Periodontal disease, commonly known as gum disease, is the most common adult dental affliction. About 30% of the population experiences gum disease, and it’s the number one cause of tooth loss in adults. Many denture cases begin as a result of of this condition. While not curable, it is controllable. It requires a focused strategy, similar to managing other chronic conditions such as high blood pressure or diabetes.
Gum disease can advance in stealth mode with few signs or symptoms in its early stages. Many patients diagnosed with this condition find themselves surprised at the quiet damage progressing in their mouths. In simpler terms, consider the gums and bone around your teeth as the foundation where they sit. Just like a house, the foundation must be sound regardless of the beauty of the house. When the foundation crumbles, the rest of it goes too.
What Causes Gum Disease?
Our mouths provide a home to millions of bacteria, both beneficial and harmful. Bacteria form a sticky substance called plaque, that adheres to the teeth. Brushing and flossing aim to remove plaque before it mineralizes into tartar. Tartar becomes a colony for more bacteria and adds to their population while pumping out toxins into the gums.
Gums react to this bacterial invasion with an inflammatory response under the direction of the immune system. Around the base of each tooth, a small collar of gum tissue exists that forms a small crevice or pocket. This warm, dark environment provides a perfect habitat for deeper tartar and bacterial penetration, with their toxins seeping into the base of the collar.
Early inflammation results in bleeding gums, known as gingivitis. Bacteria left untreated and undisturbed successfully create a chronic infection in the gum collar. In many cases, the bone begins to deteriorate around the teeth as the bacteria burrow deeper into the gums. While gums may be slightly tender at this stage, there’s generally minimal discomfort as the bone dissolves.
More than 50% of the bone around your teeth can disappear before any signs of looseness or pain begin to appear. The bone around teeth never regenerates, making this loss permanent and harder to control as the bacteria hide deeper into the gums. Untreated gum disease leads to abscess and generalized tooth loss in many advanced cases.
We draw on objective clinical data to form a gum disease diagnosis and to grade the condition. The small collar of gum around each tooth usually sits 2-3 millimeters deep. Floss or toothpics easily clean this small crevice. Dr. Mai or our hygiene team can measure and chart multiple areas using a small measuring device. If these measurements register beyond 3 millimeters and include bleeding areas, the disease is present. Deeper findings indicate more advanced disease than shallower readings.
Dr. Mai also considers the texture and shape of your gums, and any detectable movement in each tooth. It’s also vital to examine the levels, shape, and density of the bone around your teeth with digital x-rays. By drawing together numerous findings, a clear picture forms about your gum condition.
After establishing a diagnosis defining the severity of gum disease, we develop a personalized treatment plan with you. In milder forms with little or no bone loss, one or two visits with our hygiene team can bring the condition under control. After you leave our office with a strategy for daily home care and an established schedule for maintenance, there may be little additional treatment needed.
If the inflammation has advanced with measurable bone loss, a proactive approach to halt the destruction should be strongly considered. We often suggest gentle numbing of your gums for your comfort during the deeper cleaning process. Each area undergoes meticulous cleaning above and below the gum line and usually over a period of several visits. The infected collar or pocket around each tooth, including the mineralized tartar, must be carefully cleaned out with hand and ultrasonic instruments. Polishing of the teeth for glassy surfaces that help repel stain and plaque accumulation concludes this initial therapy.
Dr. Mai may suggest a medicated rinse, an electric toothbrush, a Waterpik, or other resources to help you with your ongoing cleansing efforts. Remember, gum disease can be controlled but not cured. Dedicated daily efforts must be consistent to control the disease.
Regular home care is critical to arrest the progression of gum disease. Within a few hours of careful cleaning, the bacteria repopulate and adhere to the teeth. Plaque left undisturbed starts to harden and mineralize within 24 hours. Deeper gum pockets require even more diligence to prevent the bacteria from burrowing further into the foundation of your teeth.
Since the deepest sections of gum pockets previously damaged by bacteria can be difficult to reach at home, a particular maintenance schedule with us proves essential. We can customize your plan to include 2, 3 or 4 visits a year depending on the severity of disease and its response to treatment and home care.
If our combined efforts don’t halt your gum disease, we refer you to a trusted specialist, known as a periodontist. With specialized training in many gum conditions, further treatment may be recommended.
Current research continuously maintains clear links between bacterial disease in your mouth and ailments in other parts of the body. Moreover, studies show a link between oral bacteria and conditions such as heart disease, stroke, arthritis, Alzheimer’s, and certain types of cancers. The integration of oral and general health has never been better understood than it is now.
Bleeding gums provide a direct pathway into the bloodstream, allowing an ideal journey for traveling toxic oral bacteria. In fact, if bleeding gums connected into a single patch, it would create a 2 x 2-inch square. If an open wound of this size existed on your skin, infection would be a concern. Bleeding, infected gums open this door to your body where bacteria saturate in colonies. 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, making it harder to control. This two-way relationship between two chronic conditions emphasizes the importance of optimal oral health.