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Gum Disease

Gum Disease

Gum disease or periodontal disease is the result of infections and inflammation of the gums and bone that surround and support the teeth. According to the Centers for Disease Control and Prevention (CDC), 47.2 percent of adults aged 30 years and older have some form of periodontal disease.

Gum disease in its early stages begins with bacterial growth in the mouth, and if left untreated ends with tooth loss due to the destruction of the tissue surrounding the teeth.

Are there different stages of gum disease?

The early stage of gum disease is known as gingivitis where the gums become swollen and red, and they may bleed. A more serious form of gum disease is known as periodontitis where the gums can pull away from the tooth, bone can be lost, and teeth may loosen or fall out.

What causes gum disease?

The major cause of gum disease is plaque build-up due to poor oral hygiene (irregular brushing and flossing).

Plaque, the sticky, film of bacteria that forms on the teeth, develops when food containing carbohydrates, sugar, and starches are left on the teeth. The bacteria that live in your mouth feed off of these foods, producing acids that eventually destroy both tooth enamel and result in tooth decay. Plaque can also develop on the tooth roots under the gum and cause a breakdown of the bone supporting the tooth.

Are there risk factors associated with gum disease?

Certain factors increase the risk of gum disease, including

  • Smoking
  • Alcohol consumption
  • Poor oral hygiene
  • High sugar intake
  • Diabetes
  • Illnesses and diseases such as cancer or HIV interfere with the immune system
  • Female hormonal changes make gums more sensitive, making it easier to develop gingivitis
  • Some drugs and medications that cause dry mouth
  • Old age (the CDC states that 70.1 percent of adults 65 years and older have periodontal disease)
  • Family history of gum disease

What is the link between diabetes and gum disease?

There is emerging evidence (epidemiological data) to support the existence of a two-way relationship between diabetes and periodontitis, with diabetes increasing the risk for periodontitis, and periodontal inflammation negatively affecting glycemic control. Diabetic patients must, therefore, take extra special care of their oral health, as gum disease can actually raise their blood sugar level. With proper gum disease treatment, however, diabetics can control their diabetes.

What are the warning signs of gum disease?

The warning signs for gum disease may not always be obvious, but they do point to some form of the disease, including

  • Bleeding gums during and after brushing
  • Red or swollen gums
  • Tender or bleeding gums
  • Receding gums
  • Persistent bad breath or a bad taste in the mouth
  • Painful chewing
  • Loose teeth
  • Sensitive teeth
  • Gums that have pulled away from your teeth
  • Formation of deep pockets between teeth and gums
  • Any change in the way your teeth fit together when you bite
  • Any change in the fit of partial dentures

What happens if gum disease is left untreated?

If gingivitis is left untreated, it can lead to periodontitis (gum disease), where irreversible bone or other tissue damage may occur. When this happens, the inner layer of the gum and bone pull away from the teeth and form pockets that collect debris and can become infected. As the plaque spreads and grows below the gum line, the pockets deepen and more gum tissue and bone are destroyed. As a result, teeth are no longer anchored in place, they become loose and eventually fall out.

How is gum disease diagnosed?

For a diagnosis of gum disease, Dr. Tinkle or Dr. Yoon will examine your gums for bleeding, swelling, firmness, and pocket depth (the space between the gum and tooth). The larger and deeper the pocket, the more severe the disease. Your doctor will also examine your teeth to see the movement and sensitivity of teeth and proper teeth alignment, and your jawbone to help detect the breakdown of bone surrounding your teeth.

How is gum disease treated?

If you are diagnosed with gum disease, your doctor will develop a treatment plan for you that is based on your stage of the disease, how you have responded to earlier treatments, and your overall health. Options range from non-surgical to control bacterial growth to surgery to restore supportive tissues.

Gingivitis is treatable with regular dental check-ups and dental cleanings. The more severe forms of periodontal disease can also be treated successfully but may require more extensive treatment. Such treatment might include a deep cleaning of the tooth root surfaces below the gums, medications prescribed to take by mouth or placed directly under the gums, and sometimes corrective surgery. These treatments promote reattachment of healthy gums to teeth; reduce swelling, depth of pockets, the risk of infection; and stop disease progression.

What non-surgical treatment options are available?

For active gum disease, your doctor may recommend scaling and root planing, which is a non-surgical treatment option.

Scaling and root planing treatment are deep cleaning procedures done under a local anesthetic. Plaque and tartar (hardened plaque or calculus) are scraped away (scaling) from above and below the gum line, and rough spots on the tooth are made smooth (planing). In smoothing the rough spots, bacteria is removed and provides a clean surface for the gums to reattach to the teeth.

What surgical options are available?

For patients who need more than scaling and root planing to treat gum disease, surgical options are recommended. Some of those options include:

  • Flap Surgery/Pocket Reduction Surgery
  • Bone Graft
  • Soft Tissue Grafts
  • Guided Tissue Regeneration
  • Bone Surgery

Flap surgery/pocket reduction surgery – involves lifting back the gums to remove tartar build-up. In more severe cases, bone is smoothed to limit areas where bacteria can grow.

Bone grafts – aid in the growth of bone to restore the stability of teeth. Fragments of your own bone, synthetic bone, or donated bone can be used to replace bone destroyed by gum disease.

Soft tissue grafts – are done to reinforce thin gums or fill in places where gums have receded. The tissue is grafted from the roof of the mouth and stitched in place to the affected area.

Guided tissue regeneration – is done to stimulate bone and gum tissue growth. A small piece of mesh-like fabric is inserted between the bone and gum tissue to keep the gum tissue from growing into the area where the bone should be. This procedure is often done in combination with flap surgery, and both are done to allow the bone and connective tissue to regrow to better support the teeth.

Bone surgery – is done to smooth shallow craters in the bone. The bone around the tooth is reshaped to decrease the craters, making it harder for bacteria to collect and grow. This procedure is often done following flap surgery.

Can gum disease be prevented?

Yes, gum disease can be prevented or controlled with daily brushing and flossing, and regular professional cleanings twice a year. This regimen will significantly help to control plaque, which is key to restoring your oral health.

For severe cases of periodontal disease, your doctor may require that you have dental cleanings more than twice a year to remove the plaque and tartar build-up on the tooth. Dental cleanings are a preventive measure to prevent disease progression and are not a treatment for active gum disease.

What if you haven’t been to the dentist in a long time?

At Belmont Family Dentistry, we understand that some patients haven’t been to the dentist in a while, and as a result, they are wary about calling to schedule an appointment. Don’t be anxious about calling us. We are not here to judge you or admonish you. We are here to help restore your oral health.

If you suspect you have gum disease, call us at (503) 234-1218 to make an appointment for diagnosis and treatment recommendations.