with one of our dentists. A thorough assessment of your teeth and gums will allow us to determine if there is an issue of concern.
It is important to note that smoking, diabetes, certain illnesses and hormonal issues can cause gum disease to progress at a much more rapid rate.
CAN IT BE TREATED?
If you are experiencing occasional bleeding when brushing, you may likely have mild gingivitis. Luckily, this is completely reversible and can be managed with a home care program of correct brushing and flossing, along with regular visits to our friendly dentists.
More advanced cases once identified can also be treated, however the damage done in Periodontitis is usually irreversible. The focus becomes on preventing the progression of the disease and minimising any further damage.
Spring Orchid Dental has a dedicated team of dentists who specialise in looking after general gum health and treating gum disease issues, they spend the time to carefully and thoroughly scale and clean the teeth and gums and provide oral care advice as needed.
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. Unfortunately if left to progress, this eventually causes teeth to become loose and fall out.
HERE ARE SOME OF THE MOST COMMON PERIODONTAL DISEASE TYPES:
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.
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.
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.
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 gently used to measure the sulcus (pocket or space) between the tooth and the gums. 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 toxin 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 recede from the teeth. Deeper pockets form between the gums and teeth and become filled with bacteria and pus. 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 periodontal ligament continue to be destroyed. Unless treated, the affected teeth will become very 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 sulcus (pocket or space) between the tooth and gums gets filled with bacteria, plaque, and tartar, causing irritation to the surrounding tissues. When these irritants remain in the pocket space, 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, one to two regular cleanings will be recommended. You will also be given instructions on improving your daily oral hygiene habits and having regular dental cleanings.
If the disease has progressed to more advanced stages, a special periodontal cleaning called scaling and root planing (deep cleaning) will be recommended. It is usually done one quadrant of the mouth at a time while the area is numb. In this procedure, tartar, plaque, and toxins are removed from above and below the gum line (scaling) and rough spots on root surfaces are made smooth (planing). This procedure helps gum tissue to heal and pockets to shrink. 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 scaling and root planing, periodontal surgery may be needed to reduce pocket depths, making teeth easier to clean. Your dentist may also recommend that you see a Periodontist (specialist of the gums and supporting bone).
TREATMENT PROCEDURES 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.
- Ask your dentist if you have questions or concerns about periodontal disease, periodontal treatment, or dental implants.
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!
HOW CAN I TELL IF I HAVE GINGIVITIS OR PERIODONTITIS (GUM DISEASE)?
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. Unlike tooth decay, which often causes discomfort, it is possible to have periodontal disease without noticeable symptoms. Having regular dental check-ups and periodontal examinations are very important and will help detect if periodontal problems exist.
Periodontal disease begins when plaque, a sticky, colorless, film of bacteria, food debris, and saliva, is left on the teeth and gums. The bacteria produce toxins (acids) that inflame the gums and slowly destroy the bone. Brushing and flossing regularly and properly will ensure that plaque is not left behind to do its damage.
Other than poor oral hygiene, there are several other factors that may increase the risk of developing periodontal disease:
Smoking or chewing tobacco – Tobacco users are more likely than non-users to form plaque and tartar on their teeth.
Certain tooth or appliance conditions – Bridges that no longer fit properly, crowded teeth, or defective fillings that may trap plaque and bacteria.
Many medications – Steroids, cancer therapy drugs, blood pressure meds, oral contraceptives. Some medications have side affects that reduce saliva, making the mouth dry and plaque easier to adhere to the teeth and gums.
Pregnancy, oral contraceptives, and puberty – Can cause changes in hormone levels, causing gum tissue to become more sensitive to bacteria toxins.
Systemic diseases – Diabetes, blood cell disorders, HIV / AIDS, etc.
Genetics may play a role – Some patients may be predisposed to a more aggressive type of periodontitis. Patients with a family history of tooth loss should pay particular attention to their gums.
Signs and Symptoms of Periodontal Disease
Red and puffy gums– Gums should never be red or swollen.
Bleeding gums– Gums should never bleed, even when you brush vigorously or use dental floss.
Persistent bad breath– Caused by bacteria in the mouth.
New spacing between teeth– Caused by bone loss.
Loose teeth– Also caused by bone loss or weakened periodontal fibers (fibers that support the tooth to the bone).
Pus around the teeth and gums– Sign that there is an infection present.
Receding gums– Loss of gum around a tooth.
Tenderness or Discomfort– Plaque, calculus, and bacteria irritate the gums and teeth.
Good oral hygiene, a balanced diet, and regular dental visits can help reduce your risk of developing periodontal disease.
IS THERE A CORRELATION BETWEEN HEART DISEASE AND PERIODONTAL DISEASE?
Many people are unaware that having periodontal disease (the destruction of gum tissue and bone that hold our teeth in place) can affect your overall health.
Periodontal disease is one of the most common infections – often more prevalent than the common cold! Periodontal disease is not only the number one reason people lose teeth; it can also affect the health of your body!
Periodontal disease is a bacterial infection, and in its earliest stages, it’s called gingivitis. It starts when an accumulation of plaque (a colony of bacteria, food debris, and saliva) is NOT regularly removed from the gums and teeth. The bacteria in plaque produce toxins/acids that irritate and infect the gums, eventually destroying the jaw bone that supports the teeth. When periodontal disease is not treated it can eventually lead to tooth loss!
There are numerous studies that have looked into the correlation between gum disease and major medical conditions. These studies suggest people with periodontal disease are at a greater risk of systemic disease. They also indicate that periodontal disease can allow oral bacteria to enter the bloodstream and travel to major organs, beginning new infections. Research suggests that periodontal bacteria in the blood stream can:
Contribute to the development of heart disease
Increase the risk of stroke
Compromise the health of those that have diabetes or respiratory diseases
Increase a woman’s risk of having a preterm, low-birth weight baby
While there is still much research to be done in order to fully understand the link between periodontal disease and systemic diseases, research has shown that infections in the mouth can wreak havoc elsewhere in the body.
To ensure a healthy, disease-free mouth, we recommend the importance of regular dental check-ups and cleanings, which include a periodontal evaluation. Also, diligent home care and a proper diet can help reduce plaque and bacteria in the mouth.
Remember the mouth body connection! Taking care of your oral health can contribute to your overall medical health!
WHAT IS PERIODONTAL DISEASE AND HOW CAN I AVOID IT?
Periodontal disease is also known as gum disease and often begins as gingivitis. Periodontal disease in its early stages is characterised by red, swollen or puffy gums which can often bleed upon brushing of flossing. Periodontal disease is cause by bacteria called ‘plaque’ covering your teeth and penetrating the gum line. Factors such as diabetes, stress, pregnancy and some medications can also increase the likelihood of developing gum disease. Contact our dentist if you feel like you may be suffering from gum disease.
WHY DO MY GUMS BLEED?
The most common cause of bleeding gums is plaque build-up on the teeth, resulting in gum inflammation (gingivitis).
Bleeding gums is usually a sign that your oral hygiene technique may need some improvement.
If your gums are bleeding, try brush to the gum line of every tooth twice daily and floss once a day.
Bleeding gums may also be a result of gum disease (periodontitis) or other less common causes.
Please book an appointment for a check up and clean so that we can assess the health of the gums.