Gum Disease St. Louis: Periodontal Disease, Dental Treatments

What is gum disease?

Gum (periodontal) disease is the most common reason people lose their teeth. It is a chronic inflammation and infection of the gums and surrounding tissue caused by the bacteria that is in plaque. 70% of all adult tooth loss is caused by gum disease and it affects three out of four persons at some point in their life. It doesnt necessarily hurt and you may not even be aware that you have it until an advanced stage. There are two stages of gum disease:

Gingivitis a superficial infection of the gum. It is recognized by a redness and puffiness of the gums, bleeding of the gums when they are brushed, and sometimes bad breath.
Periodontitis a more advanced infection, which involves the bone. It is characterized in addition to gingivitis by receding gums, spaces opening between teeth, discomfort in the gums and loosening of the teeth.

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. Specific periodontal diseases may be associated with specific bacterial types. Gum disease progresses by starting out as a mild form of gingivitis, which is an inflammation of the gums. This is caused by not brushing and flossing on a regular basis and not having your teeth professionally cleaned by our dental hygienist. If the plaque is not removed each day by brushing and flossing, it hardens into a rough, porous substance called calculus (tartar).

Remove plaque through daily brushing, flossing and professional cleanings to prevent gum disease!

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, which 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 eventually will fall out or require us to remove it.

Are there other factors?

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 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 they are more susceptible to the development of oral infections and periodontal disease. Diabetics may experience diminished salivary flow and burning of the mouth or tongue. Dry mouth also may develop, causing an increased incidence of decay. Gum recession has been found to occur more frequently and more extensively in patients whose diabetes is poorly controlled because plaque responds differently, creating more harmful proteins in the gums.

How can gum disease affect overall health?

Researchers are finding possible links between periodontal (gum) disease and other diseases throughout the body. There may be link between periodontal disease, heart disease and other health conditions. Research suggests that gum disease may be a more serious factor for heart disease than hypertension, smoking, cholesterol, gender and age.

The current theory is that bacteria present in infected gums can come loose and move throughout the body. The same bacteria that cause gum disease and irritate your gums might travel to your arteries. Risk varies according to the level of gum infection. The worse the infection, the more likely the bacteria are to become blood-borne. Infected gums bleed, making it easier for bacteria to enter your bloodstream. If bacteria become dislodged, the bacteria enter through cuts or sores in your mouth and travel to other parts of the body through your bloodstream. Once bacteria reaches the arteries, they can irritate them in the same way that they irritate gum tissue. This could cause arterial plaque to accumulate in the arteries, which can cause hardening and block blood-flow. Compromised blood-flow to your heart can cause a heart attack. Also, arterial plaque can come loose and travel to other parts of the body. If blockage occurs in the brain it can cause a stroke.

What are the warning signs of gum disease?

Red, swollen or tender gums.
Your gums bleed when you floss, brush, or use a toothpick.
Your gums pull away from your teeth.
Your permanent teeth are separating or becoming loose.
You see puss between your teeth and gums when you press your gums.
Your teeth come together differently when you bite and chew your food.
You have noticed a change in the fit of your partial dentures.
You have bad breath.

How is gum disease detected?

In our office we do a periodontal examination at each regular dental visit for a cleaning. We will first look to see if your gums are pink, stippled and tight against the teeth. After looking at the gums we will then use a periodontal probe to measure the depth of the area between the gum and tooth. This area is normally between 2-3 mm. deep. Anything deeper indicates the beginning signs of gum disease. If gum disease is present we will then take x-rays of your teeth and gum to reveal the extent of any bone loss that may have occurred. Finally, after we have completed our examination we can than make an accurate diagnosis and discuss with you how to begin treating the gum disease.

How is gum disease treated?

In the early stages, most treatment involves scaling and root planing removing plaque and calculus around the tooth and smoothing the root surfaces. Antibiotics (Periostat) or antimicrobials may be used to supplement the effects of scaling and root planning. In most cases of early gum disease, scaling and root planning is all that is necessary. In more severe cases of gum disease after scaling and root planing has been completed, surgery could be necessary if the deeper pockets are not eliminated.

Is maintenance important?

Once you have gum disease you can’t cure it but can only control the disease by sticking to a regular oral hygiene regimen. Most patients will be seen every 3-4 months following treatment for cleaning and examining of the roots. These shorter interval cleanings have been shown to increase the long-term success of periodontal treatment and reduce the risk of relapse. This may also eliminate the need for further root planing or surgery. In between visits, you should brush at least twice a day, floss daily and brush your tongue. We will also recommend that you use an electric toothbrush to help you with those hard to reach areas. Proxy brushes (small, narrow brushes are also helpful to clean in between the recesses in the teeth. We also recommend the use of a water pick, toothpicks and rubber tip stimulators.