WHAT YOU SHOULD KNOW ABOUT PERIODONTAL DISEASE
Christiane Tourtet B.A.
September 02, 2007
An estimated 80 percent of adults in America have some kind of periodontal (gum) disease. Until they are in their 30s or 40s people usually don´t show signs of gum disease. Men are more prone to gum disease than women. It is rather rare for teenagers to develop periodontitis, however they can develop gingivitis.
Gum diseases can range from simple gum inflammation to quite serious disease that result in major damage to the bone that support the teeth as well as to the soft tissue.
Teeth are lost in the worst cases. Gum disease is a real threat to oral health, and research is also pointing to health effects that can go well beyond the mouth, such as increased risk of stroke or heart attack, difficulty controlling blood sugar levels in diabetic people, and an increasing risk of delivering preterm, low birth weight babies. Depending on how well you care for your gums and teeth daily, the disease might slow down, stop, or get worse. Some of the things you can do to prevent periodontal diseases, is to brush your teeth twice every day (preferably with a fluoride toothpaste), floss daily, eat a well balanced diet, do not use tobacco products, and visit your dentist routinely for a check-up and professional cleaning.
Our mouth is full of bacteria which along with mucus and other particles form constantly a colorless, sticky "plaque" on teeth. Flossing and brushing help get rid of the plaque, however plaque that is not removed, can become hard and form what is called bacteria-harboring "tartar" that brushing is unable to clean. Only cleaning done professionally by a dentist or a dental hygienist can remove tartar.
The longer plaque and tartar stay on the teeth, the more harmful they can become, as the bacteria produces inflammation of the gums, called "gingivitis", which results in swollen, red gums, that can bleed easily. Gingivitis is considered to be a mild form of gum disease that can be reversed with flossing and brushing every day, and by regular cleaning done by a dental hygienist or a dentist. This type of gum disease does not include any loss of tissue or bone that hold teeth in place.
However, when gingivitis is not treated, it can progress to "periodontitis" which is an inflammation around the teeth. Gums at that point pull away from the teeth and form pockets that are infected .Via the immune system the body fights the bacteria as the plaque grows and spreads below the gum line. Body´s enzymes and bacterial toxins fighting the infection start breaking down the connective tissue and the bone that hold teeth in place .If untreated, the gums, connective tissue and bones that support the teeth are destroyed. The teeth may become quite loose and might have to be removed.
People with diabetes have a much higher risk for developing infections, and that includes periodontal disease. Women, girls, going through hormonal changes can have gums more sensitive and thus may develop gingivitis. Smoking is a very significant risk factor associated with the development of periodontitis. Illnesses such as cancer and its treatment can affect the health of gums. Some medications, such as antidepressants, some heart medicines, can also affect oral health since they lessen the flow of saliva, (saliva protects gums and teeth).Genetic susceptibility can make some people more prone to severe periodontal disease than others. Stress can impair the body´s ability to fight infection, and that also includes periodontal disease.
The symptoms of gum disease are usually not noticeable until the disease is advanced. They include, bleeding, tender, red and swollen gums, persistent bad breath that does not go away, sensitive, loose teeth, painful chewing. Any of these symptoms, may be a sign of a serious problem and should be checked as soon as possible by a dentist. The dentist will ask about your medical history, in order to be able to identify risk factors and underlying conditions. The hygienist or dentist will examine your gums and note any indication of inflammation. They will use a probe (a tiny ruler) to check for periodontal pockets and to measure them. In a mouth that is healthy, the depth of these pockets usually is between 1 and 3 millimeters. They may take an X-ray to find out if there is any bone loss. The dentist may send you to a periodontist ( a specialist who treat gum diseases).
The most important goal of the treatment is to control the infection. Depending of the extent of the gum disease, the types and number of treatment will vary, however any type of treatment will require that the patient keep up good care at home, every day.
The periodentist, dentist, or dental hygienist, will remove the plaque through scaling , which means, scraping off the tartar from below and above the gum line, and via root planning, to get rid of hard spots on the root of the tooth where germs accumulate, and thus helping the removal of bacteria that is contributing to the disease. Medications might be used also as part of the treatment that include scaling and root planning, but they cannot always replace surgery.
