What is Gingivitis?Gum disease is a progressive disease that is broken down into two stages. The first stage, gingivitis, is characterized by an inflammation of the gum tissue. Gingivitis occurs when plaque—a sticky, colorless, and soft film of bacteria—is not removed by daily brushing and flossing. Plaque triggers a response from your immune system that can ultimately become counterproductive. To destroy the bacteria, your immune system will release toxins that cause inflammation and damage. During this early stage of gum disease, the damage can be reversed, because the connective tissue and bone that keep your teeth in place are still unaffected. However, gingivitis is a sneaky disease. Many patients may not notice the warning signs and symptoms because they are often painless. If left untreated, gingivitis will become periodontitis, the second stage of the disease that can cause permanent damage. That is why Nicholas Dose, DMD - Family Dental Care places a high importance on patient education.
Recognizing the symptoms of gingivitis can help save your teeth from permanent damage. These symptoms include swollen, red, and tender gums that may bleed during brushing or flossing. As the disease progresses, you may notice your gums recede or pull away from your teeth. If your teeth appear to be elongated, the chances are high that you have developed gingivitis. Pockets may begin to form between your gums and teeth, collecting food debris and plaque. In some cases, patients may experience persistent bad breath or a bad taste in their mouth.
Luckily, gingivitis is easily treatable and preventable. Professional cleanings and proper oral hygiene practices can reverse damage and stop the disease. Professional cleanings are especially important because hardened plaque buildup (tartar) can only be removed by Dr. Dose or our dental hygienist. With the right education and discipline, you can stop gingivitis before it progresses to periodontitis.
What is Periodontitis?Periodontitis is much more detrimental to your oral health. The toxins produced by your immune system begin to affect your periodontal ligaments and alveolar bone. The pockets created by gingivitis begin to deepen, the bacteria spread, and the infection worsens. Wide-spread infection can cause loss of tissue and bone. This damage can cause your teeth to loosen or fall out. Recent scientific studies have even linked advanced periodontitis to other systematic health issues.
Along with the warning signs of gingivitis, advanced periodontitis is also associated with more alarming symptoms. These include loose teeth, a change in your bite, pus between your teeth and gums, and new spaces developing between your teeth. There are several forms of periodontitis, and you may experience complications unique to your particular form of the disease. For example, patients who experience aggressive periodontitis will see an unusually rapid deterioration of their teeth and gums. This can also manifest in waves of severe damage that alternate with periods of improvement. Aggressive periodontitis usually affects otherwise healthy young patients. The most common form of the disease is chronic periodontitis. It is characterized by a slower progression and damage that develops over a longer period.
Diagnosis of Periodontal DiseaseAt Nicholas Dose, DMD - Family Dental Care, we utilize several methods to diagnose periodontal disease:
|•||The most obvious method is the examination of your gums. We will look for red, swollen, or bleeding gums.
|•||If necessary, we may suggest x-rays. A dental bitewing x-ray allows us to examine the underlying bone. This helps us determine if any bone had been lost due to periodontal disease.
|•||We may measure your gums. Using a periodontal probe, Dr. Dose can measure the depth of the pockets that surround your teeth. This should take place about once a year. If the gums are healthy, no pocket should be deeper than three millimeters.
|•||We will examine sensitive teeth. Make sure you voice any issues related to sensitivity. If tooth has become sensitive at the gum line, it may be an indicator of receding gums.|
Again, early symptoms are hard to identify at home. We cannot stress enough, the importance of regular office visits and proper oral hygiene. It can mean the difference between a lifetime of healthy teeth and a seriously destructive disease.
Risk Factors and Prevention of Periodontal DiseaseWe know that bacteria in plaque is the main culprit of periodontal disease, but there are other factors to consider. These factors can increase your risk of developing the disease or make the infection worse.
|•||Genetics. Unfortunately, some patients are just more likely to develop periodontal disease because of their genetics. If you have a family history of periodontal disease, make sure to practice excellent oral care. Despite your genes, you can still prevent or control the disease with the right precautions.
|•||Hard to clean teeth. The harder it is to clean your teeth, the more likely you are to develop plaque and tartar. Crowded teeth can cause tight contact spaces that make it more difficult for you to brush and floss in between your teeth. In severe cases, we may suggest orthodontic treatment to give you a better chance at preventing the disease. This also applies to dental appliances like braces and bridgework. Dr. Dose can show you the best way to clean around your appliances, and even suggest specialized tools to help clean the toughest spots.
|•||Tobacco use. By now, it common knowledge that smoking can significantly affect your oral health. The longer you smoke, the higher your risk for developing periodontal disease. Smoking also makes the disease more severe, because smokers tend to collect more tartar, and develop deeper periodontal pockets. It can also render periodontal treatments ineffective. Quitting smoking can significantly reduce your chances of developing periodontitis, and bring the disease under control.
|•||Stress and hormones. Stress can weaken your immune system, putting you at risk of infection, and make periodontal disease harder to treat. Fluctuating hormones during puberty and pregnancy can also increase your risk of periodontal disease, although this can be temporary.
