PERIODONTAL CARE
Periodontitis
Despite great advances made during the last two decades
in reducing tooth decay, an estimated 67 million people in
the U.S. (nearly one in three adults) suffer from some type
of periodontal, or gum, disease. In fact, periodontitis,
the most serious form of this condition, is the leading cause
of adult tooth loss in our country. Periodontal disease
begins with bacteria, which is often referred to as plaque
or calculus, and is an inhabitant of every mouth. As
bacteria make themselves at home on your gums and teeth, these
unwelcome visitors can cause your gums to become inflamed. As
a natural defense mechanism, your body attempts to oust the
bacteria by sending infection-fighting white blood cells to
the site of the inflammation. These white blood cells
release enzymes, which in some people are overproduced. This
overproduction of enzymes leads to advanced stages of gum disease
and is responsible for the destruction of the tissues that
surround and support the teeth, including the gums and bone. The
early stages of this regression is referred to as gingivitis. Untreated
gingivitis may lead to the advanced stage, periodontitis, which
may permanently damage the tissues and bone surrounding and
supporting the teeth. Unfortunately, this destruction
is largely irreversible, and good dental hygiene alone cannot
stop it. Periodontitis must be treated by dental professionals
to halt the progression of the disease and prevent tooth loss.
Recognizing Gum Disease
In many cases a person may develop
gum disease due to smoking, bacterial plaque accumulation,
and genetic susceptibility. Other
risk factors may include stress, diet, pregnancy, and conditions
such as diabetes. Symptoms include blood on the toothbrush,
bad breath, receding gums, inflamed gum tissue, loose teeth
and pockets between teeth and gums. If left untreated,
gum disease can begin to destroy a tooth's attachment to surrounding
tissues in the jaw bone. However, if gum disease is diagnosed
and treated soon enough, you can be restored to a healthy condition
which can be maintained over time.
Treating Gum Disease
Treatment for gum disease often results
in improved oral health, which can increase one's level of
comfort, appearance and self-confidence. This
can improve oral health, which can increase one's level of
comfort, appearance and self-confidence. Your periodontist
will remove the calculus above and below the gum. This
procedure is called scaling. In moderate or severe periodontitis,
it may be necessary to smooth the root surfaces of the teeth. This
procedure, called root planing, removes residual calculus and
bacterial byproducts. Other treatments can involve local
antibiotics to control the bacteria, or surgical intervention
to remove diseased tissue and restore the dental structures
to an architecture that is easier to maintain.
Regeneration
If gum disease proceeds unchecked,
it may reach a point where it is difficult to maintain the
tooth. A loose tooth
may be in need of tightening to restore function and appearance. Fortunately,
in many cases regenerative treatment can be used to regain
some of the tooth's support which has been lost to disease. Guided
Tissue Regeneration, a technique developed in the 1980's involves
placing a biocompatible membrane under the gums to cover a
defect and provide an environment in which the body can regrow
its own tissues. Regeneration can provide outcomes such
as decreased pain and increased wellness, attractiveness, and
self-confidence.
Gum Disease Risks
Cardiovascular Disease - Preliminary studies
show that people with periodontal disease are one and a half
to two times more likely to suffer a fatal heart attack and
nearly three times more likely to suffer a stroke.
Diabetes - It
has long been known that people with diabetes are more susceptible
to bacterial infections like periodontal disease. Recent
studies reveal that moderate to advanced periodontal disease
also makes it more difficult for people with diabetes to
maintain proper blood sugar levels.
Premature Birth - Researchers
at the University of North Carolina School of Dentistry found
that as many as 18% of the 250,000 premature babies born every
year may be linked to gum disease.
Respiratory Disease - Growing
research is beginning to suggest a new risk factor for respiratory
disease - periodontal disease. Infections in the mouth,
like periodontal disease, are associated with increased risk
of respiratory infection.
55 or older
If you are fifty-five or older, your
chances of developing periodontal disease increase considerably. To
help protect your oral health, keep these things in mind:
- Reduced saliva flow is a common
problem among older adults. Hundreds
of medications (such as high blood pressure drugs, diuretics,
decongestants and antidepressants), as well as medical disorders,
can cause dry mouth. Dry mouth can make you more susceptible
to tooth decay and periodontal disease.
- Many older adults have receding
gums. Receding gums
leave the roots of the teeth exposed, making tooth roots
vulnerable to decay and periodontal disease.
- Medical conditions associated with
aging, such as diabetes and osteoporosis, may increase
our risk of periodontal disease. In
addition, memory problems may lead to lessened oral hygiene. And,
arthritis can make brushing and flossing more difficult.
- Women who are menopausal or post-menopausal
may experience discomfort in the mouth, including pain
and burning sensations in the gum tissue, altered taste,
receding gums and dry mouth. These
changes, attributed to hormonal reduction, can leave you
more susceptible to periodontal disease.
Women & Gum Disease
Puberty - During puberty,
an increased level of sex hormones, such as progesterone
and possibly estrogen, in a young woman's maturing system
causes increased blood circulation to the gums. This, in turn, may cause an increase in
the gums' sensitivity which leads to a greater susceptibility
or reaction to any irritation, including food particles, plaque
bacteria and calculus (or tartar). The gums react to
local irritants and swell. Since the cause of this swelling
is due to local irritants, these must be removed by a dental
professional. If not treated, the bone and tissue surrounding
the teeth can be damaged.
Menstruation - Gingivitis
(red, swollen, tender or bleeding gums) can be much more
prevalent during menstruation. Again, this is due to an increased
amount of progesterone in your system before your period begins,
accompanied by plaque accumulation. Occasionally, some
women experience sores or bleeding in the mouth three or four
days before their period begins. Another rare occurrence
for some women is gingivitis during menstruation, which is
marked by reappearing gingival (gum) bleeding, a bright red
swelling of the gums between the teeth and sores on the tongue
and the inside of the cheek. Menstruation gingivitis
usually occurs right before a woman's period and clears up
once her period has started.
Pregnancy - Most
commonly, women experience increased gingivitis beginning
in the second or third month that increases in severity though
the eighth month and begins to decrease in the ninth month. This condition,
called pregnancy gingivitis, is marked by an increased amount
of swelling, bleeding and redness in the gum tissue in response
to a very small amount of plaque or calculus. This again
is caused by an increased level of progesterone in the system. If
you are thinking about getting pregnant, you may want to consider
visiting a periodontist for a full periodontal evaluation. Also,
once you become pregnant, regular periodontal examinations
are very important. You might benefit from more frequent
professional cleanings during your second trimester or early
third trimester. If tenderness, bleeding or gum swelling
occurs at any time during your pregnancy, talk with your periodontist
as soon as possible. Occasionally, the inflamed gum tissue
will form a large lump. These growths, called pregnancy
tumors, usually appear by the third month of pregnancy, but
may occur at any time during the course of pregnancy. A
pregnancy tumor usually has many deep red pin-point markings
on it and is not cancerous in any way. The tumor is usually
painless, however, it can become painful if it interferes with
your bite or if debris collects beneath it. They are
treated by careful professional removal of all local irritants. If
it persists, the tumor may require removal by a periodontist.
Oral contraceptives - If
you are taking any oral contraceptives (birth control pills),
you may be susceptible to those same oral health conditions
that affect pregnant women due to the increases levels of
progesterone in your system.
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