Some medications that are currently used are prescription antimicrobial mouthrinse containing the antimicrobial chlorhexidine, to control bacteria during the treatment of gingivitis and following gum surgery. It is used like a regular mouthwash. Antiseptic "chip" which is a very small piece of gelatin filled with chlorhexidine, can be used to control bacteria and reduce the size of periodontal pockets. It is placed in the pockets, after root planning where the medicine over time, is slowly released .Antibiotic gel containing the antibiotic doxycycline, can be put in the pockets after scaling and root planning, and is released slowly over a period of about seven days. Antibiotic microspheres, which are very small particles containing the antibiotic minocycline, can be put into the pockets after scaling and root planning. These particles release minocycline slowly over time. A low dose of the medication doxycycline (an enzyme suppressant) in a pill form can be used in combination with scaling and root planning, in order to hold back the body´s enzyme response, because if not controlled, certain enzymes can break down gum tissue.
However, depending on the severity of the periodontal disease, surgical treatment might be advised. More studies especially long-term studies will be needed to find out whether using medications reduces the need for surgery and if using medications is effective over a lengthy period of time. If inflammation and deep pockets remain after treatment with medications and deep cleansing, a periodontist may have to perform flap surgery which is a common surgery involving lifting back the gums and removing tartar. The gums, then, are sutured back in place, so that the tissue fit tightly around the tooth again. Sometimes, in addition to flap surgery, a periodontist might suggest tissue or bone grafts, to replace or encourage new growth of gum tissue or bone that have been destroyed by periodontitis. A technique called guided tissue regeneration, which is a tiny piece of mesh-like fabric inserted between the gum tissue and the bone, can be used in bone grafting, as it will prevent the gum tissue from growing into the area where the bone should be, thus allowing the connective tissue and the bone to grow again. Each case is different, and it is not possible to predict for sure which grafts will be successful over
long term. The results of treatment depends on many factors, such as the severity of the disease, some risk factors such as smoking, the ability to maintain at home oral hygiene. It is best to ask your periodontist what might be the level of success in your particular situation. It is also advised to get a second opinion, when considering extensive dental treatment, by calling for instance your dental society, which can provide you with the names of practitioners in your area.
Reference:
NIDCR, National Institute of Dental and Craniofacial Research.
© 2007 Christiane Tourtet, all rights reserved.
Gum diseases can range from simple gum inflammation to quite serious disease that result in major damage to the bone that support the teeth as well as to the soft tissue.
Teeth are lost in the worst cases. Gum disease is a real threat to oral health, and research is also pointing to health effects that can go well beyond the mouth, such as increased risk of stroke or heart attack, difficulty controlling blood sugar levels in diabetic people, and an increasing risk of delivering preterm, low birth weight babies. Depending on how well you care for your gums and teeth daily, the disease might slow down, stop, or get worse. Some of the things you can do to prevent periodontal diseases, is to brush your teeth twice every day (preferably with a fluoride toothpaste), floss daily, eat a well balanced diet, do not use tobacco products, and visit your dentist routinely for a check-up and professional cleaning.
Our mouth is full of bacteria which along with mucus and other particles form constantly a colorless, sticky "plaque" on teeth. Flossing and brushing help get rid of the plaque, however plaque that is not removed, can become hard and form what is called bacteria-harboring "tartar" that brushing is unable to clean. Only cleaning done professionally by a dentist or a dental hygienist can remove tartar.
The longer plaque and tartar stay on the teeth, the more harmful they can become, as the bacteria produces inflammation of the gums, called "gingivitis", which results in swollen, red gums, that can bleed easily. Gingivitis is considered to be a mild form of gum disease that can be reversed with flossing and brushing every day, and by regular cleaning done by a dental hygienist or a dentist. This type of gum disease does not include any loss of tissue or bone that hold teeth in place.
However, when gingivitis is not treated, it can progress to "periodontitis" which is an inflammation around the teeth. Gums at that point pull away from the teeth and form pockets that are infected .Via the immune system the body fights the bacteria as the plaque grows and spreads below the gum line. Body´s enzymes and bacterial toxins fighting the infection start breaking down the connective tissue and the bone that hold teeth in place .If untreated, the gums, connective tissue and bones that support the teeth are destroyed. The teeth may become quite loose and might have to be removed.
