Periodontal Disease – Gum Disease @eine kleine dental

What is it?

Periodontal disease (commonly referred to as gum disease) is the leading cause of tooth loss in adults. It is a chronic bacterial infection that causes the gums to become inflamed. Periodontal therapy, such as root scaling and planning, treats the disease process by removing bacterial plaque, calculus and toxins

Periodontal disease is comprised of two main categories: gingivitis and periodontitis.

Gingivitis is inflammation of the gingiva (gums). It is indicated by swelling, redness and bleeding of the gums when they are brushed or probed. Most people – probably 90% or more have had gingivitis at some time during their lives.

Periodontitis is often the silent destroyer. Gum inflammation spreads so that the bone which supports the teeth deteriorates. In its early stages this deterioration is unknown to the patient. There is no pain and the surface signs are similar to gingivitis. Over time there is deepening of the pockets around the teeth with gum recession, and eventual loosening of the teeth when enough bones is lost.

What happens

Both gingivitis and periodontitis are caused by bacterial plaque. It is important to remove the harmful plaque on a daily basis through effective flossing, brushing and maintenance of good dental hygiene. Other factors can contribute to the progression of periodontal disease. Smoking has been shown to have an adverse effect on periodontal health. In women, changes in hormone levels can increase gingival inflammation. Some women experience pregnancy gingivitis – severe inflammation of the gums – due to the overgrowth of certain bacteria which feed on hormones secreted in the fluid from the gingival.

Periodontal disease is an inflammatory reaction to the plaque which collects on your teeth and under your guns. As the plaque collects on your teeth, the mass absorbs the minerals in the saliva. Over time, the soft plaque hardens into dental calculus, or tartar. Calculus provides an environment which enables plaque to thrive. When allowed to grow unimpeded, it will eventually become an irritant to the gum tissues and triggers an inflammatory response. As the inflammatory response continues the destruction spreads from the soft tissue of the gums to the alveolar bone which supports the teeth. As this bone is destroyed the teeth may become loose and change position. When this occurs the periodontitis has progressed to an advanced stage.

You may be able to detect some of the signs of periodontal disease yourself –  these are;

• Bleeding gums
• Redness of the gums – which should normally be pink
• Bad breath
• Mobile teeth

The most common being the “pink toothbrush syndrome”. This indicates gums which bleed when you brush your teeth. Many people assume that a little bleeding is natural, usually because their gums have always bled when they cleaned their teeth. Bleeding is a sign of inflammation but it does not signify the extent of the problem. Gum redness and bad breath are also not a measure of the severity but they are significant warning signs. When your teeth start to drift around – you can be certain that the problem is at the severe stage.

Treatments

If you think you have periodontal disease a visit to your dentist is in order. A thorough examination will include measuring periodontal pockets with a probe. Gingivitis is marked by bleeding with gentle probing. Periodontitis is marked by probing depths of 4 millimeters or more.

First and foremost, the plaque must be thoroughly removed on a daily basis for inflammation to be controlled. Good brushing and flossing technique are important. Scaling and root planning – “Deep cleaning” – scraping your teeth and scraping under the gums – constitutes the basic therapeutic approach to treating periodontal disease. This can be done with a hand tools and an ultrasonic cleaner. Scaling and root planning may require anesthesia due to the potential discomfort. Once the scaling is complete the teeth are polished to remove any stains and loose plaque. Polishing with a rotating rubber cap and a mild abrasive or “Basic cleaning” can be effective in treating mild gingivitis but is not effective in treating periodontitis.