Hygiene & Periodontal Disease

What is periodontal disease? How is it caused? How can it be treated?

Periodontal Disease
Periodontal (gum) disease, including gingivitis and periodontitis, is a serious infection that, left untreated, can lead to tooth loss. The word "periodontal" literally means around the tooth. Periodontal disease is a chronic bacterial infection that affects the gums and bone supporting the teeth.

Periodontal disease can affect one tooth or many teeth. It begins when the bacteria in plaque (the sticky, colorless film that constantly forms on your teeth) causes the gums to become inflamed. In the mildest form of the disease, gingivitis, the gums redden, swell and bleed easily. There is usually little or no discomfort. Gingivitis is often caused by inadequate oral hygiene. Gingivitis is reversible with professional periodontal disease treatment and good oral home care.

Untreated gingivitis can advance to periodontitis. With time, plaque can spread and grow below the gum line. Toxins produced by the bacteria in plaque irritate the gums. The toxins stimulate a chronic inflammatory response in which the body in essence turns on itself, and the tissues and bone that support the teeth are broken down and destroyed. Most of the time this detrruction happens below the surface of the gumline and goes unnoticed by the patient.

The gums attacment to the roots degenerates, forming pockets (spaces between the teeth and gums) that probe deeper than normal and become infected. As the disease progresses, the pockets deepen and more bone is destroyed. Often, this destructive process has very mild symptoms. Eventually, teeth can become loose and may have to be removed if periodontal disease treatment was not initiated early enough.

What Causes Periodontal Disease?
The main cause of periodontal disease is bacterial plaque, a sticky, colorless film that constantly forms on your teeth. However, factors like the following also affect the health of your gums and the progression of the disease.

Smoking/Tobacco Use - Tobacco use is linked with many serious illnesses such as cancer and heart disease, as well as numerous other health problems. Tobacco users also are at increased risk for periodontal disease. In fact, recent studies have shown that tobacco use may be one of the most significant risk factors in the development and progression of periodontal disease.

Genetics - Research proves that up to 30% of the population may be genetically susceptible to gum disease. Despite aggressive oral care habits, these people may be six times more likely to develop periodontal disease. Identifying these people with a genetic test before they even show signs of the disease and getting them into early interceptive treatment may help them keep their teeth for a lifetime.

Pregnancy and Puberty -Brushing and flossing daily, a healthy diet, and regular exercise are all important to help you stay in shape. At specific times in your life, you need to take extra care of yourself. Times when you mature and change, for example, puberty or menopause, and times when you have special health needs, such as menstruation or pregnancy. During these particular times, your body experiences hormonal changes. These changes can affect many of the tissues in your body, including your gums. Your gums can become sensitive, and at times react strongly to the hormonal fluctuations. This may make you more susceptible to gum disease. Additionally, recent studies suggest that pregnant women with gum disease are seven times more likely to deliver preterm, low birth weight babies.

Stress - Stress is linked to many serious conditions such as hypertension and numerous other health problems. What you may not know is that stress also is a risk factor for periodontal disease. Research demonstrates that stress can make it more difficult for the body to fight off infection, including periodontal diseases.

Diabetes - Diabetes is a disease that causes altered levels of sugar in the blood. Diabetes develops from either a deficiency in insulin production (a hormone that is the key component in the body's ability to use blood sugars) or the body's inability to use insulin correctly. According to the American Diabetes Association, approximately 16 million Americans have diabetes; however, more than half have not been diagnosed with this disease. If you are diabetic, you are at higher risk for developing infections, including periodontal diseases. These infections can impair the ability to process and/or utilize insulin, which may cause your diabetes to be more difficult to control and your infection to be more severe than a non-diabetic. Because of the direct relationship of diabetis to gum disease, we have aided in the diagnosis of many previously undiagnosed diabetic conditions. As stated by one of our patients recently, after referral to his physician for evaluluation, "My doctor said to tell you thanks for saving my life." 

Other Systemic Diseases - Diseases that interfere with the body's immune system may worsen the condition of the gums.

Types of Periodontal Disease
There are many forms of periodontal disease requiring treatment. The most common ones include the following.

Gingivitis -Gingivitis is the mildest form of periodontal disease. It causes the gums to become red, swollen, and bleed easily. There is usually little or no discomfort at this stage. Gingivitis is reversible with professional treatment and good at home oral care.

Mild Periodontitis - If gingivitis, the mildest form of periodontal disease, is left untreated, it can advance to more advanced periodontitis. In the mild stage, periodontal diseases begin to destroy the bone and tissue that support the teeth.

Moderate to Advanced Periodontitis - Moderate to advanced periodontitis develops if earlier forms of the disease like gingivitis and mild periodontitis are left untreated. This is the stage where bone loss occurs and leads to loss of teeth in the most advanced cases. Fortunately, with today's advancements in periodontal disease therapy, our practice is able to keep the number of patients who loose teeth from this disease to a small percentage of less than 2% of patients.

Diagnosing Periodontal Disease
You may not realize that persistent swollen, red or bleeding gums, tooth sensitivity, and bad breath are warning signs of periodontal disease. While we can determine if you do have this problem, here are ten questions you can ask yourself about the warning signs behind periodontal disease so that you can seek treatment.

Methods of Periodontal Disease Treatment
If you're diagnosed with periodontal disease, we may recommend periodontal surgery to correct and prevent problems. Periodontal disease treatment or surgery is necessary when we determine that the tissue around your teeth is unhealthy and cannot be repaired with non-surgical treatment. Generally dental hygienists perforn non-surgical treatment with a procedure known as scaling and root planing where the surfaces of the roots below the gumline are cleaned with special instruments called curettes. This treatment is very effective at reversing periodontal disease and must be followed closely by our hygienists.

Depending on the severity of your periodontal disease or the response to scaling and root planing, some of the following periodontal disease treatments may be prescribed:

Pocket Reduction Surgery
Guided Tissue Regeneration or Guided Bone Regeneration Procedures
Crown Lengthening
Soft Tissue Grafts
Dental Implants (if you've already lost a tooth due to periodontal disease)