What is Gum Disease?
Gum disease or periodontal
disease, a chronic inflammation
and infection of the gums and
surrounding tissue, is the major
cause of about 70 percent of adult
tooth loss, affecting three out of
four persons at some point in their
life.
What causes gum disease?
Bacterial plaque -a sticky,
colorless film that constantly
forms on the teeth -is recognized
as the primary cause of gum
disease. Specific periodontal
diseases may be associated with
specific bacterial types. If plaque
isn't removed each day by
brushing and flossing, it hardens
into a rough, porous substance
called calculus (also known as tar-
tar).Toxins (poisons) produced
and released by bacteria in plaque
irritate the gums. These toxins
cause the breakdown of the fibers
that hold the gums tightly to the
teeth, creating periodontal pockets
which fill with even more toxins
and bacteria. As the disease
progresses, pockets extend deeper
and the bacteria moves down until
the bone that holds the tooth in
place is destroyed. The tooth
eventually will fallout or require
extraction.
Are there other factors?
Yes. Genetics is also a factor, as
are lifestyle choices. A diet low in
nutrients can diminish the body's
ability to fight infection. Smokers
and spit tobacco users have more
irritation to gum tissues than non-
tobacco users, while stress can also
affect the ability to ward
off disease. Diseases that interfere
with the body's immune system,
such as leukemia and AIDS, may
worsen the condition of the gums. In
patients with uncontrolled diabetes,
where the body is more prone to
infection, gum disease is more
severe or harder to control.
What are the warning signs
of gum disease?
Signs include red, swollen or
tender gums, bleeding while
brushing or flossing, gums that
pull away from teeth, loose or
separating teeth, puss between the
gum and tooth, persistent bad
breath, change in the way teeth fit
together when the patient bites,
and a change in the fit of partial
dentures. While patients are
advised to check for the warning
signs, there might not be any
discomfort until the disease has
spread to a point where the tooth is
unsalvageable. That's why patients
are advised to get frequent dental
exams.
What does periodontal treatment
involve?
In
In the early Stages, most treatment
involves scaling and root planing-
removing plaque and calculus
around the tooth and smoothing the
root surfaces. Antibiotics or antimi-
crobials may be used to supplement
the effects of scaling and root
planing. In most cases of early gum
disease, called gingivitis, scaling
and root planing and proper daily
cleaning achieve a satisfactory
result. More advanced cases may
require surgical treatment,
which involves cutting the gums,
and removing the hardened plaque
build-up and recontouring the
damaged bone. The procedure is also
designed to smooth root surfaces and
reposition the gum tissue so it will
be easier to keep clean.
How do you prevent gum disease?
Removing plaque through daily
brushing, flossing and professional
cleaning is the best way to minimize
your risk. Your dentist can design a
personalized program of home oral
care to meet your needs. If a dentist
doesn't do a periodontal exam
during a regular visit, the patient
should request it. Children also
should be examined.
What is the role of the general
dentist?
The general dentist usually detects
gum disease and treats it in the early
stages. Some general dentists have
acquired additional expertise to treat
more advanced conditions of the
disease. If the general dentist
believes that the gum disease
requires treatment by a specialist, the
patient will be referred to a
periodontist. The dentist and
periodontist will
work together to formulate a treatment
plan for [he patient.
Is maintenance important?
Sticking to a regular oral hygiene
regimen is crucial for patients who
want to sustain the results of
therapy. Patients should visit the
dentist every 3-4 months (or more,
depending on the patient) for spot
scaling and root planing and an
overall exam. In between visits,
they should brush at least twice a
day, floss daily, and brush their
tongue. Manual soft nylon bristle
brushes are the most dependable
and least expensive. Electric
brushes are also a good option, but
don't reach any further into the
pocket than manual brushes. Proxy
brushes (small, narrow brushes) are
the best way to clean in between the
recesses in the teeth, and should be
used once a day. Wooden tooth
picks and rubber tips should only
be used if recommended by your
dentist.
Sources' The American Academy of
Periodontology; Atrix Laboratories, Inc.;
"Non-surgical
Periodontal
Therapy:
Essential and Adjunctive Methods," by ~R.
Creene, BaS, FasRCPs, the British Dental
This information was compiled for General Dentistry. Your dentist cares about long-term dental health for you and your family and demonstrates that concern by
belonging to the Academy of General Dentistry. As one of the 35,000 general dentists in the United Sates and Canada who are member of the Academy, your dentists
participates in an ongoing program of professional development and continuing education to remain current with advances in the profession and to provide quality patient
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