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Periodontal (Gum) Disease

While it may seem inevitable that teeth will be lost with age, it is actually possible to maintain a complete set of teeth for a lifetime. One crucial step in achieving this is to prevent periodontal disease, which is caused by bacteria that attack the tissues surrounding the teeth. Unfortunately, the signs and symptoms of gum disease are not always obvious to individuals, making it important to seek regular dental check-ups.

Almost everyone who does not maintain proper daily oral hygiene will develop gingivitis, a bacterial gum infection. If left untreated, gingivitis can progress to periodontitis, a condition that involves bone loss around the teeth. As bone tissue diminishes, the gums detach from the teeth, creating pockets where bacteria can thrive beyond the reach of regular brushing and flossing. As periodontal disease advances and more bone is lost, tooth loss may occur. Genetic factors also play a role, as periodontal disease tends to run in families. The encouraging news is that even at more advanced stages, periodontal disease can be managed and controlled.

Signs and Symptoms of Periodontal Disease

It is crucial to recognize that periodontal disease can be present without noticeable symptoms, especially in individuals who smoke, as nicotine reduces blood supply and can mask gum tissue bleeding and swelling. However, there are key signs to watch out for:

  1. Bleeding gums — Bleeding during brushing, flossing, or eating hard foods is not normal and may indicate gum disease. Even if the bleeding is minimal, it should be taken seriously.

  2. Bad breath — Constant bad breath or a bad taste in your mouth that does not improve with oral hygiene measures could be a sign of gum disease and bacterial buildup.

  3. Redness or swelling of the gums —Red, swollen, or tender gums can indicate the presence of gum disease. Healthy gums should appear pink and firm.

  • Receding gums —If you observe that your teeth appear more elongated than before, it could indicate gum tissue recession, where the gums have pulled back from the tooth surface, exposing the underlying tooth roots.

  • Sensitivity — If there is gum recession, the exposed roots may become sensitive to hot or cold.

  • Periodontal abscess — Bacteria can become enclosed in a periodontal pocket and the area will fill with pus, becoming swollen and painful.

  • Loose teeth — As periodontal disease progresses, it can cause the supporting bone and tissues to deteriorate, leading to loose or shifting teeth.

Treatment Options

Periodontal therapy begins with an assessment of your oral hygiene practices and guidance on improving them. This is followed by the mechanical removal of plaque and hardened deposits (tartar or calculus) from the root surfaces through a process called scaling, root planing, or debridement. Hand instruments and/or ultrasonic instruments that vibrate at a high frequency may be used for this purpose. In some cases, antimicrobial products or antibiotics applied locally may be recommended to aid in healing and reduce the depth of pockets between the inflamed gum tissue and teeth. The goal is to eliminate the need for periodontal surgery whenever possible. However, in certain situations, surgical procedures may be required to address deep pockets. Various types of surgeries are available to address different issues, and in some cases, a combination of procedures may be employed to minimize the number of surgeries needed and reduce treatment costs.

Periodontal Disease & Your Overall Health

Periodontal disease not only affects oral health but has also been associated with more significant conditions like cardiovascular disease (CVD), diabetes, and preterm births. Research has proposed two possible explanations for the link between gum disease and these medical concerns. Firstly, moderate to severe periodontal disease can contribute to increased systemic inflammation, which is a common feature of chronic inflammatory diseases. Secondly, certain bacteria present in periodontal pockets surrounding diseased teeth have been identified in the plaques found in blood vessels of individuals with CVD. Consequently, reducing periodontal inflammation may have a beneficial effect on systemic inflammation.

Preventive Strategies

To prevent periodontal disease, it is crucial to practice effective daily oral hygiene by brushing and flossing your teeth. Regular dental checkups and professional cleanings every few months are also essential for maintaining periodontal health, as they can target areas that may be difficult to reach with a toothbrush and floss alone.

Early signs of gum disease can be detected through visual examination of your gum tissues and assessing their attachment to the teeth. Dental radiographs (x-rays) can also be used to evaluate the health of the tooth-supporting bone.

In addition to oral hygiene, there are other measures you can take to promote periodontal health. These include adopting a healthy diet, managing stress levels, and eliminating harmful habits such as smoking. By incorporating these practices into your lifestyle, you can increase the likelihood of keeping your teeth for a lifetime.

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