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What
is gum disease?
Gum
disease or periodontal disease, a chronic inflammation and infection
of the gums and surrounding tissue, is the major cause of about
70 percent of adult tooth loss, affecting three out of four persons
at some point in their life.
What
causes gum disease?
Bacterial
plaque-a sticky, colorless film that constantly forms on the teeth-is
recognized as the primary cause of gum disease. Specific periodontal
diseases may be associated with specific bacterial types. If plaque
isn't removed each day by brushing and flossing, it hardens into
a rough, porous substance called calculus (also known as tartar).
Toxins (poisons) produced and released by bacteria in plaque irritate
the gums, These toxins cause the breakdown of the fibers that hold
the gums tightly to the teeth, creating periodontal pockets which
fill with even more toxins and bacteria. As the disease progresses,
pockets extend deeper and the bacteria move down until the bone
that holds the tooth in place is destroyed. The tooth eventually
will fall out or require extraction.
Are there
other factors?
Yes.
Genetics is also a factor, as are lifestyle choices. A diet low
in nutrients can diminish the body's ability to fight infection.
Smokers and spit tobacco users have more irritation to gum tissues
as well as systemic effects than those who don't, while stress can
also affect the ability to ward off disease. Diseases that interfere
with the body's immune system, such as leukemia and AIDS, may worsen
the condition of the gums. In patients with uncontrolled diabetes,
where the body is more prone to infection, gum disease is more severe
and harder to control.
What
are the warning signs of gum disease?
Signs
include red, swollen or tender gums, bleeding while brushing or
flossing, gums that pull away from teeth, loose or separating teeth,
puss between the gum and tooth, persistent bad breath, change in
the way teeth fit together when the patient bites, and a change
in the fit of partial dentures. While patients are advised to check
for the warning signs, there might not be any discomfort until the
disease has spread to a point where the tooth is unsalvageable.
That's why patients are advised to get frequent dental exams.
What
does periodontal treatment involve?
In the
early stages, most treatment involves scaling and root planing-removing
plaque and calculus around the tooth and smoothing the root surfaces.
Antibiotics or antimicrobials may be used to supplement the effects
of scaling and root planing. In most cases of early gum disease,
called gingivitis, scaling and root planing and proper daily cleaning
achieve a satisfactory result. More advanced cases may require surgical
treatment, which involves cutting the gums, and removing the hardened
plaque buildup and recontouring the damaged bone. The procedure
is also designed to smooth root surfaces and reposition the gum
tissue so it will be easier to keep clean.
How
do you prevent gum disease?
Removing
plaque through daily brushing, flossing and professional cleaning
is the best way to minimize your risk. Your dentist can design a
personalized program of home oral care to meet your needs. If a
dentist doesn't do a periodontal exam during a regular visit, the
patient should request it. Children should also be examined.
What
is the role of the general dentist?
The
general dentist usually detects gum disease and treats it in the
early stages. Some general dentists have acquired the additional
expertise to treat more advanced conditions of the disease. If the
general dentist believes that the gum disease requires treatment
by a specialist, the patient will be referred to a periodontist.
The dentist and periodontist will work together to formulate a treatment
plan for the patient.
Is
maintenance important?
Sticking
to a regular oral hygiene regimen is crucial for patients who want
to sustain the results of therapy. Patients should visit the dentist
every 34 months (or more, depending on the patient) for spot scaling
and root planing and an overall exam. In between visits, they should
follow a mutually agreed upon regimen which meets their specific
needs that can include as well as brushing and flossing, other measures
such as rinsing, irrigating, tongue brushing, etc. Manual soft nylon
bristle brushes are the most dependable and least expensive. Electric
brushes are also a good option, but don't reach any further into
the pocket than manual brushes. Proxy brushes (small, narrow brushes)
are the best way to clean in between the recesses in the teeth,
and should be used once a day. Wooden tooth picks and rubber tips
should only be used if recommended by your dentist.
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