Gum Disease? An Oral Health Epidemic
What is periodontal disease?
Gum disease (or periodontal disease), a chronic inflammation and infection of the gums and surrounding tissue, is the major cause of about 70% of adult tooth loss, affecting three out of four persons at some point in their lives.
What causes gum disease?
Bacterial plaque - a sticky, colorless film that constantly forms on the teeth - is 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 tartar). 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 pockets that fill with even more toxins and bacteria. As the disease progresses, pockets extend deeper and the bacteria move down until the bone that holds the tooth in place is destroyed. The tooth eventually will fall out or require extraction.
Are there other factors?
Yes. Genetics is also a factor, as are lifestyle choices. A nutrient-poor diet 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 immune system, such as AIDS and leukemia, may worsen the condition of the gums. In patients with uncontrolled diabetes, gum disease can be more severe or harder to control.
What are the warning signs?
Signs include red, swollen or tender gums, bleeding while brushing or flossing, gums that pull away from teeth, loose or separating teeth, pus 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 at which the tooth is unsalvageable. That's why patients are advised to get frequent dental exams.
What does periodontal treatment involve?
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 antimicrobials 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 provide a satisfactory result. More advanced cases may require surgical treatment, which can involve cutting the gums and removing the hardened plaque build-up, then re-contouring the damaged bone. The procedure is also designed to smooth root surfaces and reposition the gum tissue so it will be easier to clean.
How is gum disease prevented?
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 examination during a regular visit, the patient should request it. Children also should be examined.
How important is maintenance?
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 examination. In between visits, they should brush at least twice a day, floss daily, and brush the 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 toothpicks and rubber tips should only be used if recommended by your dentist.
Reprinted with permission from the Academy of General Dentistry
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