Periodontal Disease

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Periodontal disease, also known as gum disease, is inflammation of the gums and other tissues surrounding the teeth that is caused by a bacterial infection. The disorder affects as many as 75 percent of adults over age 35. It is the main cause of tooth loss in adults.

The earliest stage of periodontal disease is called gingivitis. The main symptom of gingivitis is gums that bleed when you brush or floss your teeth. At this stage, gum disease is both preventable and reversible because the plaque buildup has not yet extended below the gum line to the roots. Brushing your teeth daily is not enough to prevent gingivitis. The only way to stop gingivitis and to prevent further inflammation is to brush your teeth consistently twice a day, floss your teeth daily, and have a professional tooth cleaning at least twice a year. You should also maintain a balanced diet and avoid smoking or chewing tobacco.

Left untreated, the gums begin to pull away from the teeth, and pockets form between the teeth and the gums. The pockets may become filled with pus, and the gums may recede farther. Plaque spreads to the roots of the teeth, and the infection begins to damage the bone and other supporting tissue. The teeth begin to shift and loosen and either fall out or have to be extracted (pulled) by the dentist.

Warning Signs of Periodontal Disease

Periodontal disease, also known as gum disease, is the number one cause of tooth loss in American adults. It may also be a risk factor for heart disease or other medical conditions. An estimated 75 percent of adults over age 35 in the United States have some form of periodontal disease, but the disorder is easily reversed in its early stages by consistent, daily toothbrushing and flossing. Because periodontal disease is painless, you may not know that you have it. If you notice any of the following signs of periodontal disease, see your dentist right away:

  • gums that bleed when you brush or floss your teeth
  • red, swollen, or tender gums
  • gums that have pulled away from your teeth
  • bad breath or a bad taste in your mouth that does not go away
  • pockets of pus around your teeth and gums
  • loose teeth
  • pain when chewing

Not only is periodontal disease damaging to your teeth and gums, it also may adversely affect your overall health. Periodontal disease may contribute to the development of heart disease, the number one cause of death in the United States. Doctors are still not sure why there appears to be a connection between periodontal disease and heart disease, but research has shown that the bacteria responsible for periodontal disease can enter the bloodstream and cause plaque buildup in the arteries leading to the heart. Periodontal disease also has been implicated in the development of stroke, pneumonia, and peptic ulcers.

It is important to have regular dental checkups to prevent and detect periodontal disease. If you think you have the condition, see your dentist right away. He or she will perform a thorough examination of your mouth, teeth, and gums. If the condition is present, the dentist will probably assess the sever-



Concerns ity of the disorder by checking for bleeding with a probe, measuring the depth 411

of any pockets, assessing how well each affected tooth is still attached, and Teeth and evaluating bone loss through dental X rays. He or she will develop a treatment Gums plan that is tailored to your needs, depending on the extent of the periodontal disease.

Dentists use a variety of therapies to treat periodontal disease, but all focus on the removal and control of the infectious bacterial plaque. In a process known as scaling, the dentist uses handheld instruments to remove the hardened plaque and calculus from above and below the gum line. During root planing, the dentist smoothes out the surface of the root by removing the bacteria and toxins that lead to periodontal disease. Ultrasonic scaling involves use of an instrument that converts a high-frequency electrical current into mechanical vibrations, which remove plaque and calculus. The dentist may also use a technique called subgingival debridement to remove tooth surface irritants from below the gums so that infection will not occur at the treated site.

If periodontal disease has progressed to an advanced stage, the dentist may have to treat it with one of two surgical techniques. Both procedures attempt to remove diseased tissue so that new replacement tissue can grow. The first technique is called resective surgery, in which the dentist lifts the gum away from the tooth and bone to remove diseased tissue and reshape infected bone. The dentist then repositions the gum and stitches it back into place. Another type of surgery, known as regenerative surgery, attempts to actually regrow the jawbone and supporting tissue by using special inserts that help new tissue grow.

Dentists are beginning to use some new therapies to fight periodontal disease. Inserts containing antibiotics or anti-inflammatory drugs are available that can be placed directly into infected pockets to destroy bacteria. Mouth rinses or toothpastes containing drugs or antimicrobial agents that can destroy the microorganisms responsible for periodontal disease also have been developed. Ask your dentist to recommend one.

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