Periodontal (Gum) Disease

What is periodontal (gum) disease?
Types of periodontal (gum) diseases
The mouth-body connection
Types of Periodontal Treatment

What is periodontal (gum) disease?

The main cause of periodontal (gum) disease is plaque, but other factors affect the health of your gums.

Periodontal (gum) diseases, including gingivitis and periodontitis, are serious infections that, left untreated, can lead to tooth loss. Periodontal disease can affect one tooth or many teeth. The main cause of periodontal disease is bacterial plaque, a sticky, colorless film that constantly forms on yur teeth. However, factors like the following also affect the health of your gums.

  1. Smoking/Tobacco UseAs you probably already know, tobacco use is linked with many serious illnesses such as cancer, lung disease and heart disease, as well as numerous other health problems. What you may not know is that tobacco users also are at increased risk for periodontal disease. In fact, recent studies have shown that tobacco use may be one of the most significant risk factors in the development and progression of periodontal disease.
  2. GeneticsResearch proves that up to 30% of the population may be genetically susceptible to gum disease. Despite aggressive oral care habits, these people may be six times more likely to develop periodontal disease. Identifying these people with a genetic test before they even show signs of the disease and getting them into early interventive treatment may help them keep their teeth for a lifetime.
  3. Puberty, Pregnancy and Menopause in WomenA woman’s health needs are unique. Though brushing and flossing daily, a healthy diet, and regular exercise are important for oral health throughout life, there are certain times in a woman’s life when extra care is needed times when you mature and change such as puberty or menopause, and times when you have special health needs, such as menstruation or pregnancy. During these particular times, a woman’s body experiences hormonal changes that can affect many of the tissues in your body, including the gums. Your gums can become sensitive, and at times react strongly to the hormonal fluctuations. This may make you more susceptible to gum disease. Additionally, recent studies suggest that pregnant women with gum disease are seven times more likely to deliver preterm, low birth weight babies.
  4. StressAs you probably already know, stress is linked to many serious conditions such as hypertension, cancer, and numerous other health problems. What you may not know is that stress also is a risk factor for periodontal disease. Research demonstrates that stress can make it more difficult for the body to fight off infection, including periodontal diseases.
  5. MedicationsSome drugs, such as oral contraceptives, anti-depressants, and certain heart medicines, can affect your oral health. Just as you notify your pharmacist and other health care providers of all medicines you are taking and any changes in your overall health, you should also inform your dental care provider.
  6. Clenching or Grinding Your TeethHas anyone ever told you that you grind your teeth at night Is your jaw sore from clenching your teeth when you’re taking a test or solving a problem at work Clenching or grinding your teeth can put excess force on the supporting tissues of the teeth and could speed up the rate at which these periodontal tissues are destroyed.
  7. DiabetesDiabetes is a disease that causes altered levels of sugar in the blood. Diabetes develops from either a deficiency in insulin production (a hormone that is the key component in the body’s ability to use blood sugars) or the body’s inability to use insulin correctly. According to the American Diabetes Association, approximately 16 million Americans have diabetes; however, more than half have not been diagnosed with this disease. If you are diabetic, you are at higher risk for developing infections, including periodontal diseases. These infections can impair the ability to process and/or utilize insulin, which may cause your diabetes to be more difficult to control and your infection to be more severe than a non-diabetic.

Types of periodontal (gum) diseases

Untreated gingivitis can advance to periodontitis and eventually lead to tooth loss and other health problems.

Periodontal (gum) diseases, including gingivitis and periodontitis, are serious infections that, left untreated, can lead to tooth loss. The word periodonta

  1. Gingivitis
    Gingivitis is the mildest form of periodontal disease. It causes the gums to become red, swollen, and bleed easily. There is usually little or no discomfort at this stage. Gingivitis is often caused by inadequate oral hygiene. Gingivitis is reversible with professional treatment and good oral home care.l literally means “around the tooth.” Periodontal disease is a chronic bacterial infection that affects the gums and bone supporting the teeth. Periodontal disease can affect one tooth or many teeth. It begins when the bacteria in plaque (the sticky, colorless film that constantly forms on your teeth) causes the gums to become inflamed.
  2. Periodontitis
    Untreated gingivitis can advance to periodontitis. With time, plaque can spread and grow below the gum line. Toxins produced by the bacteria in plaque irritate the gums. The toxins stimulate a chronic inflammatory response in which the body in essence turns on itself, and the tissues and bone that support the teeth are broken down and destroyed. Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. Often, this destructive process has very mild symptoms. Eventually, teeth can become loose and may have to be removed.
    There are many forms of periodontitis. The most common ones include the following.
  • Aggressive periodontitis occurs in patients who are otherwise clinically healthy. Common features include rapid attachment loss and bone destruction and familial aggregation.
  • Chronic periodontitis results in inflammation within the supporting tissues of the teeth, progressive attachment and bone loss. This is the most frequently occurring form of periodontitis and is characterized by pocket formation and/or recession of the gingiva. It is prevalent in adults, but can occur at any age. Progression of attachment loss usually occurs slowly, but periods of rapid progression can occur.
  • Periodontitis as a manifestation of systemic diseases often begins at a young age. Systemic conditions such as heart disease, respiratory disease, and diabetes are associated with this form of periodontitis.
  • Necrotizing periodontal disease is an infection characterized by necrosis of gingival tissues, periodontal ligament and alveolar bone. These lesions are most commonly observed in individuals with systemic conditions such as HIV infection, malnutrition and immunosuppression.