People with diabetes have a much higher risk for developing infections, and that includes periodontal disease. Women, girls, going through hormonal changes can have gums more sensitive and thus may develop gingivitis. Smoking is a very significant risk factor associated with the development of periodontitis. Illnesses such as cancer and its treatment can affect the health of gums. Some medications, such as antidepressants, some heart medicines, can also affect oral health since they lessen the flow of saliva, (saliva protects gums and teeth).Genetic susceptibility can make some people more prone to severe periodontal disease than others. Stress can impair the body´s ability to fight infection, and that also includes periodontal disease.
The symptoms of gum disease are usually not noticeable until the disease is advanced. They include, bleeding, tender, red and swollen gums, persistent bad breath that does not go away, sensitive, loose teeth, painful chewing. Any of these symptoms, may be a sign of a serious problem and should be checked as soon as possible by a dentist. The dentist will ask about your medical history, in order to be able to identify risk factors and underlying conditions. The hygienist or dentist will examine your gums and note any indication of inflammation. They will use a probe (a tiny ruler) to check for periodontal pockets and to measure them. In a mouth that is healthy, the depth of these pockets usually is between 1 and 3 millimeters. They may take an X-ray to find out if there is any bone loss. The dentist may send you to a periodontist ( a specialist who treat gum diseases).
The most important goal of the treatment is to control the infection. Depending of the extent of the gum disease, the types and number of treatment will vary, however any type of treatment will require that the patient keep up good care at home, every day.
The periodentist, dentist, or dental hygienist, will remove the plaque through scaling , which means, scraping off the tartar from below and above the gum line, and via root planning, to get rid of hard spots on the root of the tooth where germs accumulate, and thus helping the removal of bacteria that is contributing to the disease. Medications might be used also as part of the treatment that include scaling and root planning, but they cannot always replace surgery.
Some medications that are currently used are prescription antimicrobial mouthrinse containing the antimicrobial chlorhexidine, to control bacteria during the treatment of gingivitis and following gum surgery. It is used like a regular mouthwash. Antiseptic "chip" which is a very small piece of gelatin filled with chlorhexidine, can be used to control bacteria and reduce the size of periodontal pockets. It is placed in the pockets, after root planning where the medicine over time, is slowly released .Antibiotic gel containing the antibiotic doxycycline, can be put in the pockets after scaling and root planning, and is released slowly over a period of about seven days. Antibiotic microspheres, which are very small particles containing the antibiotic minocycline, can be put into the pockets after scaling and root planning. These particles release minocycline slowly over time. A low dose of the medication doxycycline (an enzyme suppressant) in a pill form can be used in combination with scaling and root planning, in order to hold back the body´s enzyme response, because if not controlled, certain enzymes can break down gum tissue.
However, depending on the severity of the periodontal disease, surgical treatment might be advised. More studies especially long-term studies will be needed to find out whether using medications reduces the need for surgery and if using medications is effective over a lengthy period of time. If inflammation and deep pockets remain after treatment with medications and deep cleansing, a periodontist may have to perform flap surgery which is a common surgery involving lifting back the gums and removing tartar. The gums, then, are sutured back in place, so that the tissue fit tightly around the tooth again. Sometimes, in addition to flap surgery, a periodontist might suggest tissue or bone grafts, to replace or encourage new growth of gum tissue or bone that have been destroyed by periodontitis. A technique called guided tissue regeneration, which is a tiny piece of mesh-like fabric inserted between the gum tissue and the bone, can be used in bone grafting, as it will prevent the gum tissue from growing into the area where the bone should be, thus allowing the connective tissue and the bone to grow again. Each case is different, and it is not possible to predict for sure which grafts will be successful over
long term. The results of treatment depends on many factors, such as the severity of the disease, some risk factors such as smoking, the ability to maintain at home oral hygiene. It is best to ask your periodontist what might be the level of success in your particular situation. It is also advised to get a second opinion, when considering extensive dental treatment, by calling for instance your dental society, which can provide you with the names of practitioners in your area.
Reference:
NIDCR, National Institute of Dental and Craniofacial Research.
© 2007 Christiane Tourtet, all rights reserved.
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