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PERIODONTICS - Non Surgical

Periodontal Disease (Gum Disease): The Tooth Loss Culprit

Gum disease or periodontal disease (also known as periodontitis) is an inflammatory condition affecting the tissues surrounding a tooth. It is recognized as the leading cause of tooth loss. Gum disease may initially appear as gingivitis and may progress to periodontitis, if left untreated.

• Gingivitis is a bacterial infection of the tissues in the mouth and the first sign that a patient is at risk for periodontal disease.

• Periodontal disease is another type of bacterial infection in which the toxins produced by the bacteria affect the teeth’s connective tissue and bone.

The Signs of Gum Disease

As the infection progresses, the bone may recede and the gums may or may not recede. In some cases, the roots of the tooth may become exposed; this exposure may cause tooth sensitivity. Furthermore, pus may be produced, and pockets may form between the gum and tooth. These symptoms are possibly reflective of periodontal disease.

It is important to visit your dentist for professional examinations and dental cleanings to identify gum disease. For example, bone recession is not visible to the naked eye and, if left undetected, may contribute to tooth loss. Let’s explore some of the common signs of gum disease:


• Bleeding gums during tooth brushing or otherwise
• Sensitive, red or swollen gums
• Bad breath
• Teeth that are loose or appear to have shifted

Causes of Gum Disease

Improper Dental Hygiene: If plaque is not removed through daily dental hygiene practices and regular professional dental cleanings, bacteria may set in and cause gingivitis.

Organic Changes in the Mouth: Changes in hormone levels during pregnancy, puberty, and menopause may make teeth more susceptible to gum disease. This is because changes that occur in metabolism during these time periods may affect the organic balance in the mouth.

Medical Conditions: Serious conditions that affect the body’s ability to produce sugar (such as diabetes or kidney disease) may contribute to periodontal disease. Furthermore, the Center for Disease Control has found an association between illnesses and gum disease. These diseases include stroke and heart attack. Finally, certain medical conditions and medications used to treat medical conditions may produce the overgrowth of gums. Overgrown gums are more susceptible to bacteria that can contribute to gum disease.

Saliva Flow Inhibitors: Certain medications that may produce oral side effects or dry mouth syndrome (xerostoma) may contribute to reduction of protective saliva flow, potentially leading to gum disease. Seniors may be more susceptible to dry mouth syndrome because of the natural reduction of salivary flow that is associated with age.

Poor Functional Habits: Teeth grinding or clenching may impair the surrounding tissue and is a possible contributor to gum disease.

Signs and Symptoms

Symptoms may include the following:

Occasional redness or bleeding of gums while brushing teeth, using dental floss or biting into hard food (e.g. apples) (though this may occur even in gingivitis, where there is no attachment loss)

Occasional gum swellings that recurs halitosis, or bad breath, and a persistent metallic taste in the mouth gingival recession, resulting in apparent lengthening of teeth. (This may also be caused by heavy handed brushing or with a stiff tooth brush.) deep pockets between the teeth and the gums (pockets are sites where the attachment has been gradually destroyed by collagen-destroying enzymes, known as collagenases) loose teeth, in the later stages (though this may occur for other reasons as well).

Patients should realize that the gingival inflammation and bone destruction are largely painless. Hence, people may wrongly assume that painless bleeding after teeth cleaning is insignificant, although this may be a symptom of progressing periodontitis in that patient.

Prevention

Daily oral hygiene measures to prevent periodontal disease include:

Brushing properly on a regular basis (at least twice daily), with the patient attempting to direct the toothbrush bristles underneath the gum-line, so as to help disrupt the bacterial growth and formation of subgingival plaque and calculus.


Flossing daily and using interdental brushes (if there is a sufficiently large space between teeth), as well as cleaning behind the last tooth in each quarter.

Using an antiseptic mouthwash. Chlorhexidine gluconate based mouthwash or hydrogen peroxide in combination with careful oral hygiene may cure gingivitis, although they cannot reverse any attachment loss due to periodontitis. (Alcohol based mouthwashes may aggravate the condition).

Regular dental check-ups and professional teeth cleaning as required. Dental check-ups serve to monitor the person's oral hygiene methods and levels of attachment around teeth, identify any early signs of periodontitis, and monitor response to treatment.

Oil pulling, an alternative medicine procedure, performed on an empty stomach...

Typically dental hygienists (or dentists) use special instruments to clean (debride) teeth below the gumline and disrupt any plaque growing below the gumline. This is a standard treatment to prevent any further progress of established periodontitis. Studies show that after such a professional cleaning (periodontal debridement), bacteria and plaque tend to grow back to pre-cleaning levels after about 3-4 months.

Hence, in theory, cleanings every 3-4 months might be expected to also prevent the initial onset of periodontitis. However, analysis of published research has reported little evidence either to support this or the intervals at which this should occur. Instead it is advocated that the interval between dental check-ups should be determined specifically for each patient between every 3 to 24 months.

Nonetheless, the continued stabilization of a patient's periodontal state depends largely, if not primarily, on the patient's oral hygiene at home if not on the go too. Without daily oral hygiene, periodontal disease will not be overcome, especially if the patient has a history of extensive periodontal disease.

 

 


 

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