PERIODONTICS
- Non Surgical
Periodontal
Disease (Gum Disease): The Tooth Loss Culprit
Gum disease or
periodontal disease (also known as periodontitis) is an inflammatory
condition affecting the tissues surrounding a tooth. It is recognized
as the leading cause of tooth loss. Gum disease may initially
appear as gingivitis and may progress to periodontitis, if left
untreated.
• Gingivitis is a bacterial infection of the tissues in the mouth
and the first sign that a patient is at risk for periodontal disease.
• Periodontal
disease is another type of bacterial infection in which the toxins
produced by the bacteria affect the teeth’s connective tissue
and bone.
The Signs
of Gum Disease
As the infection
progresses, the bone may recede and the gums may or may not recede.
In some cases, the roots of the tooth may become exposed; this
exposure may cause tooth sensitivity. Furthermore, pus may be
produced, and pockets may form between the gum and tooth. These
symptoms are possibly reflective of periodontal disease.
It is important
to visit your dentist for professional examinations and dental
cleanings to identify gum disease. For example, bone recession
is not visible to the naked eye and, if left undetected, may contribute
to tooth loss. Let’s explore some of the common signs of gum disease:
• Bleeding gums during tooth brushing or otherwise
• Sensitive, red or swollen gums
• Bad breath
• Teeth that are loose or appear to have shifted
Causes
of Gum Disease
Improper
Dental Hygiene: If plaque is not removed through
daily dental hygiene practices and regular professional dental
cleanings, bacteria may set in and cause gingivitis.
Organic
Changes in the Mouth: Changes in hormone levels
during pregnancy, puberty, and menopause may make teeth more susceptible
to gum disease. This is because changes that occur in metabolism
during these time periods may affect the organic balance in the
mouth.
Medical
Conditions: Serious conditions that affect the
body’s ability to produce sugar (such as diabetes or kidney disease)
may contribute to periodontal disease. Furthermore, the Center
for Disease Control has found an association between illnesses
and gum disease. These diseases include stroke and heart attack.
Finally, certain medical conditions and medications used to treat
medical conditions may produce the overgrowth of gums. Overgrown
gums are more susceptible to bacteria that can contribute to gum
disease.
Saliva
Flow Inhibitors: Certain
medications that may produce oral side effects or dry mouth syndrome
(xerostoma) may contribute to reduction of protective saliva flow,
potentially leading to gum disease. Seniors may be more susceptible
to dry mouth syndrome because of the natural reduction of salivary
flow that is associated with age.
Poor
Functional Habits: Teeth grinding or clenching
may impair the surrounding tissue and is a possible contributor
to gum disease.
Signs
and Symptoms
Symptoms may include
the following:
Occasional
redness or bleeding of gums while brushing teeth,
using dental floss or biting into hard food (e.g. apples) (though
this may occur even in gingivitis, where there is no attachment
loss)
Occasional
gum swellings that recurs halitosis, or bad breath,
and a persistent metallic taste in the mouth gingival recession,
resulting in apparent lengthening of teeth. (This may also be
caused by heavy handed brushing or with a stiff tooth brush.)
deep pockets between the teeth and the gums (pockets are sites
where the attachment has been gradually destroyed by collagen-destroying
enzymes, known as collagenases) loose teeth, in the later stages
(though this may occur for other reasons as well).
Patients should
realize that the gingival inflammation and bone destruction are
largely painless. Hence, people may wrongly assume that painless
bleeding after teeth cleaning is insignificant, although this
may be a symptom of progressing periodontitis in that patient.
Prevention
Daily oral hygiene
measures to prevent periodontal disease include:
Brushing
properly on a regular basis (at least twice
daily), with the patient attempting to direct the toothbrush bristles
underneath the gum-line, so as to help disrupt the bacterial growth
and formation of subgingival plaque and calculus.
Flossing daily and using interdental
brushes (if there is a sufficiently large
space between teeth), as well as cleaning behind the last tooth
in each quarter.
Using
an antiseptic mouthwash. Chlorhexidine gluconate
based mouthwash or hydrogen peroxide in combination with careful
oral hygiene may cure gingivitis, although they cannot reverse
any attachment loss due to periodontitis. (Alcohol based mouthwashes
may aggravate the condition).
Regular
dental check-ups and professional teeth cleaning
as required. Dental check-ups serve to monitor the person's oral
hygiene methods and levels of attachment around teeth, identify
any early signs of periodontitis, and monitor response to treatment.
Oil
pulling, an
alternative medicine procedure, performed on an empty stomach...
Typically dental
hygienists (or dentists) use special instruments to clean (debride)
teeth below the gumline and disrupt any plaque growing below the
gumline. This is a standard treatment to prevent any further progress
of established periodontitis. Studies show that after such a professional
cleaning (periodontal debridement), bacteria and plaque tend to
grow back to pre-cleaning levels after about 3-4 months.
Hence, in theory,
cleanings every 3-4 months might be expected to also prevent the
initial onset of periodontitis. However, analysis of published
research has reported little evidence either to support this or
the intervals at which this should occur. Instead it is advocated
that the interval between dental check-ups should be determined
specifically for each patient between every 3 to 24 months.
Nonetheless, the
continued stabilization of a patient's periodontal state depends
largely, if not primarily, on the patient's oral hygiene at home
if not on the go too. Without daily oral hygiene, periodontal
disease will not be overcome, especially if the patient has a
history of extensive periodontal disease.
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