The Mouth-Body Connection

Periodontal disease, a chronic inflammatory disease, is linked to other serious health risks.
  • Pregnancy Problems
  • Diabetes
  • Respiratory Diseases
  • Osteoporosis
  • Heart Disease and Stroke

In July 1998, the American Academy of Periodontology launched an effort to educate the public about new findings which support what dental professionals had long suspected: Infections in the mouth can play havoc elsewhere in the body. For a long time it was thought that bacteria was the factor that linked periodontal disease to other infections in the body, however, new research demonstrates that inflammation may link periodontal disease to other chronic conditions.
Research has shown, and experts agree, that there is an association between periodontal diseases and other chronic inflammatory conditions, such as diabetes, cardiovascular disease and Alzheimer’s disease. Therefore, treating inflammation may not only help manage periodontal diseases but may also help with the management of other chronic inflammatory conditions.
When an inflammatory condition is suspected or diagnosed, it is important to consult with both a general physician and a dental health professional, such as a periodontist. Sometimes the only way to detect periodontal diseases is through a periodontal evaluation. A periodontal evaluation may be especially important if you:

  • Have a high risk for periodontal diseases.
  • Have heart disease, diabetes, respiratory disease or osteoporosis, or are thinking of becoming pregnant.
  • Have a family member with periodontal disease. Research suggests that the bacteria that cause periodontal disease can pass through saliva. This means the common contact of saliva in families puts children and couples at risk for contracting the periodontal disease of another family member.
  • Have a sore or irritation in your mouth that does not get better within two weeks.
  • Diseases that interfere with the body’s immune system may worsen the condition of the gums.
Poor Nutrition and Obesity

As you may already know, a diet low in important nutrients can compromise the body’s immune system and make it harder for the body to fight off infection. Because periodontal disease is a serious infection, poor nutrition can worsen the condition of your gums.

Types of Gum Treatment

  • Non-Surgical Treatments
  • Periodontal Surgery
  • Regeneration
  • Crown lengthening surgery
  • Gum grafting
  • Laser Therapy
  • Cosmetic Procedures

Following are some of the procedures that periodontists use to treat patients diagnosed with a periodontal (gum) disease. A periodontist is a dentist who specializes in the prevention, diagnosis and treatment of periodontal disease. Periodontists receive extensive training in these areas, including three additional years of education beyond dental school. Periodontists are familiar with the latest techniques for diagnosing and treating periodontal disease. In addition, they can perform cosmetic periodontal procedures to help you achieve the smile you desire.

Case-1

Periodontal (Gum) Disease

This sweet patient came to see me for a second opinion. Multiple dentists had suggested removing all of her teeth for dental implants. With proper gum treatment and maintenance protocol in our office, she still maintains all of her natural teeth and she couldn’t be happier.

A. Non-Surgical Treatments

The American Academy of Periodontics treatment guidelines stress that periodontal health should be achieved in the least invasive and most cost-effective manner. This is often accomplished through non-surgical periodontal treatment, including scaling and root planing (a careful cleaning of the root surfaces to remove plaque and calculus [tartar] from deep periodontal pockets and to smooth the tooth root to remove bacterial toxins), followed by adjunctive therapy such as local delivery antimicrobials and host modulation, as needed on a case-by-case basis.

Most periodontists would agree that after scaling and root planing, many patients do not require any further active treatment, including surgical therapy. However, the majority of patients will require ongoing maintenance therapy to sustain health. Non-surgical therapy does have its limitations, however, and when it does not achieve periodontal health, surgery may be indicated to restore periodontal anatomy damaged by periodontal diseases and to facilitate oral hygiene practices.

B. Surgical Treatment

If you’re diagnosed with periodontal disease, your periodontist may recommend periodontal surgery. Periodontal surgery is necessary when your periodontist determines that the tissue around your teeth is unhealthy and cannot be repaired with non-surgical treatment. Following are the four types of surgical treatments most commonly prescribed:

Pocket Depth Reduction

When supporting tissue and bone is destroyed, “pockets” form around the teeth.

