Periodontal Disease
- NEW JERSEY PERIODONTIST -
Periodontal Disease in Tenafly
The word periodontal means “around the tooth". Periodontal disease (also known as periodontitis and gum disease) attacks the gums and the bone that support the teeth.
Plaque is a sticky film of food debris, bacteria, and saliva. If plaque is not removed, it turns into calculus (tartar). When plaque and calculus are not removed, they begin to destroy the gums and bone. Periodontal disease is characterized by red, swollen, and bleeding gums.
Periodontal disease often arises from gingivitis, a bacterial infection irritating gum tissue. Once bacteria settle in gum pockets, treatment becomes challenging, progressing to jawbone and tissue destruction, potentially causing tooth loss.
Periodontal disease, the leading cause of tooth loss, may be linked to various other diseases like stroke, pneumonia, diabetes, cardiovascular issues, and pregnancy risks. Research is ongoing to understand how inflammation and bacteria from periodontal disease affect these conditions. Additionally, smoking heightens the risk of periodontal disease.
Good oral hygiene, a balanced diet, and regular dental visits can help reduce your risk of developing periodontal disease.
- ORAL HEALTHCARE -
Types of Periodontal Disease
There are many different varieties of periodontal disease, and many ways in which these variations manifest themselves. All require immediate treatment by a periodontist to halt the progression and save the gum tissue and bone. Here are some of the most common types of periodontal disease along with the treatments typically performed to correct them.
- PERIODONTAL CARE -
Signs & Symptoms of Periodontal Disease
Bleeding Gums
Gums should never bleed, even when you brush vigorously or use dental floss.
Loose Teeth
Also caused by bone loss or weakened periodontal fibers.
Teeth Spacing
New spacing between teeth caused by bone loss.
Bad Breath
Persistent bad breath caused by bacteria in the mouth.
Pus Around the Teeth & Gums
Sign that there is an infection present.
Receding Gums
Loss of gum around a tooth.
Red & Puffy Gums
Gums should never be red or swollen.
Tenderness or Discomfort
Plaque, calculus, and bacteria irritate the gums and teeth.
- ABOUT PERIODONTAL DISEASE -
Frequently Asked Questions
How is periodontal disease diagnosed?
Periodontal disease is diagnosed by your dentist or dental hygienist during a periodontal examination. This type of exam should always be part of your regular dental check-up.
A periodontal probe (small dental instrument) is gently used to measure the sulcus (pocket or space) between the tooth and the gums. The depth of a healthy sulcus measures three millimeters or less and does not bleed. The periodontal probe helps indicate if pockets are deeper than three millimeters. As periodontal disease progresses, the pockets usually get deeper.
Your dentist or hygienist will use pocket depths, amount of bleeding, inflammation, tooth mobility, etc., to make a diagnosis that will fall into a category below:
● Gingivitis
Gingivitis is the first stage of periodontal disease. Plaque and its toxin by-products irritate the gums, making them tender, inflamed, and likely to bleed.
● Periodontitis
Plaque hardens into calculus (tartar). As calculus and plaque continue to build up, the gums begin to recede from the teeth. Deeper pockets form between the gums and teeth and become filled with bacteria and pus. The gums become very irritated, inflamed, and bleed easily. Slight to moderate bone loss may be present.
● Advanced Periodontitis
The teeth lose more support as the gums, bone, and periodontal ligament continue to be destroyed. Unless treated, the affected teeth will become very loose and may be lost. Generalized moderate to severe bone loss may be present.What are the treatment methods for periodontal disease?
Periodontal treatment methods depend upon the type and severity of the disease. Your dentist and dental hygienist will evaluate for periodontal disease and recommend the appropriate treatment.
Periodontal disease progresses as the sulcus (pocket or space) between the tooth and gums gets filled with bacteria, plaque, and tartar, causing irritation to the surrounding tissues. When these irritants remain in the pocket space, they can cause damage to the gums and eventually, the bone that supports the teeth!
If the disease is caught in the early stages of gingivitis, and no damage has been done, one to two regular cleanings will be recommended. You will also be given instructions on improving your daily oral hygiene habits and having regular dental cleanings.
If the disease has progressed to more advanced stages, a special periodontal cleaning called scaling and root planing (deep cleaning) will be recommended. It is usually done one quadrant of the mouth at a time while the area is numb. In this procedure, tartar, plaque, and toxins are removed from above and below the gum line (scaling) and rough spots on root surfaces are made smooth (planing).
This procedure helps gum tissue to heal and pockets to shrink. Medications, special medicated mouth rinses, and an electric tooth brush may be recommended to help control infection and healing.
