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Understanding
Gingivitis and Periodontal Disease
The warning signs of periodontal disease include
red, swollen or tender gums, bleeding
while brushing or flossing, gums that pull away
from teeth, pus between the gum and the
tooth, persistent bad breath, change in the way
the teeth fit together when the patient bites,
and a change in the fit of partial dentures.
You have heard the terms on television ads, seen them in
print ads, and on the labels of an assortment of dental
products.
But what do terms like plaque, gingivitis, tarter, and
periodontal disease mean?
Periodontal disease or gum disease, a chronic
inflammation and infection of the gums and surrounding
tissue,
is the major cause of adult tooth loss, affecting three
out of four persons.
There are two main types of gum disease- gingivitis and
periodontitis.
Gingivitis is inflammation of the gums characterized
by redness, tenderness, swelling and bleeding of the
gums. With treatment, gingivitis is completely
reversible.
Untreated, gingivitis can progress into periodontitis,
where the inflammation affects the bone and supporting
structures
of the teeth. Periodontitis can affect one tooth or all
the teeth.
Plaque - a film that consists of millions of
bacteria - is the primary cause of periodontal disease.
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 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
will eventually fall out or require extraction.
progression of bone loss
While plaque is the cause of gum disease, genetics and
lifestyle choices are also factors. Smokers have a
greater
incidence and severity of periodontal disease, while
stress and poor diet 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, gum disease is
more severe or harder to control.
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.
A routine part of every dental exam is a screening for
periodontal disease. X-rays and periodontal probing are
the two major ways to detect periodontal disease.
Probing involves measuring the depth of the pockets
between the teeth and gums, with deepening pockets being
one of the first warning signs of problems.
What does periodontal treatment involve?
In the early stages, most treatment involves scaling and
root planing - removing plaque and calculus around the
tooth
and on the root surfaces. In most cases of early gum
disease, 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.
Removing
plaque through daily brushing, flossing and professional
cleaning is the best way to minimize your risk of
developing gum disease. |