Many of you have heard the terms gingivitis and gum disease because of the many advertisements from toothpastes and mouthwashes on television, but few actually know what gum disease really is and what the treatments are. Periodontal Disease is the one of the most common teeth problems in the entire world. Gum disease can affect our overall health and has been linked to several heart studies showing a direct link to heart disease.
What is Gum Disease?
The difference between each of us is the severity of the disease. Periodontal disease is cause by bacteria that is naturally in our mouths. Bacteria will grow uncontrollably if it is not maintained with good home hygiene and professional treatment. When the bacteria proceed to the base of the gums, it will begin to colonize in large amounts and destroy the bone surrounding the roots of the teeth. In almost every case, you will see red, swollen, and bleeding gums. Depending on the severity of the disease, you may see gum recession around the roots and possibly a significant accumulation of calculus (hard plaque buildup).
What are the types of gum disease?
Gingivitis is the mildest form of periodontal disease. It causes the gums to become red, swollen, and bleed easily. There is usually little or no discomfort at this stage. Gingivitis is often caused by inadequate oral hygiene. Gingivitis is reversible with professional treatment and good oral home care.
Untreated gingivitis can advance to periodontitis. With time, plaque can spread and grow below the gum line. Toxins produced by the bacteria in plaque irritate the gums. The toxins stimulate a chronic inflammatory response in which the body in essence turns on itself, and the tissues and bone that support the teeth are broken down and destroyed. Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. Often, this destructive process has very mild symptoms. Eventually, teeth can become loose and may have to be removed.
There are many forms of periodontitis. The most common ones include the following.
- Aggressive periodontitis occurs in patients who are otherwise clinically healthy. Common features include rapid attachment loss and bone destruction and familial aggregation.
- Chronic periodontitis results in inflammation within the supporting tissues of the teeth, progressive attachment and bone loss. This is the most frequently occurring form of periodontitis and is characterized by pocket formation and/or recession of the gingiva. It is prevalent in adults, but can occur at any age. Progression of attachment loss usually occurs slowly, but periods of rapid progression can occur.
- Periodontitis as a manifestation of systemic diseases often begins at a young age. Systemic conditions such as heart disease, respiratory disease, and diabetes are associated with this form of periodontitis.
- Necrotizing periodontal disease is an infection characterized by necrosis of gingival tissues, periodontal ligament and alveolar bone. These lesions are most commonly observed in individuals with systemic conditions such as HIV infection, malnutrition and immunosuppression.
What are the treatments involved?
- Gingivitis can usually be treated with a Prophylaxis.
- Most people will refer to this treatment as a "cleaning".
- This treatment consists of the removal of small deposits of tartar buildup and stains on the surfaces of the teeth.
- A prophylaxis includes any measure that is taken to prevent disease before it occurs.
- The prophylaxis helps to prevent plaque, tooth decay, and gum disease, but does not treat the gum disease.
- Periodontitis is treated much differently than a prophylaxis.
- This treatment is often referred to as a "deep cleaning". The proper term is scaling and root planning.
- Because there is an active disease process occurring, the treatment begins with removing the layers of buildup that has accumulated over time.
- This accumulation is removed from the surface of the teeth as well as the roots of the teeth.
- After all surfaces have been cleaned properly, an anti-bacterial rinse is used to irrigate the pockets and flush out the remaining bacterial remnants.
- This treatment will require the teeth and gums to be numbed with local anesthetic, but usually there is little post-op sensitivity.
What are the risks in doing nothing?
- Tooth loss
- Tooth mobility
- Severe recession of gums (causes the teeth to look longer than they really are)
- Bleeding and painful gums
- Periodontal abscesses (infections of the gums)
- Tooth abscess
* The same blood in your gums is in your heart and the type of bacteria associated with periodontal disease has been linked to heart disease. So the risk of no treatment can extend well beyond the mouth.