Most people have heard of gum disease, but dentists know it as periodontal disease. It's not just one disease, according to the American Academy of Periodontology, but several with a common cause: bacteria in dental plaque. Let's take a look at how it is caused and what to do to treat it.
The most common and well known form of gum disease is gingivitis. The condition involves the inflammation of the gingiva or gums surrounding the necks of the teeth, and is caused by plaque developing along the gumline. Symptoms include red and swollen gums, as well as gum bleeding, which can be seen on your toothbrush or at a dental exam. Often noticeable through bad breath, gingivitis can also be caused by a number of health conditions or medical changes in an individual. Hormone changes from puberty and pregnancy in the presence of bacterial plaque, for instance, will intensify the disease. Dentists call these forms of the disease "puberty gingivitis" and "pregnancy gingivitis."
Teenagers need to maintain good oral hygiene and have professional cleanings twice a year to prevent gingivitis. Pregnant women have a higher risk of developing periodontal disease during pregnancy, so they should also be aware of the necessity for frequent cleanings during the pregnancy.
Prevention of Gingivitis
Fortunately, there is no bone loss around the teeth from the development of gingivitis, and it can be easily treated or prevented. A quality soft toothbrush, especially a battery-powered one, should be used twice a day to decrease the risk of developing gingivitis. Flossing will further reduce the chances of developing the disease, as will other common oral hygienic practices: mouth rinses, water picks and interproximal cleansing devices. Those who currently have this condition may choose to improve their gum defenses with stronger toothpastes. The absolute best way to prevent gingivitis is to see a dentist or dental hygienist for a regular cleaning twice a year.
The second-most common periodontal disease is "periodontitis." Like gingivitis, it is caused by bacterial plaque, but it can cause loss of bone support within the teeth. It can be treated or prevented, but rarely can the damage be reversed. Periodontitis can occur if gingivitis is left untreated. Signs of periodontitis, like gingivitis, include red and swollen gums, and bleeding. The formation of gum pockets around the teeth may also occur, which is defined by an opening around the gum tissue of the teeth. This allows bacteria and the formation of tartar to get deeper under the gum line. This deepening of the pocket is associated with bone loss, and can lead to tooth loss if left untreated.
Risks of Periodontitis
Not everyone with gingivitis will get this form of periodontal disease, but there are risks factors that can make certain people more likely to develop it. Smoking is a major risk factor, and can make treatment difficult. Uncontrolled diabetes, obesity, genetic susceptibility and poor oral hygiene can all heighten a person's risk of developing periodontitis. Untreated periodontitis can not only yield tooth loss, but create systemic health issues such as an increased risk of cardiovascular (heart) disease.
Prevention of Peridontitis
A sensitive toothbrush is always the first step, and proper oral hygiene is a must to help prevent periodontitis. If you're a smoker, quitting is also highly recommended. Treatment of periodontitis by your dentist and hygienist will include deep cleanings, called scaling and root planing, but more serious areas of bone loss around the teeth may require gum surgery, including gum and bone grafts.
Keep in mind: After the periodontitis is controlled, it is never truly cured. Seek frequent annual cleanings to prevent long-term problems, and do your part to make sure you're never a candidate for the worst of the disease.
About the author: James Burke Fine, DMD, is Assistant Dean for Postdoctoral Programs, Professor of Clinical Dentistry, and Director of Postgraduate Periodontics at Columbia University College of Dental Medicine, New York. He has been a principal investigator or co-investigator in funded research projects and has authored or co-authored numerous articles, chapters, and abstracts in the literature regarding periodontal disease, including co-authoring the text Clinical Guide to Periodontics. In addition, Fine has presented at invited lectures and seminars. He maintains a practice limited to periodontics in Hoboken, NJ, and in the faculty practice at Columbia University.