Every house is built upon a foundation, or it would not stand very long. Similarly, teeth have a supporting structure to give them strength. And like a house, there are many threats that can erode the foundation without vigilant care. Periodontal disease is one of the greatest threats to dental health because it deteriorates and undermines both function and appearance. Don’t wait until your gums bleed or hurt before considering their health.
What is Periodontal Disease?
Periodontal disease is an infection that affects the tissues and bone that support teeth. Healthy gum tissue fits like a cuff around each tooth. When someone has periodontal disease, the gum tissue pulls away from the tooth. As the disease worsens, the tissue and bone that support the tooth are destroyed. Over time, teeth may fall out or need to be removed. Treating periodontal disease in the early stages can help prevent tooth loss.
Periodontal disease affects whole-body health.
Tooth loss is not the only possible problem posed by periodontal diseases. There may be a link between periodontal disease and cardiovascular disease (heart disease and stroke). High stress may also be linked to periodontal disease. Researchers are still studying these links.
How do I know if I have periodontal disease?
It can be hard to know. You can have periodontal disease without clear 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 when you brush or floss
- Red, swollen, or tender gums
- Gums that have pulled away from your teeth
- Bad breath that doesn’t go away
- 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 disease?
Periodontal disease is caused by plaque, a sticky film that is always forming on your teeth. Plaque contains bacteria that produce harmful toxins. If teeth are not cleaned well, toxins can irritate and inflame the gums.
Inflamed gums can pull away from the teeth and from spaces called pockets. The pockets provide a home for more bacteria. If the infected pockets are not treated, the disease can get worse. The bone and other tissues that support teeth are damaged.
Plaque can be removed if you brush your teeth twice a day and floss daily. If plaque stays on teeth, it can harden into a rough surface called tartar. Tartar can only be removed when teeth are cleaned at your dental office.
How can I prevent periodontal disease?
A good oral hygiene routine practiced for a few minutes twice a day can help reduce your risk of getting periodontal disease and tooth decay.
- Brush your teeth twice a day with fluoride toothpaste.
- Floss daily to remove plaque and food that your toothbrush cannot reach.
- If you need extra help controlling gingivitis and plaque, your dentist or hygienist may recommend using an ADA-accepted germ-fighting mouth rinse or other oral hygiene aids.
- Eat a balanced diet for good general health and limit snacks, especially sticky and sugary snacks.
- Visit your dentist regularly. Professional cleanings are the only way to remove tartar, which traps bacteria along the gums and can cause infection.
Are you at risk?
There are several factors that increase the risk of developing periodontal disease:
- People who smoke or chew tobacco are more likely to have periodontal disease. Periodontal disease is also less successful in patients who continue to smoke.
- Diseases that affect the whole body – such as diabetes, blood cell disorders, HIV infections, and AIDS – can lower resistance to infection, making periodontal disease more severe.
- Many medications – like steroids, some anti-seizure drugs, cancer therapy drugs, blood pressure drugs and birth control pills – can affect the gums. Some medications have side effects that reduce saliva. A lack of saliva can result in constant dry mouth, which can irritate soft tissues. Tell your dentist about all your medications and any changes that occur in your health.
- Changes in the body’s hormone levels – teens, pregnant women, and those taking birth control pills can face this. These changes can cause gum tissue to become more sensitive to the toxins produced by bacteria.
- Genes may play a role. Some patients may be more likely to get a more severe type of periodontitis. If your parents wear dentures or you have a family history of tooth loss, be extra alert for changes to your gums.
- The bacteria associated with periodontal disease may be passed from parents to children and between partners. Research suggests that the bacteria that cause periodontal disease can be passed through saliva.
Checking for periodontal disease.
During your routine dental checkup, the dentist or hygienist examines your gums. A periodontal probe is gently used to measure the depth of the pockets surrounding each tooth. When the teeth are healthy, the pocket depth is usually 3 millimeters or less/. Hence, you will hear the hygienist saying the numbers 1, 2, and 3. The periodontal probe can indicate whether you have developed any pockets. Generally, the more severe the disease, the deeper the pockets. Hence a more progresses patient will hear the hygienist saying numbers like 4, 5, or 6.
Dental X-rays usually are taken to check the amount of bone supporting the teeth and to find other problems not visible during the clinical exam. If periodontal disease is diagnosed, the dentist may provide treatment or may refer you to a periodontist, a dentist who specializes in this disease.
Treating periodontal disease.
Periodontal treatment methods depend upon the type and severity of the disease. If the disease is caught very early (when it is gingivitis), and no damage has been done to the supporting structures under the teeth, you may simply have a professional cleaning and be given instructions on improving your daily oral hygiene.
Even with these measures, some patients develop more severe periodontal disease that must be treated. The first step usually involves a special cleaning, called scaling and root planing. In this treatment, plaque and tartar are carefully removed down to the bottom of each periodontal pocket. Part of this procedure includes smoothing the tooth’s root surfaces to allow the gum tissue to heal and reattach to the tooth. This is sometimes called “periodontal cleaning” or “periodontal scaling” and may take more than one visit.
Your dentist also may recommend medicines to help control infection and pain, or to aid healing. These medications could include a pill, mouth rinse, or a substance that the dentist places directly in the periodontal pocket after scaling and root planning. Your dentist may also stress the need to stop using tobacco and to control any related systemic disease, like diabetes.
At your follow up visits, the dentist or hygienist measures the pocket depths again to check the effect of scaling and root planning. If the disease continues to advance to the point where the periodontal pockets deepen and the supporting bone is lost, more treatment may be necessary. You may be referred to a periodontist.
Care after treatment.
Once your periodontal treatment is completed, your dentist may recommend more frequent checkups. Regular dental visits and deep cleanings are important to keep periodontal disease under control. In some cases, your appointments alternate between your general dentist and a periodontist.
Good oral hygiene at home is also important to help keep periodontal disease from becoming more serious or from coming back. It just takes a few minutes twice a day to care for your teeth and gums. Daily cleaning helps keep the plaque under control and reduces tartar buildup.
If you use tobacco, ask your dentist or physician for information about how to successfully stop the habit. Tobacco contains chemicals that can slow the healing process and make the treatment results less predictable.
You don’t have to lose teeth to periodontal disease. Brush, clean between your teeth, eat a balanced diet, and schedule regular dental visits for a lifetime of healthy smiles.
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Improve and maintain your oral health. Visit our dental office located in downtown Evanston, convenient to Skokie, Wilmette, and Northern Chicago suburbs. We look forward to helping you! —Dr. Arnold K. Chernoff