Periodontal (Gum) Disease

By Peter Merai, DDS, FAGD

Comprehensive Dental Care

. http://chooseoralhealth.com/

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Periodontal (Gum) Disease

Gum disease is caused by the accumulation of bacteria in spaces below the gum line called periodontal pockets. Most people do not know how to brush below the gum line so bacteria growth can go unchecked. Gum disease is often not painful until it is too late, at which time extensive treatment may become necessary or the dentist may have to remove the affected teeth.

Gum disease bacteria destroy the bone and soft tissue (gums) that support and surround teeth. Once this important tooth foundation gets weakened, the teeth become loose. Signs and symptoms of gum disease include Red, swollen and/or bleeding gums, bad breath, loose teeth, teeth that appear to be drifting or spreading apart, abscessed teeth, change in the way partial dentures fit or tooth loss.

Many studies have linked periodontal disease with several health conditions including cardiovascular disease, diabetes, pneumonia, chronic kidney disease, and premature births.

The head and neck region has a vast array of blood vessels. Gum disease bacteria can easily enter these vessels and travel anywhere. The bacteria can cross the placenta in pregnant women, which can lead to a still birth. Heart attacks and strokes have been linked to periodontal disease. In some cases the bacteria can be inhaled during sleep and the patient can succumb to a fatal pneumonia.

Diabetics can have extraordinary amounts of gum disease bacteria. On the other hand, chronic gum disease disrupts diabetic control and so a vicious cycle of advancing gum disease and worsening diabetes ensues. Diabetic control improves when the cycle is broken by treating the periodontal disease.

Cigarette smoking complicates gum disease treatment. Relapse potential is high in smokers since nicotine induced vasoconstriction of blood vessels leads to poor healing response.

Treatment of gum disease is done by scaling and root planing under local anesthesia. Sometimes flap surgery is often indicated. Laser periodontal surgery can be a less invasive surgical procedure than traditional surgery. Laser surgery does not involve cutting and stitching.

Some people mistakenly believe that rinsing with mouthwashes, hydrogen peroxide, or even Chlorhexidine solution will treat their gum disease. No liquid substance (with just rinsing) can penetrate below the gum line. Also any toothbrush with moving bristles cannot effectively brush below the gum line. That is why electric toothbrushes are inefficient in brushing.

The only predictable ways to decrease gum disease bacteria is by mechanically inserting the bristles of a flat toothbrush starting at a 45 degree angle on the teeth and sliding the bristles below the tissue level. Flossing is the second way. Thirdly, a water pick used at high speed can help to pull the most destructive mobile bacteria type from below the tissue line.