Periodontal "Gum Disease" & Therapy
If you have been diagnosed with periodontal disease, you are not alone. Many people have the same problem. The word “periodontal” literally means around the tooth. The gum line adjoins next to the tooth and forms a slight v-shaped crevice called a sulcus. In healthy gums, this space is usually three millimeters or less. Greater than 3 mm of pocket is often of concern and may indicate pathology such as localized or generalized gum disease (although there are other causes too.) Seventy-eight percent of the adult population has some form of periodontal disease.
Our mouth is filled with countless bacteria. The disease begins when certain bacteria in plaque (the sticky, colorless film that constantly forms on the teeth and the surfaces lining the mouth) produces toxins and enzymes that irritate the gums and cause inflammation that may be painless. As the tissues are damaged, the sulcus deepens to a depth that is greater than three millimeters. Usually, the more severe the disease, the deeper the pocket, and more severe bone loss occurs. When neglected, the teeth can become loose and fall out. Bacteria in our saliva and plaque can spread and populate in pockets below the gum line before or after tooth loss. Infected pockets allow the bacteria to enter into the blood stream and travel to major organs, with the potential of developing new infections and disease processes.
Research has identified possible links of periodontal disease to diabetes, premature births, diabetes, heart disease, heart valve infections, prosthetic and joint infections, osteoporosis, oral and systemic bacterial/viral/fungal infections, inflammatory disorders, hormonal fluctuations with this list being inconclusive. Systemic disease such as diabetes, blood cell disorders, HIV infections, and AIDS can lower the body’s resistance to infection, making periodontal diseases more severe. Many medications such as steroids, anti-epileptic drugs, cancer therapy drugs, blood pressure drugs and oral contraceptives can affect the gums. Treatments such as chemotherapy and radiation may damage salivary flow that reduces the immunoglobulins in our saliva to fight harmful bacteria. Poor fitting bridges, crooked, crowded teeth or defective fillings may hold plaque and increase risk of developing periodontal disease. Puberty, pregnancy and oral contraceptives change the body’s hormone levels, causing sensitivity to toxins and enzymes to accelerate growth of some bacteria.
Periodontal disease has been shown to be an infectious disease when bacteria from saliva, food or drink is shared. Family members frequently develop similar infections because of this.
Treating and managing periodontal disease can help improve management of diabetes and other systemic diseases. Heart disease is the leading killer of men and women in the US. Researchers have linked patients with periodontal disease to have twice the likelihood of cardiovascular disease. Pre-existing periodontal disease can also aggravate existing heart conditions, so it is essential to obtain prompt treatment for periodontal disease.
Although good oral hygiene can help prevent periodontal disease, research shows that up to 30% of the population may be genetically susceptible to the disease. These people may be six times more likely to develop periodontal disease. Smoking has been found to correlate with periodontitis and often exacerbates the disease. Periodontal disease is a serious inflammatory condition. Treatment is the first step in preventing tooth loss. Once the hardened tartar forms, it can only be removed when teeth are cleaned professionally at the dental office.
Deep cleanings by a dental hygienist, also professionally termed “SRP” or Scaling and Root Planing may be a necessary procedure to clean out or “debride” the pocket and obtain a smooth root surface. A clean pocket and tooth root surface have the ability to reattach to each other, usually gaining 2-4mm of reattachment. Pockets that remain infected usually clinically produce “BOP” of bleeding upon probing (provocation) due to continued inflammation. Medicated discs may be placed into the pocket after the sulcus and tooth surface are cleaned to assist in a more complete opportunity for reattachment of the fibers. Medical insurance often assists with coverage for the expense of the medication but dental insurance is billed for the dental treatment.
Some types of periodontal infection include: Gingivitis, Acute periodontitis, Chronic periodontitis, Aggressive periodontitis, periodontitis as a manifestation of systemic disease, and Necrotizing periodontal diseases.