Periodontal (Gum) Disease

What is gum disease?

Gum disease, or periodontal disease is a chronic inflammation and infection of the gums and surrounding tissue. It is the major cause of about 70% of adult tooth loss, affecting three out of four persons at some point in their life. Periodontal diseases include gingivitis and periodontitis.

What causes gum disease?

Bacterial plaque – a sticky, colorless film that constantly forms on the teeth – is recognized as the primary cause of gum disease. If plaque is not removed each day by brushing and flossing, it hardens into a rough, porous substance called calculus (also known as tartar). Toxins produced and released by bacteria in plaque irritate the gums. These toxins cause the breakdown of the fibers that hold the gums tightly to the teeth, creating periodontal pockets that fill with even more toxins and bacteria. As the disease progresses, pockets extend deeper and the bacteria moves down until the bone that holds the tooth in place is destroyed. The tooth will eventually fall out or require extraction.

Are there other factors that contribute to gum disease?

Yes. Genetics is also a factor, as are lifestyle choices. A diet low in nutrients can diminish the body's ability to fight infection. Smokers and spit tobacco users have more irritation to gum tissues than non-tobacco users, while stress can also affect the ability to ward off disease. Diseases that interfere with the body's immune system, such as leukemia and AIDS, may worsen the condition of the gums. In patients with uncontrolled diabetes, where the body is more prone to infection, gum disease is more severe or harder to control. Pregnant women experience elevated levels of hormones that cause the gums to react differently to the bacteria found in plaque, and in many cases can cause a condition known as "pregnancy gingivitis."

What are the warning signs of gum disease?

Signs include red, swollen or tender gums, bleeding while brushing or flossing, gums that pull away from teeth, loose or separating teeth, pus between the gum and tooth, persistent bad breath, a change in the way teeth fit together when the patient bites and a change in the fit of partial dentures. While patients are advised to check for the warning signs, there may not be any discomfort until the disease has spread to a point where the tooth is unsalvageable. That is why we advise our patients to have regular dental exams.

What does periodontal treatment involve?

In the early stages of gum disease, most treatment involves a special cleaning called scaling and root planning, which removes plaque and tartar around the tooth and under the gum tissues. Antibiotics or antimicrobials may be used to supplement the effects of scaling and root planing. In most cases of early gum disease, called gingivitis, scaling and root planing and proper daily cleaning achieve a satisfactory result. More advanced cases may require surgical treatment, which involves removing diseased portions of the gums and hardened plaque build-up, as well as recontouring the damaged bone. The procedure is also designed to smooth root surfaces and reposition the gum tissue so it will be easier to keep clean.

How do you prevent gum disease?

Removing plaque through daily brushing, flossing and professional cleaning is the best way to minimize your risk. Drs. Camp and Heubner can design a personalized program of home oral care to meet your needs.

What is the role of the general dentist?

The general dentist usually detects gum disease and treats it in the early stages. If the general dentist believes that the gum disease requires treatment by a specialist, the patient will be referred to a periodontist. The dentist and periodontist will work together to formulate a treatment plan for the patient.

How can I maintain treatment at home?

Sticking to a regular oral hygiene regimen is crucial if you want to sustain the results of your periodontal therapy. You should visit Dr. Camp, Dr. Heubner or your periodontist every three to four months for a professional cleaning, which may occasionally include spot scaling and root planing. During this visit, Drs. Camp or Heubner will also carefully re-evaluate the gum tissues to ensure that their health is optimal. In between visits, you should brush 2-3 times a day, floss daily and brush their tongue. Manual soft nylon bristle brushes are very dependable and least expensive. Electric brushes are also a great option that a lot of patients prefer, but they are more expensive. Proxy brushes (small, narrow brushes) and other interdental cleaners are the best way to clean between the recesses in the teeth and should be used once a day. Wooden toothpicks and rubber tips should only be used if recommended.

The periodontal-systemic disease interrelationships

Tooth loss is not the only potential problem posed by periodontal diseases. Research suggests that there may be a link between periodontal diseases and other health concerns such as diabetes, cardiovascular disease, stroke, bacterial pneumonia, and increased risk during pregnancy. Researchers are trying to determine if bacteria and inflammation associated with periodontal diseases play a role in affecting these systemic diseases and conditions.