Your bone and gum tissue should fit snugly around your teeth like a turtleneck around your neck. When you have periodontal disease, this supporting tissue and bone is destroyed, forming “pockets” around the teeth.
Over time, these pockets become deeper, providing a larger space for bacteria to live. As bacteria develop around the teeth, they can accumulate and advance under the gum tissue. These deep pockets collect even more bacteria, resulting in further bone and tissue loss. Eventually, if too much bone is lost, the teeth will need to be extracted.

Your periodontist has measured the depth of your pocket(s). A pocket reduction procedure has been recommended because you have pockets that are too deep to clean with daily at-home oral hygiene and a professional care routine.
During this procedure, your periodontist folds back the gum tissue and removes the disease-causing bacteria before securing the tissue into place. In some cases, irregular surfaces of the damaged bone are smoothed to limit areas where disease-causing bacteria can hide. This allows the gum tissue to better reattach to healthy bone.

What are the benefits of this procedure?

Reducing pocket depth and eliminating existing bacteria are important to prevent damage caused by the progression of periodontal disease and to help you maintain a healthy smile. Eliminating bacteria alone may not be sufficient to prevent disease recurrence. Deeper pockets are more difficult for you and your dental care professional to clean, so it’s important for you to reduce them. Reduced pockets and a combination of daily oral hygiene and professional maintenance care increase your chances of keeping your natural teeth and decrease the chance of serious health problems associated with periodontal disease.

Regeneration

Our specialist may recommend a regenerative procedure when the bone supporting your teeth has been destroyed. These procedures can reverse some of the damage by regenerating lost bone and tissue. During this procedure, a periodontist folds back the gum tissue and removes the disease-causing bacteria. Membranes (filters), bone grafts or tissue-stimulating proteins can be used to encourage your body’s natural ability to regenerate bone and tissue. There are many options to enhance support for your teeth and to restore your bone to a healthy level. Your periodontist will discuss your best options with you.
What are the benefits of this procedure?
Eliminating existing bacteria and regenerating bone and tissue helps to reduce pocket depth and repair damage caused by the progression of periodontal disease. With a combination of daily oral hygiene and professional maintenance care, you’ll increase the chances of keeping your natural teeth and decrease the chances of serious health problems associated with periodontal disease.

Crown Lengthening surgery

Case esthetic crown lengthening

Case Crown Lengthening Surgery

Your teeth may actually be the proper lengths, but they’re covered with too much gum tissue

Periodontal procedures are available to lay the groundwork for restorative and cosmetic dentistry and/or to improve the esthetics of your gum line. Your teeth may actually be the proper lengths, but they’re covered with too much gum tissue. To correct this, our specialist performs crown lengthening.
During this procedure, excess gum and bone tissue is reshaped to expose more of the natural tooth. This can be done to one tooth, to even your gum line, or to several teeth to expose a natural, broad smile.
We may also recommend crown lengthening to make a restorative or cosmetic dental procedure possible. Perhaps your tooth is decayed, broken below the gum line, or has insufficient tooth structure for a restoration, such as a crown or bridge. Crown lengthening adjusts the gum and bone level to expose more of the tooth so it can be restored.

What are the benefits of this procedure?

Whether you have crown lengthening to improve function or esthetics, patients often receive the benefits of both: a beautiful new smile and improved periodontal health your keys to smiling, eating and speaking with comfort and confidence.

Gum Grafts

Case Gum grafting surgery 1

Case gum grafting surgery

Periodontal procedures are available to stop further dental problems and gum recession

Periodontal procedures are available to stop further dental problems and gum recession, and/or to improve the esthetics of your gum line. Exposed tooth roots are the result of gum recession. Perhaps you wish to enhance your smile by covering one or more of these roots that make your teeth appear too long. Or, maybe you’re not bothered by the appearance of these areas, but you cringe because the exposed roots are sensitive to hot or cold foods and liquids.

Your gums may have receded for a variety of reasons, including aggressive tooth brushing or periodontal disease. You may not be in control of what caused the recession, but prior to treatment your periodontist can help you identify the factors contributing to the problem. Once these contributing factors are controlled, a soft tissue graft procedure will repair the defect and help to prevent additional recession and bone loss.

Soft tissue grafts can be used to cover roots or develop gum tissue where absent due to excessive gingival recession. During this procedure, your periodontist takes gum tissue from your palate or another donor source to cover the exposed root. This can be done for one tooth or several teeth to even your gum line and reduce sensitivity.

What are the benefits of this procedure?

A soft tissue graft can reduce further recession and bone loss. In some cases, it can cover exposed roots to protect them from decay. This may reduce tooth sensitivity and improve the esthetics of your smile. Whether you have a soft tissue graft to improve function or esthetics, patients often receive multiple benefits: a beautiful new smile; improved periodontal health; eating, and speaking with comfort and confidence.