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Gingivitis and Periodontal Disease

If you are over 30, the odds are 1 in 3 that gum diseases are sapping your health. If you are over 55, the odds are even more alarming---1 in 2. Gum disease is the primary cause of tooth loss in adults over the age of 35.

Periodontal disease causes not only bad breath and tooth loss, but may lead to a variety of serious and life- threatening systemic conditions, including heart disease, stroke, diabetes and even cancer.


Gum disease is a chronic, highly contagious bacterial infection that can easily be passed from one person to another. While everyone has bacteria in their mouths, not everyone develops gum disease. There are identifiable risk factors that can make it more likely for the bacteria in your mouth to result in destructive gum disease. We now know that due to these risk factors some patients can clean their teeth and visit the dentist religiously and still have gum problems.

Over time, food and bacteria tend to collect between the teeth and gum. If this debris is not adequately removed, the bacteria migrate deeper under the gum line. In a susceptible patient, a space or “pocket” forms between the tooth and gum. Once these pockets of bacteria form below the gum line, you cannot reach them even with good tooth brushing and flossing.

The bacteria multiply and cause the gum cells to release a variety of substances that aggravate and inflame the gum tissues. The gum tissue and then the supporting bone are slowly destroyed. If enough bone tissue is destroyed, the teeth loosen and are eventually lost.


Gum disease rarely causes pain or any symptoms since the infection readily drains up through the gum. Often you cannot tell you even have gum disease until the gums are inspected and checked for pockets. Just because it doesn’t hurt doesn’t mean all is well. We can detect gum disease early and prevent or repair its damage. You can keep watch also. Bleeding is a strong indicator of gum inflammation. Healthy gums do not bleed at all when brushed or flossed. If you have any gum bleeding when you clean your teeth, your gums are inflamed.


We now know that this ongoing bacterial infection in your mouth can have far reaching effects elsewhere in your body. When the gums are chronically inflamed, these bacteria can gain entrance into your bloodstream and spread to other parts of your body. Gum disease increases your risk for heart disease. Gum disease has been linked to pulmonary infections and gastric ulcers. Gum disease in diabetics makes control of blood sugar more difficult. Gum disease during pregnancy increases the risk for pre-term, low birth weight babies. The American Academy of Periondontology’s website ( www.Perio.org) has patient- oriented information concerning the increased risk for other health problems when gum disease is allowed to persist.


The progression of gum disease can be halted if the bacteria and debris are removed from those pockets. Fortunately, a variety of new techniques have allowed us to successfully treat chronic gum infections much more conservatively.

Our foundational approach is to use aggressive, but non-surgical or minimally invasive procedures to help you achieve and then maintain a preferred level of oral health.


WHAT ARE YOUR RISK FACTORS?

At least half of the population may be genetically predisposed to suffer from periodontal diseases.

Smoking plays a major role, and increases the risk of losing your teeth up to fivefold. For a long time, the link to smoking was thought to be just a lifestyle issue. Now it’s understood that the chemicals in tobacco products cause damage. Nicotine causes significant changes in the blood vessels and the tissues of the mouth.

Diabetes, leukemia, AIDS/HIV, and even stress and medications that cause dry mouth also increase the likelihood of periodontitis.

While age is not a causative factor, certain hormonally triggered life-stages are, they include puberty, pregnancy, and menopause, when estrogen and progesterone levels climb, causing the gums to react differently to the bacteria found in plaque. The resulting gingivitis is often temporary---- assuming the patient practices diligent dental care.

Due to the contagious nature of gum disease you may also be at increased risk if a member of your household has periodontal disease. These bacteria are easily passed from person to person through close contact (sharing of utensils, cups, kissing, etc.)


TREATMENT RECOMMENDATIONS :

Successful outcomes in treating various severities of periodontal disease depend greatly on appropriate clinical treatments as well as use of certain medications and excellent home care.

Treatment is likely to start out conservatively. Gingivitis and early gum disease may be arrested by routine professional cleanings and more diligent home care.

As for prophylactic cleanings, we’ve all learned the mantra “regular visits every 6 months”. In reality, each patient has individual cleaning needs. Many are now seen every 3 months.

The more advanced the periodontal disease is, the more targeted and specific the treatment protocol has to be.

In our office we recommend a periodontal therapy appointment every 3 months. Research has shown that this frequency disrupts bacterial growth sufficiently to slow soft tissue damage and boneloss so that the disease can stabilize and healing can occur. Without treatment, periodontal disease will progress over time.

We also recommend an antimicrobial mouth rinse (0.12% chlorhexidine- PERIDEX or PERIOGUARD) to be used for the first 2 weeks following your periodontal therapy appointment. This will greatly assist in further reducing the numbers of damaging bacteria. It will also help to diminish any tooth sensitivity you may be experiencing.

In some cases, referral to a periodontal specialist may be necessary to treat a more aggressive or therapy- resistant form of periodontal disease.

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