If the pockets do not heal after scaling and root planing, periodontal surgery may be needed to reduce pocket depths, making teeth easier to clean. Your dentist may also recommend that you see a periodontist (specialist of the gums and supporting bone).
How to maintain your gums healthy?
It only takes twenty-four hours for plaque that is not removed from your teeth to turn into calculus (tartar)! Daily home cleaning helps control plaque and tartar formation, but those hard-to-reach areas will always need special attention.
Once your periodontal treatment has been completed, your dentist and dental hygienist will recommend that you have regular maintenance cleanings (periodontal cleanings), usually four times a year. At these cleaning appointments, the pocket depths will be carefully checked to ensure that they are healthy. Plaque and calculus that is difficult for you to remove on a daily basis will be removed from above and below the gum line.
In addition to your periodontal cleaning and evaluation, your appointment will usually include:
● Examination of diagnostic x-rays (radiographs): Essential for detection of decay, tumors, cysts, and bone loss. X-rays also help determine tooth and root positions.● Examination of existing restorations: Check current fillings, crowns, etc.● Examination of tooth decay: Check all tooth surfaces for decay.● Oral cancer screening: Check the face, neck, lips, tongue, throat, cheek tissues, and gums for any signs of oral cancer.● Oral hygiene recommendations: Review and recommend oral hygiene aids as needed. (Electric toothbrushes, special periodontal brushes, fluorides, rinses, etc.)● Teeth polishing: Remove stains and plaque that is not otherwise removed during tooth brushing and scaling.Good oral hygiene practices and periodontal cleanings are essential in maintaining dental health and keeping periodontal disease under control!What are the common causes of periodontal disease?
There are genetic and environmental factors involved in the onset of gum disease, and in many cases, the risk of developing periodontitis can be significantly lowered by taking preventative measures.
Here are some of the most common causes of gum disease:
● Poor dental hygiene - Preventing dental disease starts at home with good oral hygiene and a balanced diet. Prevention also includes regular dental visits, which include exams, cleanings, and x-rays. A combination of excellent home care and professional dental care will preserve the natural dentition and support of bony structures. When bacteria and calculus (tartar) are not removed, the gums and bone around the teeth become affected by bacterial toxins and can cause gingivitis or periodontitis, which ultimately lead to tooth loss.
● Tobacco use – Research has indicated that smoking and tobacco use are some of the most significant factors in the development and progression of gum disease. In addition to smokers experiencing a slower recovery and healing rate, smokers are far more likely to suffer from calculus (tartar) build-up on teeth, deep pockets in the gingival tissue, and significant bone loss.
● Genetic predisposition – Despite practicing rigorous oral hygiene routines, as much as 30% of the population may have a strong genetic predisposition to gum disease. These individuals are six times more likely to develop periodontal disease than individuals with no genetic predisposition. Genetic tests can be used to determine susceptibility and early intervention can be performed to keep the oral cavity healthy.
● Pregnancy and menopause – During pregnancy, regular brushing and flossing is critical. Hormonal changes experienced by the body can cause the gum tissue to become more sensitive, rendering them more susceptible to gum disease.
● Chronic stress and poor diet – Stress lowers the ability of the immune system to fight off disease, which means bacterial infection can beat the body’s defense system. Poor diet or malnutrition can also lower the body’s ability to fight periodontal infections, as well as negatively affect the health of the gums.
● Diabetes and underlying medical issues – Many medical conditions can intensify or accelerate the onset and progression of gum disease, including respiratory disease, heart disease, arthritis and osteoporosis. Diabetes hinders the body’s ability to utilize insulin, which makes bacterial infections in the gums more difficult to control and cure.
● Grinding teeth – The clenching or grinding of teeth can significantly damage the supporting tissue surrounding the teeth. Grinding one’s teeth is usually associated with a “bad bite” or the misalignment of the teeth. When an individual is suffering from gum disease, the additional destruction of gingival tissue due to grinding can accelerate the progression of the disease.
● Medication – Many drugs, including oral contraceptive pills, heart medicines, anti-depressants, and steroids, affect the overall condition of teeth and gums, making them more susceptible to gum disease. Steroid use promotes gingival overgrowth, which makes swelling more commonplace and allows bacteria to colonize more readily in the gum tissue.
- PERIODONTAL DISEASE & CHRONIC CONDITIONS -
Mouth-Body Connection
Research studies have shown that there is a strong association between periodontal disease and other chronic conditions such as diabetes, heart disease, pregnancy complications and respiratory disease.
Halting the progression of periodontal disease and maintaining excellent standards of oral hygiene will not only reduce the risk of gum disease and bone loss, but also reduce the chances of developing other serious illnesses.