Millions of Americans have gum disease, but many are unaware that they have this serious infection. Periodontal diseases are infections of the gum tissue, and they cause destruction of the bone that supports teeth. A major indicator of gum disease is inflammation, which is the body's way of shielding, guarding and protecting itself from infection. It is important for individuals to recognize the signs and symptoms of gum disease. Different therapy methods are available for gum disease treatment.
What Causes Gum Disease?
Periodontal diseases are caused by bacterial plaque, a sticky film that continuously forms around the teeth. The accumulation of bacterial plaque around the teeth can advance beneath the gum tissue. When bacterial plaque settles over time, it hardens into dental calculus, known as tartar. In a healthy mouth, the gum tissues and bone fit snugly around the teeth; however, when periodontal disease is manifested, the bone and gum tissues become damaged and form pockets around the teeth. As time progresses, these pockets become deeper, which enables bacterial plaque to settle and thrive. Bacterial plaque can be removed through daily brushing, flossing and routine dental cleanings, all of which can help stem the risk of gum disease.
Whom Does Gum Disease Affect?
Many Americans suffer from the effects of gum disease. Periodontal disease affects both children and adults. There are approximately 64.7 million Americans who have periodontitis, according to research from the Centers for Disease Control and Prevention. Periodontal disease is more common in men (56.4 percent) than in women (38.4 percent). There are different forms of periodontal disease, which collectively affects 47.2 percent of adults age 30 years and older.The most common and prevalent form of periodontal disease among both children and adolescents is gingivitis. The incidence of gum infections increases with age; in fact, 70.1 percent of adults age 65 and older have periodontal disease.
Signs and Symptoms
Periodontal diseases can be painless; therefore, it is important for you to be aware of any of the following symptoms:
- Bleeding: Gums that easily bleed when brushing or flossing.
- Puffiness: Swollen, red or tender gums.
- Recession: Gum tissue that moves away from the tooth.
- Bad breath: Persistent bad breath or bad taste in mouth.
- Loose teeth: Permanent teeth that can be moved back and forth or shifted.
- Poorly fitting teeth: A change in the way your teeth fit together.
- Poorly fitting partial dentures: A change in the fit of partial dentures.
- Pus: Visible pus surrounding teeth and gums.
- Painful chewing: Sharp or dull pains when chewing foods.
- Teeth sensitivity: Teeth that are overly sensitive to cold or hot temperatures.
There are certain factors that contribute to an increase in the risk of developing periodontal disease, such as stress, genetics and age. The use of tobacco products, poor oral hygiene, poor nutrition and obesity can all affect the gums. Also teens, women taking oral contraceptives and women who are pregnant are more likely to be at risk of periodontal diseases due to changes in their body's hormonal levels. Bacterial plaque can be held in place around crooked teeth, poorly fitting bridges and fillings that are worn or cracked. The use of certain medications, such as drugs for cancer therapy, steroids, some calcium channel blockers and some anti-epilepsy drugs can contribute to periodontal diseases.
Scientific evidence links certain systemic diseases with periodontal disease. Research suggests that the risk of heart disease increases with individuals who have periodontal disease. Respiratory diseases have been linked with periodontal diseases due to oral bacteria, which can be aspirated into the lungs and cause pneumonia. Research findings have demonstrated that the probability that men with gum disease will develop pancreatic cancer is 54 percent, kidney cancer 49 percent and blood cancers 30 percent. Diabetic patients are more prone to periodontal disease, which increases complications from diabetes and blood sugar levels. There are several studies that indicate a relationship between periodontal disease and stroke. Research also suggests a link between bone loss in the jaw and osteoporosis.
Forms of Gum Disease
There are different forms of periodontal disease, but the following are the most common:
- Chronic gingivitis: A reversible, milder form of periodontal disease marked by inflammation, redness and bleeding of the gums. (There is no bone loss with gingivitis.)
- Aggressive periodontitis: Rapid loss of gum attachment and bone destruction in a short period.
- Chronic periodontitis: The most common and advanced form of periodontitis — progresses slowly.
- Necrotizing periodontal disease: An infection resulting from death (necrosis) of gum tissues surrounding the tooth and connecting bone. (Common symptoms are a foul odor and painful bleeding gums.)
Gum Disease Treatment
A dentist or periodontist may recommend certain procedures after diagnosing, determining a prognosis and facilitating a treatment plan. One treatment method for periodontal disease is accomplished by scaling and root planning or nonsurgical periodontal therapy, which accomplishes the removal of bacterial plaque and dental calculus (tartar) from the root surfaces through procedures using hand, sonic and ultrasonic instruments. Adjunct therapy, such as antimicrobial medicines, is typically followed after scaling and root planning.
Laser treatment is sometimes used as an adjunct to scaling and root planing. During periodontal procedures, each laser uses different wavelengths and power levels to safely remove calculus deposits. Another form of treatment is pharmacological therapy, which involves both systemic and local drug delivery. Systemic antibiotics are used to decrease or halt the progression of periodontitis; however, local delivery involves chemotherapeutic agents (chemical substance) that provide controlled delivery within periodontal pockets to improve periodontal health. Surgical therapy procedures are used to provide better access for removal of bacterial plaque and dental calculus; to construct gum tissues; and to reduce depth of pockets. Regenerative surgical therapy procedures are performed to regenerate lost bone and tissue when the bone supporting teeth has been destroyed by periodontal disease. Some of the damage can be reversed through regenerating lost tissue and bone.
Routine dental visits should occur at least once a year, but they must become more frequent if you experience any of the above symptoms. The state of your periodontal health can be determined when a comprehensive evaluation is performed by your dentist, periodontist or dental hygienist. After scaling and root planning or surgery, follow-up visits are necessary to re-examine your periodontal health status and need for further surgery. Re-evaluation should occur four weeks following scaling and root planning. Routine maintenance visits should occur every three to four months.