What are Gingivitis and Periodontitis?
Gingivitis refers to the first stage of periodontal disease. During this stage of the disease, the gums become inflamed, red and bleed. Sticky, colorless films of bacteria (plaque) are responsible for causing the symptoms one experiences with gingivitis. If left untreated, Periodontitis results.
Periodontitis is a serious gum infection: Periodontitis damages the gums, causing them to recede. This infection also destroys the bone that is responsible for providing the teeth with the support they need, which can cause the teeth to become loose, eventually leading to tooth loss.
What are Gum Disease Risk Factors?
Plaque is the principal reason that an individual develops gum disease; however, other factors can affect the health of the gums.
Other risk factors include:
- Tobacco use – studies indicate that tobacco may be a significant risk factor in developing gum disease: Furthermore, continued smoking causes gum disease to progress.
- Age – According to the CDC, a little more than 70 percent of Americans who are 65 years or older have Periodontitis.
- Genetics – It is believed that some individuals are genetically susceptible to developing gum disease.
- Medications – Certain medicines can affect an individual’s oral health. These drugs include antidepressants, oral contraceptives and a variety of heart medications.
- Stress – Just as stress has been linked to a variety of severe conditions (cancer, high blood pressure, etc.), it is a risk factor for gum disease as well.
- Grinding or clenching the teeth – When an individual clenches or grinds his/her teeth, an excess amount of force is placed on the gums, which could increase the progression of gum disease by destroying the periodontal tissues at a faster rate.
- Obesity – Research indicates that obesity may increase the likelihood that an individual will develop gum disease.
- Poor nutrition – Since periodontal disease starts as an infection, anything that compromises the body’s ability to fight off infection increases the risk of developing periodontal disease.
- Systemic diseases – Diseases such as rheumatoid arthritis and diabetes are known to alter the efficiency of the inflammatory system, these types of conditions may negatively affect the condition of the gingiva (gums).
What are the Symptoms of Gum Disease?
Unfortunately, gum disease is frequently silent until it reaches the advanced stages, which is why prevention through good oral hygiene is recommended.
Nevertheless, there are some warning signs once the advanced stage of gum disease is present:
- Gums that bleed while eating solid foods, flossing or brushing the teeth.
- Inflamed, red gums that are tender or any other type of pain in the mouth.
- Constant halitosis (bad breath).
- Loose teeth.
- Teeth that are changing position.
- Mouth sores.
- Changes in the way an individual’s teeth fit together when taking a bite.
- Pus is present between the teeth and gums.
- Receding gums that cause the teeth to look longer than they were before the gums started pulling away.
- Changes in the way that a partial fits.
Can Gum Disease be Prevented?
Yes, gum disease can be prevented through the practice of good oral hygiene, which includes:
- Flossing at least once daily to remove plaque and particles of food that a toothbrush is unable to reach.
- Brushing after meals help in the removal of trapped food debris and plaque.
- The tongue houses bacteria as well, for this reason, the tongue must also be brushed.
- Discussing any of the risk factors (listed above) for developing periodontal disease with his or her dental professional.
- Using mouthwash to reduce plaque and remove food particles missed when flossing, and brushing.
- Visiting a periodontist annually for a Comprehensive Periodontal Evaluation (CPE).
Parents can begin brushing their child’s teeth with a small amount of toothpaste once he or she turns 12 months old. Also, once the gaps between the child’s teeth close, flossing should be implemented.
Is Gum Disease Associated with Any Other Diseases?
Yes, previously, it was believed that bacteria played a role in linking gum disease to other diseases; however, research indicates that inflammation may be the contributing factor. Consequently, addressing inflammation may accomplish much more than just helping with the management of gum disease, it may also assist with managing other chronic conditions that cause inflammation.
These conditions include:
- Heart Disease – Scientists think that the swelling associated with gum disease may be the link between heart disease and periodontal disease. Furthermore, gum disease can negatively affect existing heart conditions. For this reason, individuals who are at an increased risk for infective endocarditis may need to receive antibiotics before dental procedures are performed.
- Diabetes – Individuals who are diabetic are at an increased risk of developing gum disease: Furthermore, if periodontal disease is present, it can increase an individual’s glucose levels, leading to diabetic complications. In fact, gum disease is frequently considered one of the complications associated with diabetes.
