CAUSES, PREVENTION, TREATMENT & HOME CARE
Periodontal disease is a condition that affects the supporting structures, primarily bone and gum tissues, which hold your teeth in place. Having good periodontal health is important for maintaining the long term function and aesthetics of your teeth as well as being an integral part of maintaining your overall health. As gum disease progresses, you will see loosening and loss of teeth, longer teeth that compromise the natural beauty of your smile, a reduced ability to properly chew your food and an increased risk of systemic disease.
CAUSES OF PERIODONTAL DISEASE
There are two basic types of gum disease, periodontitis and recession. Both types of disease result in the loss of supporting structure, gum tissue and bone, around the teeth. Periodontitis, a loss of gum and bone due to a bacterial infection, will affect approximately 75% of the population at some point in their life and is the leading cause of tooth loss after the age of 35.
As soon as we brush our teeth, bacteria in our mouths begin attaching to our teeth. The bacteria take the food that we eat and turn it in to toxins and irritants. The combination of the bacteria, food and toxins is what makes up dental plaque. Plaque is a very soft material that is attached to your teeth and with proper daily brushing and flossing can be easily removed. If you do not get the plaque off, it will begin to calcify into a hard substance called calculus or tartar which you cannot remove easily.
The plaque and tarter can cause irritation in your gum and bone. As this irritation progresses, it will begin to dissolve the gum and bone attachment around the tooth. The inflammation causing the loss of bone and gum is also thought to get into the blood stream and cause inflammation and disease in other parts of the body. As the gum disease progresses, eventually the teeth will lose their support and be lost.
Ironically, gum disease is usually asymptomatic. People do not know that they have gum disease unless their dentist tells them they do after doing a thorough examination. Because periodontitis is usually a chronic disease that occurs over a long period of time, like heart disease or diabetes, symptoms are not noticed until the advanced stages of the disease.
Factors that contribute to the progression of gum disease include tobacco usage, diabetes, stress, clenching or grinding teeth, medications, poor nutrition and hormonal changes (puberty, menstruation, pregnancy, etc.).
Recession is a second common form of gum disease resulting in the loss of gum and bone support but usually has less to do with the bacteria in your mouth and more to do with the amount of supporting bone and gum tissue you have around your teeth. Recession results in the loss of gum and bone primarily on the outside of the tooth and results in the exposure of the root of the tooth. As the root gets exposed, the teeth appear longer than normal and may become sensitive.
The thicker the gum and bone are around the teeth, the more resistant the tooth is to having recession. Each tooth should have two types of gum tissue around it, a band of thick pink tissue called keratinized tissue right around the crown of the tooth and then the cheek tissue either above or below the keratinized tissue. The keratinized tissue is essential to maintaining the long term health of the teeth. If this tissue is either not present due to genetic factors or is lost due to traumatic brushing or by some other means, the gum and bone will frequently begin to recede and expose the root of the tooth.
PREVENTION OF PERIODONTAL DISEASE
The primary factors in preventing gum disease are maintaining good daily oral hygiene and seeing your dentist for dental cleanings on a regular basis. Daily brushing and flossing to remove dental plaque and oral bacteria is the most effective way to prevent gum disease. For the most part, you have control of your oral health. Individuals that are diligent with their home care rarely have problems with gum disease.
Seeing your dentist regularly for an examination and cleaning is also very important for maintaining good oral health. Regular examinations are important to identify any disease progression at the earliest stages where they can usually be managed with very conservative treatment. Cleanings allow deposits of calculus and tartar that have built up over time to be removed. This allows the health of the gums to be optimized and supports the efforts you are making at home.