|•||Clenching or grinding your teeth. Pressure and excess force on your teeth can accelerate the breakdown of periodontal ligament and bone. These habits do not cause periodontal disease, but increase the severity of infection is already present. Many patients can eliminate these habits by being mindful and relaxed when they recognize them happening. In severe cases, we may suggest you use an occlusal guard or bite guard to reduce pressure.
|•||Other diseases. Certain disease can increase your chances of developing periodontal disease. Patients with diabetes or inflammatory conditions such as rheumatoid arthritis are more prone to developing periodontitis.
|•||Medications. Medications for depression or high blood pressure can reduce the flow of saliva and cause dry mouth. Without enough saliva, plaque is more likely to form and cause tooth decay. Other medications can enlarge gum tissue, making it easier for plaque to become trapped in pockets.|
According to the Centers for Disease Control and Prevention (CDC), periodontal disease affects almost 50 percent of Americans over the age of 30. Gingivitis can develop as early as your teenage years. Staying educated on risk factors and prevention techniques is an effective way to combat periodontal disease before advanced treatment becomes necessary.
Treatment of Advanced Periodontal DiseaseThere are several ways to treat advanced periodontal disease.
|•||Nonsurgical treatment. This is the first step to treating periodontitis. Our dental hygienist will perform a professional deep cleaning, known as scaling and root planing. The procedure involves the use of an ultrasonic scaler to remove plaque and tartar off the surfaces of your tooth and root. Ultrasonic scalers can reach the deepest pockets, kill bacteria causing microbes, and prevent future growth. After the procedure, your gums should heal and reattach to the healthy surfaces of your teeth.
|•||Pocket reduction. If your gum tissue does not properly heal around the tooth after a deep cleaning, we may suggest a pocket reduction or flap surgery. During flap surgery, an oral surgeon or periodontist, will fold the gums back, remove infectious bacteria, and smooth out damaged surface areas. This allows the gum tissue to reattach to healthy bone.
|•||Regenerative procedures. For the most severe cases of periodontal disease, gum or bone grafting may be necessary to help save your teeth. Both procedures involve taking healthy tissue or bone, and placing it on the location of gum recession or bone loss. This is usually the final effort to help your body effectively regrow tissue and bone.
|•||Home maintenance. After you have been successfully treated for advanced periodontal disease, it is crucial to maintain a diligent oral hygiene regime. Dr. Dose will make sure you understand and apply proper brushing and flossing techniques. You will need to keep a close eye on your periodontal health to ensure the infection does not resurface.|
Link Between Periodontal Disease and Oral Systematic HealthRecently, researchers have been conducting studies to determine a link between periodontal disease and other major health problems. While many questions remain, and more research is needed, studies have suggested several possible connections.
Periodontal disease may be linked to heart disease and stroke. Research suggests that the bacteria responsible for periodontitis can travel through your bloodstream. Once it reaches the arteries in your heart, it can trigger inflammation and cause your arteries to narrow. The bacteria may also make you more susceptible to blood clots, which can increase the chances of a stroke.
Studies have also suggested that periodontal infection can make it more difficult for your body to control blood sugar levels. Diabetes can put you at greater risk for periodontitis, and vice versa. Diabetic patients with periodontitis may find it harder to monitor their glucose levels. Infection in your body can raise your blood sugar levels and require the use of more insulin.
Women with moderate to severe periodontitis may experience complications during pregnancy. Although the exact correlation between oral bacteria and premature births is not quite clear, it appears that periodontitis can limit the growth of a fetus. It may also cause the body to produce a higher level of labor-inducing chemicals. This is more notable in patients whose periodontitis worsens during pregnancy. Diabetic women with periodontitis are at an even higher risk.
If a patient is prone to lung problems, inhaling oral bacteria may result in aspiration pneumonia. Patients that have been sedated or have tracheal tubes tend to be at a higher risk for aspiration pneumonia. This information is particularly important for older patients that reside in nursing homes.
Common Misconceptions About Periodontal HealthKnowledge is power. Understanding the most common misconceptions about periodontal health can help you avoid periodontal disease. According to the American Academy of Periodontology (AAP), the most common misconceptions are:
|•||Bloody gums are normal when brushing and flossing. In reality, bloody gums are one of the first indicators of periodontal disease.
|•||We brush our teeth to remove food debris. In reality, daily oral hygiene is important because it minimizes the formation of plaque. If the plaque is not removed, it will irritate the gums and eventually lead to periodontal disease.
|•||Cavities are the number one reason we lose teeth. In reality, periodontal disease combined with cavities are the primary cause of tooth loss.
|•||Bad breath comes from bad oral hygiene. In reality, bacteria in the mouth produce sulfur compounds. When these compounds build up, bad breath can become a clinical condition. Patients who are genetically prone to infection may experience bad breath, despite exceptional oral hygiene.
|•||Stress does not create oral health complications. In reality, researchers have found that financial strain and poor coping methods can increase the likelihood of periodontal disease. Patients who practice stress-reducing techniques, decrease their chances of developing infections.|