Periodontal Diseases

Periodontal diseases, also known as gum disease, are some of the most common infections in the United States. In fact, more than 75 percent of American adults over age 35 have some form of periodontal disease.

Despite the number of people infected with these diseases, most believe they don’t have them. In a recent survey, eight out of ten Americans believed they did not have periodontal disease, but seven out of ten exhibited one or more symptoms.

Periodontal disease has been linked to an increased risk of other serious diseases, including cardiovascular disease. By improving your periodontal health, you can lower your risk of heart attack and stroke.

Periodontal diseases are painless until their advanced stages. If left untreated, periodontal diseases can result in bad breath, red, swollen and bleeding gums, and eventually, tooth loss. In fact, periodontal diseases are the leading cause of adult tooth loss.

What are periodontal diseases?

The word “periodontal” literally means “around the tooth.” Periodontal diseases are bacterial gum infections that destroy the attachment fibers and supporting bone that hold your teeth in your mouth. Daily home oral care, including proper brushing and flossing, is necessary to prevent plaque build-up.

If plaque is not removed, it can turn into a hard substance called calculus in less than two days. Calculus is so hard it can only be removed during a professional cleaning. If calculus develops below the gums on the tooth root, it makes plaque removal more difficult, leaving you at increased risk for periodontal diseases.

Toxins (or poisons) produced by the bacteria in plaque irritate the gums, causing infection. These toxins also can destroy the supporting tissues around the teeth, including the bone.

When this happens, gums separate from the teeth, forming pockets that fill with even more plaque and more infection. As the diseases progress, these pockets deepen, more gum tissue and bone are destroyed, and the teeth eventually become loose. If periodontal diseases are not treated, the teeth may need to be removed.

Periodontal diseases can affect one tooth or many teeth. For example, your front teeth may not show signs of periodontal diseases while a tooth in the back of your mouth may become loose due to severe disease progression.

There are many forms of periodontal diseases. The most common ones include:

GINGIVITIS

The mildest form of the diseases, gingivitis causes the gums to become red, swell and bleed easily. There is usually little or no discomfort at this stage. Gingivitis is reversible with professional treatment and good oral home care.

pd_healthygums

Healthy Gums

Gingivitis

Gingivitis

MILD PERIODONTITIS

If gingivitis is left untreated, it can advance to periodontitis. In the mild stage, periodontal diseases begin to destroy the bone and tissue that support the teeth.

MODERATE-ADVANCED PERIODONTITIS

In the moderate/advanced stages, periodontal diseases can lead to more bone and tissue destruction. The most advanced form of these diseases includes extensive bone and tissue loss. Teeth often become loose and may have to be removed.

What other factors might contribute to periodontal diseases?

Although plaque is the primary cause of periodontal diseases, other factors can affect the health of your gums, including:

SMOKING/TOBACCO USE: Tobacco users are more likely to get periodontal diseases and suffer from the more severe forms. Also, healing following therapy may take more time.

PREGNANCY AND PUBERTY: Some hormonal changes can cause the gums to become red and tender and bleed easily. Any pre-existing periodontal diseases can become more severe. Pregnant women should have their teeth cleaned thoroughly throughout pregnancy.

STRESS: Stress can make it more difficult for the body to fight off infection, including periodontal diseases.

MEDICATIONS: Some drugs, such as oral contraceptives, antidepressants and certain heart medicines, can affect oral health.

CLENCHING OR GRINDING YOUR TEETH: These habits can put excess force on the supporting tissues of the teeth and could speed up the rate at which these tissues are destroyed.

DIABETES: Periodontal diseases can be more severe in diabetics. In addition, untreated periodontal diseases can make it harder for diabetics to keep their disease under control.

POOR NUTRITION: A diet low in important nutrients also can make it harder for the body to fight off infection.

SYSTEMIC DISEASES: Diseases that interfere with the body’s immune system may worsen the condition of the gums.

What are soft tissue grafts?

Soft tissue grafts and other root coverage procedures are designed to cover exposed roots, to reduce further gum recession and to protect your vulnerable roots from decay.

Before soft tissue graft

Before soft tissue graft

After soft tissue graft

After soft tissue graft

What are the signs of periodontal diseases?

The following are the most common symptoms of periodontal diseases:

  • Bleeding gums during brushing
  • Red, swollen or tender gums
  • Gums that have pulled away from the teeth
  • Persistent bad breath
  • Pus between the teeth and gums (leaving a bad taste)
  • Loose or separating teeth
  • A change in the way your teeth fit together when you bite
  • A change in the fit of partial dentures

You may have periodontal diseases and not have any of these symptoms. Most people don’t experience pain with periodontal diseases. If you have any of the above symptoms, you should schedule an appointment with a periodontist for a complete evaluation. Many people over the age of 35 develop periodontal diseases.

What is the treatment for periodontal diseases?

Once your periodontal health has been evaluated, Dr. Batos will work with you to determine the treatment options that are best to arrest your disease and bring you back to health.

Depending on how far the diseases have progressed, treatment can vary widely. If caught in the early stages, simple procedures are done that will remove the plaque and calculus from below the gumline and eliminate the infection-causing bacteria. If these diseases have advanced to the point where the periodontal pockets are deep and the supporting bone is lost, further treatment might be necessary.

What are bone grafting and GBR?

Bone grafting is a surgical procedure that replaces missing bone with a material called a bone graft. This material not only replaces missing bone, but also helps your body regrow lost bone. This new bone growth strengthens the grafted area by forming a bridge between your existing bone and graft. Over time the newly formed bone will replace much of the grafted material. GBR is a procedure in which a membrane is placed over the bone graft site. This membrane further encourages new bone to grow and also prevents the growth of scar tissue into the grafted site.


Periodontal defects

Periodontal defects

Defects following cyst or tumor surgery

Defects following cyst or tumor surgery

Defects following tooth extraction

Defects following tooth extraction

Defects around dental implants

Defects around dental implants

Normal

Normal

Deficient

Deficient


How can periodontal diseases be prevented?

To keep teeth for a lifetime, you must remove the plaque from your teeth and gums every day by brushing and flossing. Review how you brush and floss with your dental professional. He or she can help you fine-tune your technique, so that your at-home efforts are even more effective.

Regular dental visits also are important. Daily cleaning will keep calculus formation to a minimum, but it won’t completely prevent it. Professional cleaning is necessary to remove calculus from places your toothbrush, floss and other cleaning aids may have missed. Note: Every individual is different, Dr. Batos will inform you on how often you should be seen for a professional cleaning. Your schedule is determined by your individual needs.

Remember, good oral hygiene and regular professional care are the keys to preventing periodontal diseases. Teeth were meant to last a lifetime, and with a little tender, loving care, they can.