Gum disease, or Periodontal Disease as dentists call it, is caused by plaque which is the name given to the film of bacteria that collects on teeth. Gum disease involves the inflammation of the gums and then infection. Periodontal Disease is usually painless which can make it harder to detect. In its early stages just the gum is affected and the gums become inflamed and appear red and swollen and will bleed easily and the bleeding can often be noticed on brushing. You may notice bad breath. At this stage if you get rid of all the plaque and keep it away by careful brushing, flossing and maybe the use of mouthwashes as well your gums should return to normal.
The later stages – bone loss if the disease is not stopped it continues to spread down under the gum and the gums may become more swollen and bleed more often. The plaque may harden to tartar around the teeth. The infection spreads into the bone that holds the teeth in place and in simple terms starts to dissolve the bone away. Once the bone goes it cannot be naturally replaced.
How the teeth are affected
The effect of losing bone is that the tooth may become gradually loose and eventually if the disease process is not stopped then the affected tooth or teeth will fall out. In these later stages you will need the help of a dentist or dental hygienist to carry out cleaning under the gums to clean out the affected areas. If the disease is severe then you may need to see a specialist for treatment and sometimes gum surgery is required.
Prevention of gum disease
Gum disease can usually be prevented by good and careful teeth cleaning and regular cleanings or scale and polishes with your dentist or hygienist. Studies have also shown that smoking is a risk factor for gum disease and every effort should be stop smoking as part of treatment for the condition. Your dentist should check your gums at every check up by gently probing round your teeth to check for areas of bleeding or to look for areas where bone may be being lost. Additionally routine x-rays will show the bone levels around your mouth.
Your dentist should be keeping a record of the condition of your gums as they are as important as your teeth. If you go to the dentist regularly and keep your teeth and gums clean there is usually no reason why you should suffer from gum disease.
Types of Gum/Periodontal Disease
When left untreated, gingivitis (mild gum inflammation) can spread to below the gum line. When the gums become irritated by the toxins contained in plaque, a chronic inflammatory response causes the body to break down and destroy its own bone and soft tissue. There may be little or no symptoms as periodontal disease causes the teeth to separate from the infected gum tissue. Deepening pockets between the gums and teeth are generally indicative that soft tissue and bone is being destroyed by periodontal disease. Here are some of the most common types of periodontal disease:
Inflammation within supporting tissues cause deep pockets and gum recession. It may appear the teeth are lengthening, but in actuality, the gums (gingiva) are receding. This is the most common form of periodontal disease and is characterized by progressive loss of attachment, interspersed with periods of rapid progression.
This form of gum disease occurs in an otherwise clinically healthy individual. It is characterized by rapid loss of gum attachment, chronic bone destruction and familial aggregation.
This form of gum disease most often occurs in individuals suffering from systemic conditions such as HIV, immunosuppression and malnutrition. Necrosis (tissue death) occurs in the periodontal ligament, alveolar bone and gingival tissues.
Periodontitis caused by systemic disease
This form of gum disease often begins at an early age. Medical condition such as respiratory disease, diabetes and heart disease are common cofactors.
Treatment for Periodontal Disease
There are many surgical and nonsurgical treatments the periodontist may choose to perform, depending upon the exact condition of the teeth, gums and jawbone. A complete periodontal exam of the mouth will be done before any treatment is performed or recommended. Here are some of the more common treatments for periodontal disease:
Scaling and root planeing
In order to preserve the health of the gum tissue, the bacteria and calculus (tartar) which initially caused the infection, must be removed. The gum pockets will be cleaned and treated with antibiotics as necessary to help alleviate the infection. A prescription mouthwash may be incorporated into daily cleaning routines.
When the bone and gum tissues have been destroyed, regrowth can be actively encouraged using grafting procedures. A membrane may be inserted into the affected areas to assist in the regeneration process.
Pocket elimination surgery
Also known as flap surgery) is a surgical treatment which can be performed to reduce the pocket size between the teeth and gums. Surgery on the jawbone is another option which serves to eliminate indentations in the bone which foster the colonization of bacteria.
When teeth have been lost due to periodontal disease, the aesthetics and functionality of the mouth can be restored by implanting prosthetic teeth into the jawbone. Tissue regeneration procedures may be required prior to the placement of a dental implant in order to strengthen the bone.