Understanding Symptoms, Treatment, & Prevention of Periodontal Disease

    Periodontal Diseases
    Periodontal (gum) diseases is the major cause of tooth loss in adults, affecting three out of four people over the age of 35. In fact, more than half of all adults over age 18 already have periodontal disease in its early stages. This inflammatory disease attacks the gums, bone, and other supporting structures of the teeth.

    Gingivitis
    Gingivitis is the earliest form of periodontal disease, occurring when plaque accumulates on the teeth near the gums. The gums become inflamed, causing redness and swelling around one or more teeth. As the disease progresses, the gums tend to bleed easily. If detected and treated at this stage, the gingival tissues will return to normal.

    Periodontitis
    If left untreated, gingivitis becomes periodontitis, also known as pyorrhea. As the plaque hardens into "calculus", it extends from the gum line down along the tooth root. Gradually, the gums detach from the tooth and form pockets. Those periodontal pockets create room for even more bacterial activity and the cycle continues. As the disease progresses, the bone supporting the tooth is destroyed, resulting in tooth loss.

    Normal healthy gum tissue.

    Symptoms of Periodontal Disease
    Because you cannot see the bone destruction going on beneath the gum tissue, you may not realize you have this disease until irreversible damage has already been done.

    Your dentist can examine your gums to see if you have any periodontal problems. He may use a periodontal probe to look for pockets between you gums and teeth. This device will also measure the depth of the pockets. X-rays can determine whether any bone destruction has occurred.

    At home, you can be on the alert for the warning signs of periodontal disease. If you have any of the following symptoms, see your dentist at once:

    • Red, swollen, or tender gums.
    • Gums that bleed when you brush your teeth.
    • Pus between the teeth and gums (noticeable when the gums are pressed).
    • Loose permanent teeth.

    Inflamed gum tissue

    Gum recession and/or spaces
    • A change in the way your teeth fit together when you bite.
    • A change in the fit of your partial dentures.
    • Bad breath.

    What Causes Periodontal Disease?
    Plaque, a sticky, colorless film bacteria which continually forms on teeth, causes periodontal disease. There are at least 30 types of bacteria capable of producing periodontal diseases. The bacteria creates toxins (poisons) that irritate the gums and loosen the attachment of gum tissues to the teeth.

    Local irritants, such as smoking, chewing tobacco, or habitually clenching the teeth, can also contribute to periodontal disease. Additional factors include nutrition, certain medications, and high levels of stress.

    Can Periodontal Disease Be Controlled?
    Yes, it can. However, control and treatment depend on how far the disease has progressed and how willing the patient is to accept responsibility for proper home care.

    A measuring instrument called a periodontal probe is used to determine if there are any pockets between the gums and teeth.

    Treatment of Periodontal Disease
    Treatment of periodontal disease depends on how far the disease has progressed. In the early stages, the dentist may simply remove plaque, calculus, and the inflamed tissues from under the gums. This deep cleaning procedure involves scaling (the removal of calculus deposits on the teeth) and root planing (polishing the root surfaces to promote healing and reattachment of the gum tissue). If the disease is diagnosed in the early stages, curettage may also be used. Curettage removes the soft tissue found in the pockets and helps the gums to heal.

    When periodontitis is more advanced, gum surgery may be necessary to remove the periodontal pockets. Although gum and bone tissue that have been destroyed by advanced periodontitis do not grow back, special techniques are available to replace or rebuild some of these supporting structures.

    Treatment will include more frequent visits to the dentist to remove bacterial growth from the teeth, gum tissue, and root areas. These procedures are usually done under a local anesthetic.

    Biting irregularities and missing teeth can contribute to the destruction of the bone supporting the teeth. Your dentist can correct these conditions. Teeth must close properly so that biting pressure is evenly distributed throughout the mouth.

    Surgical Approach (Gingivectomy)

    Contouring surgery where tissue is moved aside, bone is contoured, and gum is sutured.

    How Can Periodontal Disease Be Prevented?
    Good oral hygiene is the only prevention for periodontal disease. Here's what you need to do:
    • Thoroughly brush you teeth at least once a day using fluoride toothpaste. This removes plaque from the outer, inner, and chewing surfaces of the teeth.
    • Floss each day. This removes plaque from the areas along the gumline and between the teeth where a toothbrush can't be reach. Regular daily flossing can often reverse the early stages of periodontal disease.
    • Eat a balanced diet. By consuming a variety of foods, your body will get the nutrients needed for good health.
    • See you dentist regularly. In addition to professionally cleaning your teeth, he will identify any dental problems.

    Summary
    Periodontal diseases are inflammatory and destructive. They do not cure themselves. Without treatment, more tissue becomes involved, more bone is destroyed, and more teeth are lost. By taking the time to give your teeth and gums the care they need, you can keep your teeth and your smile for years to come.