Periodontal Disease: Don’t Wait Until It Hurts
What Is Periodontal Disease?
The word periodontal means “around the tooth.” Healthy gum tissue fits like a cuff around each tooth. Where the gum meets the tooth, it forms a slight v-shaped crevice called a sulcus. In healthy teeth, the space is usually three millimeters or less.
Periodontal diseases are infections that affect the tissue and bone that support the teeth. As the tissues are damaged, the sulcus develops into a pocket that is greater than three millimeters. Generally, the more severe the disease, the greater the pocket depth and bone loss. The enlarged pockets allow harmful bacteria to grow and make it difficult to practice effective oral hygiene. Left untreated, periodontal disease may eventually lead to tooth loss.
How would I know if I had periodontal disease?
It is possible to have periodontal disease without apparent symptoms. That’s why regular dental checkups and periodontal examinations are very important.
Several warning signs can signal a problem. If you notice any of the following, see your dentist:
- Gums that bleed easily
- Red, swollen or tender gums
- Guns that have pulled away from your teeth
- Persistent bad breath
- Pus between the teeth and gums
- Loose or separating teeth
- A change in the way your teeth fit together when you bite
- A change in the fit of partial dentures
What causes periodontal diseases?
The mouth is filled with countless bacteria. Periodontal disease begins when certain bacteria in plaque (the sticky, colorless film that constantly forms on the teeth and the surfaces lining the mouth) produce toxins and enzymes that irritate the gums and cause inflammation, which may be painless, and can damage the attachment of the gum and bone to the teeth.
Good oral hygiene – brushing twice a day and flossing or using another interdental cleaner once a day – helps reduce the plaque film. Plaque that is not removed regularly can harden into rough porous deposits called calculus or tartar. Tartar is not the main cause of periodontal diseases, but the pores in tartar hold bacteria and toxins, which are impossible to remove even with regular brushing. Once the hardened tartar forms, it can only be removed when teeth are cleaned at the dental office.
The periodontal – systemic disease interrelationships
Tooth loss is not the only problem posed by periodontal diseases. Research suggests that there may be a link between periodontal diseases and other health concerns such as diabetes, cardiovascular disease, stroke, bacterial pneumonia, and increased risk during pregnancy. Researchers are trying to determine if bacteria and inflammation associated with periodontal disease play a role in affecting these systemic diseases and conditions.
Are you at risk?
There are several factors that increase the risk of developing periodontal disease:
- Studies show that people that smoke or chew tobacco are more likely to have periodontal diseases. Tobacco users are much more likely than non-users to develop plaque and tartar on their teeth. They also are more likely to have deeper pockets between their teeth and guns and greater loss of bone and tissue that supports the teeth. Periodontal treatment is also less successful in patients that continue to smoke.
- Systemic diseases, such as diabetes, blood cell disorders, HIV infections and AIDS can reduce the body’s resistance to infection, making periodontal diseases more severe. (Systemic diseases are those diseases that can affect the body as a whole.)
- Many medications – such as steroids, some types of anti-epilepsy drugs, blood pressure drugs and oral contraceptives – can effect the gums. Some medications have side effects that reduce saliva. A lack of saliva can result in chronically dry mouth, which can irritate the soft tissue. Update your medical history files at the dental office, to include all medications and any changes that occur in your health.
- Bridges that no longer fit properly, crooked or crowded teeth, or fillings that have become defective may hold plaque in place and increase the risk of developing periodontal disease.
- Puberty, pregnancy and oral contraceptives change the body’s hormone levels. This can cause gum tissue to become more sensitive to toxins and enzymes and can accelerate growth of some bacteria.
- Genetics may play a role. Some patients may be predisposed to more aggressive, severe type of periodontal disease. Patients with a family history of tooth loss or who have parents wearing dentures should pay particular attention to their gums.
- According to some studies, periodontal disease may be passed from parents to children and between couples. Research suggests that bacteria causing periodontal disease are passed through saliva.
Types Of Periodontal Disease
Gingivitis is the mildest form of periodontal disease. It causes the gums to become red, swollen and bleed easily. The is usually little or no discomfort at this stage. Gingivitis is reversible with professional treatment and good oral care at home.
Chronic periodontitis is a form of periodontal disease that results in inflammation within the supporting tissue of the teeth. Patients experience progressive loss of tissue attachment and bone. Chronic periodontitis is characterized by pocket formation and/or recession of gum tissue and is the most frequently occurring form of periodontal disease. It is prevalent in adults, but can occur at any age. Progression of attachment loss usually occurs slowly, but periods of rapid progression can occur.
Aggression periodontitis is a highly destructive form of periodontal disease that occurs in patients who are otherwise clinically healthy. Common features include rapid loss of tissue attachment and destruction of bone. This disease may occur in localized or generalized patterns.
Periodontitis as a Manifestation of Systemic Diseases. This form of periodonatal disease is associated with one of several systemic diseases such as diabetes. Patients who have rare but specified blood diseases or genetic disorders frequently show signs of periodontal disease.
Necrotizing Periodontal Diseases are infections characterized by necrosis (death) of gingival tissue, periodontal ligament and alveolar bone. These lesions are most commonly associated with pain , bleeding and foul odor. Contributing factors can include emotional stress, tobacco use and HIV infection.
Preventing Periodontal Disease
Regular checkups are important. During an examination, your gums are evaluated for periodontal disease. The dentist looks at many things, including the color and firmness of the gums. A very small instrument called a periodontal probe is used to gently measure the space between the teeth and gums. This determines whether periodontal pockets are present. The normal space between teeth and healthy gums should be three millimeters or less. Generally, the more advanced the gum disease, the greater the pocket size.
Except in unusual cases, you can help prevent gum disease by brushing twice a day and cleaning between your teeth with floss or an interdental cleaner once a day. Choose products that display the ADA Seal of Acceptance, your assurance that they meet the ADA’s criteria for safety and effectiveness. Our staff may provide additional instructions on cleaning methods or products you can use at home. Avoiding tobacco use and other healthy measures, such as eating a balanced diet, are important in preventing periodontal disease.
Even brushing and flossing regularly may not remove all plaque around the gumline. We continue to stress the importance of having regular cleanings.