- Acute Cerebrovascular Ischemia (Stroke) – A study investigating whether having an oral infection was a risk factor for acute cerebrovascular ischemia found that individuals diagnosed with a stroke were more likely to have an oral infection than their control group counterparts were.
Other Diseases Associated with Gum Disease
- Osteoporosis – Tooth loss may occur due to the loss of density of the bone responsible for supporting the teeth.
- Respiratory Disease – Bacteria growing within the oral cavity may be drawn into the lungs while taking a breath, causing respiratory conditions like bacterial pneumonia.
- Cancer – Research finds that men who have gum disease are nearly 50 percent more likely to develop kidney cancer, 30 percent more likely to develop some blood cancer and have an almost 55 percent increase in the risk of developing pancreatic cancer.
Are There Any Factors That Increase the Risk of a Woman Developing Gum Disease?
Yes, there are several factors that increase a woman’s risk of periodontal disease:
- Menstruation – Just before the onset of menstruation, some women experience bright red, inflamed gums that bleed as well as sores on the inside of their cheeks. This form of gum disease is referred to as ‘menstruation gingivitis.’ This condition usually begins directly before the period begins and clears up as soon as menstruation starts.
- Pregnancy – A woman who is pregnant and has periodontal disease may be putting her baby at risk. Periodontal disease may cause the baby to be born too early and be too small; however, this link has yet to be firmly established, and more research is necessary to confirm this relationship. Since every infection is of concern during pregnancy, women who are pregnant or are considering pregnancy should have a Comprehensive Periodontal Evaluation.
- Puberty – An increase in the level of estrogen and progesterone during puberty causes an increase in blood circulation to the gums. This additional blood flow may increase the sensitivity of the gums; thus, leading to a greater response to irritations, including plaque and food particles. As such, the gums may appear red and inflamed.
- Menopause/Post-Menopause – During and following menopause, women may notice changes in their mouths. These changes may include burning sensations, pain in the gum tissue and on the tongue. Other symptoms include a dry mouth and an altered taste (sour, peppery or salty). Additionally, some women experience shiny or dry-looking gums that bleed easily and appear either abnormally pale, or deep red in color. This condition is referred to as menopausal gingivostomatitis. Typically, estrogen supplements successfully relieve these symptoms.
Are There Factors That Increase the Likelihood a Man Will Develop Gum Disease?
Yes, research indicates that men are nearly 20 percent more likely to develop periodontal disease than women are. This substantial increase between genders may be because men are less likely to visit the dentist or because men tend to have a higher incidence of tartar, dental plaque and bleeding when their gums are probed.
Periodontal disease may impact a man’s overall health in a variety of ways:
- Cardiovascular Disease (Heart Disease) – Periodontal disease and cardiovascular disease are both chronic inflammatory conditions. Researchers state that inflammation is the connection between these two conditions: When compared to women, men are at an increased risk of developing cardiovascular disease, therefore, maintaining healthy gums helps to reduce this already increased risk.
- Prostate Health – The prostate creates and secretes an enzyme that is referred to as the prostate-specific antigen (PSA). This enzyme is usually secreted in small amounts; however, if the prostate becomes infected, inflamed or cancerous, PSA levels increase. Research indicates that men who have a periodontal disease, as well as an inflamed prostate (prostatitis), have increased levels of the prostate-specific antigen in their blood when compared to men who only have one of these conditions. Therefore, prostate health and periodontal health may be connected.
- Cancer – Men with a history of the periodontal disease have a 14 percent increase in the likelihood of developing cancer when compared to men with healthy gums.
- Impotence – Men who are older than 70 or younger than 30 and have gum disease are more likely to experience impotence. Again, inflammation seems to be the link between these two conditions: Chronic inflammation (such as that associated with gum disease) may damage blood vessels, which then leads to impotence.
What Signs Indicate That a Child May Have Gum Disease?
The Four Basic Signs of Periodontal Disease
1. Inflammation – puffy, bright red gums.
2. Halitosis – continuous bad breath (that remains even after flossing and brushing).
3. Bleeding gums – Gums that bleed while flossing, brushing or at random.
4. Receding gums – gums have pulled away from the teeth (possibly exposing the roots of the affected teeth).
Three Kinds of Gum Disease in Children
1. Chronic Gingivitis – causes the gums to turn red, become inflamed and bleed easily. This is the most common type of gum disease that children develop; however, chronic gingivitis can be prevented by practicing good oral hygiene. If not addressed, chronic gingivitis may lead to more serious forms of gum disease.
