Periodontal health simply means the absence of periodontal disease. The gums are firm, pink (not red), and do not bleed. The tissues that support the teeth are disease-free.
There are two types of periodontal disease: gingivitis and periodontitis. They manifest as inflammation and/or infection of the gums, bone, and supporting structures that surround the teeth. Both types of the disease are often characterized by:
- Persistent bad breath or bad taste in mouth
- Red, swollen, bleeding and tender (inflamed) gums
- Gums that pull away from the teeth
- Changes in how you bite and chew
- Changes in how your teeth fit together
- Pain while chewing
- Sensitive teeth
- Worn teeth
- A higher incidence of cavities
- Many other signs and symptoms
Unfortunately, the disease is very prevalent. The Centers for Disease Control and Prevention reported in 2010 that 47% of adults had mild, moderate or severe periodontal disease, and that by age 65 the rate was up to 70%. Like high blood pressure, it can cause no pain, yet pose a significant threat to your overall health. In fact, some research has found a potential link between periodontal disease and heart disease, stroke, and diabetes, among others.
Differences in genetic, environmental, and behavioral factors cause some people to be more susceptible to the disease than others. A professional examination will determine the presence or absence of the disease.
What Causes Gum Disease?
There are several hundred different kinds of bacteria in all of our mouths, totaling millions in all. Although some are good, some are bad, or can go bad. When the bacteria combine with mucous and other particles present in the mouth, like food, they form a sticky “plaque” on the teeth. Proper brushing and flossing can help reduce or remove most plaque. However, if left alone, plaque hardens to form “tartar”. This cannot be removed by brushing and flossing; only a professional cleaning by a dentist or dental hygienist can remove it.
The Two Types of Periodontal Disease
If left untreated, the presence of plaque and tartar can result in:
1. Gingivitis
If plaque and tartar remain on the teeth long enough, they can become quite harmful. As a result of gingivitis, inflammation occurs and the gums become red, swollen and bleed easily. This mild form of gum disease can often be reversed with proper brushing, flossing, and regular professional cleanings. Gingivitis affects the soft tissue (gums) around the teeth but does not destroy the bone that holds the teeth in place.
2. Periodontitis
However, untreated gingivitis advances to periodontitis, meaning inflammation from the bacterial infection surrounding the teeth. As part of this disease progression, the gums pull away from the tooth, forming openings called periodontal “pockets” between the tooth and gums. Then the pockets become infected and get deeper. Additionally, toxins develop as the body’s immune system fights the bacterial infection. These toxins penetrate into the tooth root and also destroy connective tissue and bone. The extensive destruction of the tooth, tissue, and bone may even loosen the teeth and require an extraction.
Dental Cleanings vs. Treatment for Periodontal Disease
Is there a difference?
Yes, and only a periodontal examination can determine that. Routine cleanings are to prevent infection, not to treat periodontal disease. As a result, more advanced measures will need to be taken to treat the disease if already present.
No matter what the extent of disease the evaluation reveals, all types of treatment have the same goal: to control or eliminate the inflammation and infection. In our experience, we have found that all forms of treatment will fail if there is not a diligent, uncompromising effort by the patient to keep their teeth and gums as free from infection as they possibly can. Therefore, the patient must fully commit to improving their dental health.
We individualize the treatment for infection based on the stage and severity of the disease process. The distinction is important when a patient calls and requests an appointment for a check-up and “cleaning” – what type of cleaning is appropriate?
Our dental cleanings for prevention and therapy for the treatment of periodontitis employ the most modern, research based methods. Because of this, we utilize specialized ultrasonic systems and instruments for use by hand. We also use antibiotic rinses and prescriptions when they will help decrease or eradicate infection. Each technique is intended to clean all tooth surfaces of plaque and tartar. Not only does this improve your periodontal condition, it makes it easier for you to keep your teeth clean!
In cases of periodontitis, we often advise a non-surgical procedure called scaling and root planing (“deep cleaning”). We clean off plaque and tartar above and below the gums. Because root planing smooths the root surfaces, it makes it more difficult for bacterial plaque to adhere to the teeth. The root planing also removes toxins that are on and in the root surfaces, thus decreasing their ability to destroy the teeth, gums and bone.
In advanced cases of the disease, we may also consider periodontal surgery to save the teeth from extraction.
