About Periodontal Disease
Periodontal Care
Periodontal treatment is necessary when various conditions affect the health of your gums and the regions of your jawbone which hold your teeth in place. Retaining your teeth is directly dependent on proper periodontal care and maintenance. Healthy gums enhance the appearance of your teeth, like a frame around a beautiful painting. When your gums become unhealthy, they can either recede or become swollen and red. In later stages, the supporting bone is destroyed and your teeth will shift, loosen, or fall out. These changes not only affect your ability to chew and speak, they also spoil your smile.
What is Periodontal Disease
Periodontal (gum) diseases are ongoing infections of the gums, with periods of activity which progressively destroy the supporting structures of your natural teeth. There are several different types of periodontal disease, each requiring a different treatment approach. Most forms of periodontal disease are painless. Bacterial plaque is the primary cause of gum disease in genetically susceptible individuals.
Periodontal disease is a chronic disease much like diabetes or asthma. It cannot be cured. As with all chronic diseases the goal is control.
Adults past the age of 35 lose more teeth to gum diseases than from cavities. Approximately 75% of adults are affected at some time in their life.
Often this destruction occurs beneath the gum line, especially in long-standing disease and smokers. In this instance, the gum tissue may appear normal. This explains why many people discover too late that they have the disease. Only a thorough periodontal examination can reveal if hidden disease is present.
What Causes It
Periodontal disease as well as decay are both caused by bacterial plaque. Plaque is a sticky, colorless film composed primarily of various types of bacteria which adhere to your teeth at and below the gum line. Plaque constantly forms on your teeth. It begins to form within minutes after cleaning. If not carefully removed by daily brushing and flossing, plaque hardens into a rough, porous substance known as calculus (or tartar). This cannot be removed without professional cleaning.
The bacterial plaque produces toxins or poisons that irritate the gums which may (but not always) cause them to turn red, swell, and bleed easily. If this irritation is prolonged, the gums separate from the teeth, causing periodontal pockets (spaces) to form along the tooth. As periodontal diseases progress, the supporting gum tissue and bone that holds teeth in place deteriorate. If left untreated, this leads to tooth loss.
What Are the Risk Factors?
In the last ten years, extensive research has demonstrated that periodontal disease involves a complex interaction between bacterial plaque and the patient’s immune system. This determines the severity and rate of progression of periodontal disease. Some people are fortunate and have a high resistance to bacterial plaque and demonstrate little or no periodontal disease even with large amounts of plaque. Less fortunate individuals can demonstrate severe periodontal disease at an early age with minimal plaque.
Periodontal diseases can be accelerated by a number of different risk factors. The most common ones are listed below:
Periodontal Disease & Tobacco
Current studies have now linked periodontal disease with tobacco usage. Smokers generally have more severe periodontal disease than non-smokers. There is a greater incidence of calculus formation on teeth, deeper pockets between gums and teeth as well as greater loss of the bone and fibers that hold teeth in your mouth.
Other oral problems caused by tobacco include:
- Cancer (especially the use of smokeless tobacco products)
- Mouth sores
- Gum recession
- Loss of bone and teeth
- Bad breath
- Tooth staining
- Less success with periodontal treatment and dental implants
Quitting tobacco will reduce the chance of developing the above problems.
Diabetes & Oral Health
Individuals suffering from diabetes, especially uncontrolled or poorly controlled diabetics, have a higher risk of developing bacterial infections of the mouth. These infections may impair your ability to process insulin, resulting in greater difficulty with controlling your diabetes. Periodontal diseases will be more severe than those of a non-diabetic and treatment more difficult. Fortunately, well-controlled diabetics usually respond similarly to non-diabetics.
It is very critical for diabetics to control all sources of infection. Uncontrolled periodontal disease, which is an active infection, can often lead to unstable diabetes.
Steps to prevent periodontal disease include daily brushing and flossing to remove plaque from your teeth and gums, regular dental visits for professional cleaning, and regular periodontal evaluation. And finally, you can help resist periodontal infection by maintaining control of your blood sugar levels.
Women & Periodontal Health
Throughout a woman’s life, hormonal changes affect tissue throughout the body. At these times, the chance of periodontal disease may increase, requiring special care of your oral health. Puberty, menstruation, pregnancy, oral contraception and menopause can cause fluctuations in hormone levels which impact oral tissues.
Recent studies have shown that up to 30% of the population may be more susceptible to periodontal disease.
Genetics
Despite aggressive oral care habits, people with a genetic pre-disposition may be six times more likely to develop periodontal disease.
Medications
Certain medications, such as oral contraceptives, anti-depressants, and some heart medicines, can affect your oral health. This can range from enlargement of the gums, dry mouth and increased sensitivity. Be sure to advise us of all medications you are taking to help us individualize your treatment needs.
Clenching or Grinding Your Teeth
Clenching or grinding your teeth can put excess force on the supporting tissues of the teeth and could speed up the rate at which the periodontal tissues are destroyed. Many people are totally unaware they are doing this, as it usually occurs during sleep or subconsciously during times of stress.
Stress
Although not well defined, it is known that long-term stress has a negative affect on our immune system and our ability to fight periodontal disease.
Nutrition
A diet low in important nutrients can compromise the body's immune system and make it harder for the body to fight off infection. Because periodontal disease is a chronic infection, studies have shown that poor nutrition can result in increased levels of gum disease.
Additional information on these topics can be found at the American Academy of Periodontology web site.