2. Aggressive Periodontitis – mainly affects an individual’s incisors and first molars. This disease may develop in healthy teenagers and young adults. Aggressive Periodontitis is characterized by a severe loss of the bone responsible for holding the teeth (alveolar bone). Oddly enough, individuals with this form of gum disease rarely form dental plaque or tartar.
3. Generalized Aggressive Periodontitis – typically begins around puberty and affects the entire mouth. Symptoms include swelling of the gingiva and excessive accumulations of tartar and plaque. Left untreated, this disease can cause loosening of the teeth.
To successfully treat periodontal diseases, early diagnosis is essential: Children should receive a Comprehensive Periodontal Examination during their routine visits to the dentist. An advanced form of gum disease could be an early sign of another systemic disease; therefore, children exhibiting severe gum disease should visit their physician for a general medical evaluation.
What are Peri-Implant Diseases?
Peri-implant diseases cause inflammation that affects the hard and soft tissues surrounding dental implants. Just like a natural tooth, dental implants are susceptible to bacteria. The bacteria accumulate beneath the gum line on the base of the dental implant. As time passes, the gum tissue becomes irritated, which leads to the inflammation. If not addressed early on, the tissue becomes damaged, and the bone structure below the dental implant begins deteriorating.
There are two types of peri-implant diseases, peri-implant mucositis, and peri-implantitis. Peri-implant mucositis is characterized by inflammation around the implant’s soft tissues with no indication of a bone loss. If caught in its early stages, peri-implant mucositis is treatable and can be reversed; however, if left untreated, peri-implantitis will result. Peri-implantitis is characterized by inflammation around the implant’s soft tissues as well as bone deterioration. This condition requires surgical intervention.
Symptoms of Peri-Implant Diseases – just as with periodontal disease, the peri-implant disease causes tender or red gingiva around the dental implants, and bleeding gums when brushing/flossing.
What is a Comprehensive Periodontal Evaluation (CPE)?
The American Academy of Periodontology recommends that individuals receive a yearly Comprehensive Periodontal Evaluation.
During a CPE, a dental professional examines the patients:
- bone structure;
- plaque buildup; and
Also, he or she will want to discuss any risk factors the patient has for gum disease. Once this evaluation is complete, the dental professional will have the information necessary to determine the patient’s periodontal health.
What Periodontal Treatments and Procedures do Periodontists Perform?
Periodontists specialize in treating gum disease and replacing missing teeth using dental implants.
Tray Delivery System
A custom-fit tray is created for the patient. The tray is used at home as a means to deliver medications prescribed by the dentist. This tray is similar to the trays traditionally used to deliver fluoride treatments.
Root Planing and Scaling
This procedure involves carefully removing plaque and tartar from the deep pockets that have formed around the teeth. During this procedure, bacterial toxins are removed. Following root planing and scaling, some patients will receive additional therapies.
Studies reveal that laser treatment for periodontal disease provides similar results to those achieved with scaling and root planing.
Gum Graft Surgery
This procedure is used to develop gum tissue or cover the roots of teeth where an excessive gingival recession is present.
These procedures are used to regenerate bone and tissue that has been lost due to periodontal disease.
An artificial tooth root is placed into the jaw to hold a replacement tooth or bridge.
Dental Crown Lengthening
This procedure is used to address teeth that appear too short, causing an individual to have a ‘gummy’ smile.
Periodontal Pocket Reduction
If an individual has advanced gum disease and his or her periodontal pockets are too deep to address with daily oral hygiene, a periodontal pocket reduction may be necessary.
Due to the association between gum disease and other chronic inflammatory conditions, diagnosing and treating periodontal disease promptly is essential to improving an individual’s overall health.
If you have any question or concern about gum disease or your oral health, contact us to make an appointment with our periodontist.
- DENTAL IMPLANT BENEFITS
- ORAL DISEASE AND SYSTEMIC HEALTH
- OPTIMIZING HYGIENE, REGENERATIVE AND IMPLANT DENTISTRY
- RISK ASSESSMENT OF GUM DISEASE
- DIABETES AND GUM DISEASE