Periodontal disease, commonly known as gum disease, affects about 30% of the adult population, making it the number one cause of adult tooth loss. Many patients require a set of dentures because of this chronic condition. While not curable, it is controllable with a dedicated professional hygiene regimen and consistent at-home care.
Gum disease can advance with few signs or symptoms in the early stages. Patients diagnosed with this condition usually don’t experience pain and are surprised by the quiet yet swift damage of periodontal disease. In simple terms, consider the gums and bones around your teeth as the foundation of a house. Like a house, the foundation must be sound regardless of the home’s beauty. When the foundation crumbles, the rest of it does, too.
Regular dental exams, professional cleanings, and good at-home oral hygiene practices are essential to detecting and strategically managing periodontitis.
What Causes Gum Disease?
Our mouths provide a home to millions of beneficial and harmful bacteria. Bacterial waste forms a sticky substance called plaque, which adheres to the teeth—brushing and flossing aim at removing plaque before it mineralizes into tartar. Tartar becomes a colony for more bacteria to release toxins into the gums.
Thanks to your immune system, gums react to this bacterial invasion with an inflammatory response. Around the base of each tooth is a small collar of gum tissue that forms a small crevice or pocket. This warm, dark environment provides a perfect habitat for deeper tartar and bacteria to infiltrate.
Early inflammation results in bleeding gums, commonly known as gingivitis. Untreated bacteria can create a chronic infection in the periodontal pocket. In many cases, the bone begins to deteriorate around the teeth. While gums may be slightly tender at this stage, there’s generally minimal discomfort as the bone begins to erode.
More than 50% of the bone around your teeth can disappear before signs of looseness or pain appear. This bone never regenerates, so this loss becomes permanent and more challenging to control as the bacteria hide deeper into the gums. In advanced cases, untreated gum disease can result in abscesses and generalized tooth loss.
Diagnosis
There are several factors taken into account before making a gum disease diagnosis. This includes the small collar of gum, or pocket, around each tooth, which usually sits 2-3 millimeters deep, a space easily cleaned by floss or toothpicks. Dr. Nimri and Dr. Saab, or our hygiene team, can measure and chart multiple areas using a small periodontal probe device. If these measurements are more than 3 millimeters deep and bleed upon probing, then periodontal disease is present. More profound readings indicate more advanced disease than shallower readings.
Drs. Nimri and Saab will also evaluate the texture and shape of your gums, along with any movement detectable in each tooth. It’s also vital to examine the levels, shape, and density of the bone around the teeth on digital X-rays. Collecting all of this data forms a clear picture of your gum condition.
Treatment
After establishing a diagnosis, we’ll be able to address the severity of your condition and develop a personalized treatment plan. In milder forms, meaning little or no bone loss, one or two visits with our hygiene team may bring the condition under control. We’ll provide you with a strategy for daily home care and an established schedule for maintenance so little additional treatment may be needed.
If the inflammation has advanced and measurable bone loss is evident, a proactive approach to stop further deterioration should be strongly considered. We often suggest gentle numbing of your gums and a more in-depth cleaning process called root planing or scaling. Over a few visits, a portion of your mouth will be deeply cleaned. The infected pocket around each tooth, including the mineralized tartar, must be carefully cleaned with hand and ultrasonic instruments. Polishing the teeth to establish glassy surfaces that help repel stains and plaque accumulation usually finishes this initial therapy.
Drs. Nimri and Saab may suggest a medicated rinse, electric or ultrasonic toothbrush, or other products to enhance your home care routine. Remember, gum disease can be controlled but not cured. Dedicated daily efforts must be consistent to control the disease.
Maintenance Matters
Regular home care is critical to arrest the progression of gum disease. Bacteria repopulate and adhere to the teeth within a few hours of cleaning. Left undisturbed, the plaque will harden and mineralize within 24 hours. Remember, deeper gum pockets require even more diligence to help prevent bacteria from undermining the foundation of your teeth.
When bacteria previously damage gum pockets, reaching home can often be challenging. That’s why a faithful maintenance schedule with us is essential. Depending on several factors, we can customize your plan to include two to three visits yearly. This consists of the severity of your condition, response to treatment, and the consistency of your home care.
If our combined efforts don’t slow or stop the progression of your gum disease, we will refer you to a specialist known as a periodontist. With specialized training in many gum conditions, further treatment may be recommended.
Mouth-Body Connection
Research continues to establish clear links between bacterial disease in the mouth and ailments in other parts of the body. Studies show a link between oral bacteria and conditions such as heart disease, stroke, arthritis, Alzheimer’s, and even certain types of cancers. The relationship between a person’s oral health and whole body health has never been more understood today.
Bleeding gums provide a direct pathway into the bloodstream, a journey that oral bacteria can quickly take. Infection would be a concern if an open wound existed on your skin. Gum tissue that bleeds should not be looked at any differently. This helps explain why researchers continue to identify oral bacteria deposits in various areas of our bodies.
Diabetes and other auto-immune disorders lower the body’s ability to fight infection, allowing uncontrolled gum disease to advance faster and with more destruction. Research also confirms that the inflammation in the mouth can aggravate diabetes and make it harder to control. The two-way relationship between these chronic conditions emphasizes the importance of optimal oral health.
