Periodontal Disease Overview

According to the National Institute of Dental and Craniofacial Research, 80% of all US adults have some form of periodontal disease. It is a painless disease that may have no symptoms and can go unnoticed for many years. There are two forms of this disease that need to be defined: Gingivitis and Periodontitis. Gingivitis is an infection that affects only the gums or gingiva. It doesn’t involve bone loss. Periodontitis on the other hand involves both the gingiva and the periodontium. The periodontium is one of 4 tissues that support the teeth in a person’s mouth. They consist of the gingival, the cementum (the tooth tissue that lines the outside of the roots), the periodontal ligament (the soft tissue that connects the tooth to the bone) and the alveolar bone (the bone surrounding the tooth). So periodontitis will affect all 4 of these in some way.

The root of the problem

The main cause for all forms of gum disease is plaque. Plaque consists of a bacterial matrix that forms on teeth above and below the gum line. These bacteria can cause the gums to swell and if long standing allows the ligamental attachments to break allowing more of these bacteria to enter deeper down the root surface. This soft plaque will occasionally harden. The hardened form of plaque is known as calculus or tartar. Once this forms, a dental professional will be the only one who can remove it. A dentist or hygienist as part of a routine exam, measures the pocket depths of all teeth. Any pocket 3mm of less is deemed cleansable by the patient. Anything over 5mm in depth has the potential to cause tooth loss if not treated.

Factors

According to the ADA, the number one cause for periodontal disease is patient non-compliance. The lack of home care as well as regular dental checkups is the reason. Other major risk factors that increase the risk of developing periodontal disease include tobacco chewing and smoking and disease entities such as Diabetes. Decreased immune response is the main reason for this. Medications that alter salivary consistency, crooked teeth, ill-fitting dental fillings or bridges, preganancy, the use of oral contraceptives and a family history of periodontal disease all contribute as well.

Warning signs

As mentioned before, periodontal disease is usually painless. However, there are certain signs that do occur that can signal a problem. Bleeding gums, during eating or brushing, can be a sign that periodontal disease is present. Swollen tender gums, receeding gums, persistent halitosis, loose or separating teeth, a change in the bite or change in the fit of prosthesis are also other potential signs of this problem.

Other health issues

Besides loose or shifting teeth, periodontal disease has been connected to a number of other health issues. Studies conducted by the ADA and numerous pharmaceutical firms have confirmed a number of other potential risks involved with this disease entitiy. Periodontal disease is an inflammatory disease and in individuals with impared immune response, tends to make it difficult to keep infections under control. As a result infections can spread to many other parts of the body causing new problems or can worsen any disease state that the patient already has, such as diabetes. Also a connection between women with full blown periodontal disease and low birth or preterm babies has been made. It seems that women with gum disease, produce a hormone that is very similar to that given for inducing labor. Finally periodontal disease has been connected with increased coronary plaque accumulation and respiratory infections such as pneumonia.

Solutions

When it comes to periodontal disease, prevention is the key. Six month checkups are ideal to catch the start of the problem. Daily flossing and proper brushing are essential for maintaining good oral health. Prescription rinses, such as chlorhexidine gluconate or Peridex, can help in this maintanence, if deemed necessary by your dental professional. If the disease is present, treatment will include, scaling and root planing. This is a deep cleaning necessary to remove all the plaque and calculus. Further treatment may include surgical procedures, the placement of antibiotic chips in between the gums and tooth or laser therapy.

The bottom line is that prevention is the key. Regular checkups and good patient oral hygiene discipline are the key. If the disease is present, treatment options are available. Prevention is the key to better general and oral health.

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