About Gum Disease
What is Gum (Periodontal) Disease?
75% of adults who lose teeth do so because of untreated periodontal infections.
Gum disease, or periodontal disease (from perio “around” and dont “tooth”), is a continuous bacterial infection residing in the gums and bone that surround your teeth. It is a widespread problem affecting millions of Americans, and the resulting inflammation can destroy the bone around your teeth, resulting in the loss of teeth.
As a periodontist, Dr. Greenberg specializes in the prevention, diagnosis and treatment of periodontal disease and oral inflammation. Periodontists are also experts in the placement of dental implants.
Although millions of Americans have some stage of periodontal disease, they are frequently unaware that there is a problem. It is a “quiet” disease, and substantial damage can occur without the affected person feeling discomfort or pain.
When periodontal disease affects a dental implant, this is known as peri-implantitis, and requires specialized treatment.
Recent medical research has also linked periodontal disease to serious medical conditions such as heart disease, strokes and diabetes.
The stages of Gum Disease
Healthy gums are firm, pink and do not bleed easily. Teeth are firmly in place with no damage to supporting bone structure. Gum disease is generally placed into two major categories, or stages: gingivitis [gum level infection] and periodontitis [bone level infection]. There are three levels of periodontitis, mild, moderate and severe. Dr. Greenberg can ascertain which stage of gum disease you have by probing the gums to measure the depth of the detachment of the gum pockets.
A pocket depth of 1-3 mm can indicate healthy gums, or sometimes the mild gum disease, gingivitis; pocket depths of 4 mm or more indicates an infection; pocket depths of 7 mm or more indicates a higher risk for permanent damage and tooth loss.
The progression of Gum Disease —How a pocket is formed
- Plaque (a sticky film containing bacteria) accumulates on the tooth around the gum line
- The gums swell, bleeding a bit. This is gingivitis
- In an attempt to rid the body of the invading bacteria, your body produces chemicals that in addition to attacking the bacteria, also destroy the bone and ligaments holding the bone in place. This causes the gum to begin to detach from the tooth and a “pocket” to form.
- The plaque in the pocket hardens with minerals and blood, causing calculus. The calculus serves as a trap for further plaque accumulation. The pocket continues to deepen.
Gingivitis is the mildest form of gum disease, caused by accumulation of bacteria on the teeth (plaque). It causes the gums to become red, swollen and bleed easily. There is no destruction of the bone or ligaments around the tooth at this point. Gingivitis is easily reversible with professional treatment and good oral home care.
Because gingivitis often has no symptoms distinguishing it from the more serious periodontitis, it is important to get a professional examination to find out which stage of disease you actually have.
If gingivitis is left untreated, it can advance to periodontitis. In the early stage, periodontal disease begins to destroy the bone and tissue that supports the teeth. Pocket depth is 4-5 mm.
The destruction of the supporting bone and tissue has continued and the gum continues to fall away from the tooth. Pocket depth is 6-7 mm.
In this most advanced form of periodontics there is extensive bone loss and tissue damage. Teeth often become loose and may have to be removed. Pocket depth is 8 mm or above. The depth of a tooth root is only 10-12 mm, so at this level the tooth is in severe danger.
Causes of Gum Disease
The most common causes of periodontal disease are genetics, smoking and accumulated plaque bacteria.
Plaque bacteria: Plaque is a sticky, colorless film consisting of bacteria that continually forms on our teeth, and if not removed by brushing and flossing, can form a hard buildup of tartar. This buildup irritates the gums, causing them to become inflamed and retract from the bacteria and the teeth.
Tartar (calculus): This hardened plaque lurks below the gum line, and if not removed, accumulates more plaque and causes loss of bone and tissue support around the tooth.
Poor diet: Lack of proper nutrition may cause chronic adverse conditions, including gum disease. A well balanced diet featuring fresh fruits and vegetables can boost nutritional levels.
Genetics: An estimated 50% of people are predisposed to gum disease. However, proper oral can keep the disease at bay.
Systemic diseases: Certain systemic diseases may contribute to periodontitis, including diabetes, respiratory disease, heart disease, and autoimmune disorders.
Smoking: A recent study indicates that the most damaging types of bacteria are found in the mouths of smokers.
Poor quality dentistry: Ill-fitting bridges and crowns may accumulate bacteria beneath their surfaces.
Warning signs of Gum Disease
Signs of gum disease include gums that are pulling away from teeth, redness and swelling. Bleeding usually occurs in gingivitis only, as the infection in periodontitis has dropped down into the pocket where a toothbrush or floss can no longer reach. Pain is also rarely an issue, unless an abscess has formed.
Signs that you may have gum disease include:
- Gums that are red or swollen
- Gums that have pulled away from your teeth
- Persistent bad breath
- An unpleasant taste in your mouth
- Receding gums
- A change in your bite (how your teeth fit together)
- Teeth that have become loose
- Signs of infection, such as redness, swelling or pus.
Learning to control your gum disease
Dr. Greenberg and his team can provide you with comprehensive education on how to control your gum disease or prevent future recurrence.
The relationship of Gum Disease to other diseases
While gum disease can be caused by systemic diseases such as diabetes, it can also be itself a contributor to disease in organs and systems in the body. The continuous presence of harmful bacteria in the mouth can cause or increase chronic inflammation in the body.
Chronic inflammation is generally caused by overloading the body with toxins and allergens from the environment, refined and fast foods, cigarettes and alcohol. Examples of diseases connected with chronic inflammation are diabetes, allergies, asthma, colitis, cardiovascular disease and some forms of cancer.
There have been many recent studies reporting in particular an increased risk of cardiovascular disease and strokes in patients with periodontitis.
It’s been known for years that diabetics have a greater probability of contracting periodontitis. The reverse is also true, studies show that improving periodontal health also helps to reduce the glucose counts in the bloodstream.
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