Periodontal Disease

Periodontal disease, or simply gum disease, is the single most common cause of tooth loss in adults. This inflammatory disease attacks the gums, bone and other supporting structures of the teeth.

Gum disease is caused by plaque, a colorless film of bacteria that forms on the teeth. Plaque mixes with sugars and starches in the diet to form acids and other by-products in the mouth, irritating the gums and causing them to become red, tender and swollen. It also causes the gums to bleed easily. If not removed daily, plaque hardens to form calculus (tartar) around the necks of the teeth.
The tissue that attaches the gums to the teeth can be destroyed by the irritants in plaque. The gums pull away from the teeth and small pockets form between the teeth and gums. These pockets become filled with more plaque. As the pockets deepen, it becomes impossible for you to clean the plaque out. Eventually, the bone structure supporting the teeth can be destroyed.
(During a dental checkup, the depth of the “pockets” between tooth and gum are measured. Unusually deep pockets create an environment where gum disease progresses. )
Other Causes of Periodontal Disease
1. Physical and chemical irritants impacted food, tobacco products, alcohol and the improper use of dental floss or toothpicks may irritate gum tissue.
2. Abnormal oral conditions or habits badly aligned teeth, poorly fitting bridges or partial dentures, defective fillings and harmful habits, such as grinding the teeth and chewing ice, can also cause problems.
3. Unbalanced diet — Evidence shows a link between nutritional deficiency and the body’s ability to fight off infection.
4. Pregnancy — Due to fluctuations in hormone levels, a temporary condition referred to as “pregnancy gingivitis” may occur.
5. Certain medications — Oral contraceptives, anti-epilepsy drugs, steroids, and cancer therapy drugs may have a negative effect.
6. Certain Diseases — Diabetes, uremia, liver cirrhosis, anemia, and leukemia are among the many diseases that may affect the health of your gums.
(As the pockets deepen, it becomes impossible for you to clean the plaque out through brushing or flossing. Note here the buildup of plaque as it begins to damage the gum tissue.)

What Are the Signs?

• Gums that bleed when you brush or floss your teeth
• Red, swollen or tender gums
• Gums that have receded or shrunken away from your teeth Pus between your teeth when you press your gums with your finger
• Pain when chewing
• Calculus or tartar buildup
• Teeth that seem loose or that change position
• Changes in your bite
• Changes in the way your partial dentures fit
• Bad breath or a chronic bad taste in your mouth
• Teeth that are overly sensitive to hot  and cold

Diagnosis

A thorough oral examination, including x-rays, is crucial to diagnosing periodontal disease. In most cases, we recommend an in-office exam and tooth cleaning for all adults twice a year. At that time, we may use a special instrument called a periodontal
(In advanced stages, the gums recede from the tooth, and bone structure is lost, endangering the stability of the tooth. probe to measure the depth of the pocket between the tooth and the gum tissue. The pocket depth measurement, clinical examination, and x-rays help us determine the precise location, extent, and severity of gum disease.

Treatment

The type of treatment you require depends on how advanced your particular case is. Individualized treatment may include any of the following:
1. More frequent cleanings. It may take the bacteria at the base of the pocket up to three months to colonize into numbers able to destroy the bone. Frequent cleanings can prevent this buildup.
2. Scaling and root planing. Scaling is removing the calculus deposits from your teeth. Root planing is the smoothing of the root surfaces so that the gum tissue can reattach to the tooth.
3. Curettage removes the soft tissue lining the periodontal pocket. This helps the gum tissue to heal.
4. Gingivectomy is the surgical removal of the periodontal pocket to allow easier access for cleaning.
5. Flap surgery allows us to gain access to the root of the tooth for the removal of calculus, plaque, and diseased tissue. The gum is then secured back into place.