Gum disease

A guide for people with Periodontal disease 

Periodontal disease (gum disease) is the inflammation and infection of the gums (or periodontium). It has two stages both of which are caused by your body’s reaction to bacteria contained in plaque, the sticky film that builds up on teeth. Plaque can harden and form calculus which is major contributing factor to gum disease.

The first stage of gum disease is called gingivitis. Bleeding is often noted as your body sets up reactions to kill bacteria in the plaque. This stage is treated by the removal of plaque and calculus. Importantly proper cleaning techniques should be reinforced to prevent further problems.   

gum-disease-1The next stage in gum disease is called periodontitis which is characterized by the destruction of the support tissues of the teeth. This includes both the bone and ligament that hold the teeth in place. Bleeding gums and bad breath are associated with this stage. Areas that are unable to be cleaned (periodontal pockets) are formed where bacteria establish colonies deep below the gum. The destruction of the support structures leads to recession (shrinkage) of the gums, and without treatment, this progress’ to the teeth becoming loose and painful.

The treatment for this stage is the removal of plaque and calculus. Because the bacterial colonies are deep below the gum local anaesthetic is often used to stop any pain associated with the cleaning procedure.

It is very important to review cleaning techniques as inadequacies in this area often contribute to the progression of gum disease. Proper instruction in brushing and inter-proximal (in between the teeth) cleaning needs to be undertaken to ensure the long term success of treatment.

There are many benefits to stopping the spread of gum disease. These include preventing loss of teeth, improving bad breath and a mouth that feels and tastes better.

Periodontal Disease and Health

gum-diseasePeriodontal disease has recently been closely linked to heart disease. Those that suffer from periodontal problems often have elevated rates of heart disease. While there is much research to do in this area the message is clear. Healthy gums can help keep your heart pumping! Periodontitis in pregnancy has also been linked to premature and/or low birth weight babies.  

Diagnosis

Diagnosis of periodontal disease is easy. Diagnosis is normally done during a routine examination. Areas of inflammation and bleeding reveal the presence of gingivitis. The dentist (or therapist) will also use a specially marked probe to detect where the gum attaches to the tooth.  The presence of periodontitis allows the probe to travel further down the root of a tooth and this depth (pocket depth) is recorded in millimetres. A normal reading is 2-3mm. Your dentist will check your gums and tell you the extent of any problems and can then discuss with you the most appropriate method of treatment as well as the costs involved.

Your dentist will be checking your medical history as well as your mouth as various factors can contribute to periodontal disease.

Contributing Factors

Diabetes and smoking are two common contributing factors. Both of these reduce blood flow to the gums which means healing cannot occur as it would normally. Some medications and systemic diseases can also contribute to gum disease.

gum-disease-2Untreated areas of decay and defective fillings will need to be rectified as both these things accelerate gum disease

Treatment Side Effects.

After treatment there can be some mild discomfort for a short period. Immediately there will be slight soreness from the scaling procedure. This is mild and only lasts for a day or two.

As the gums heal, shrinkage occurs which exposes areas of the root surface. These areas can be sensitive to temperature. If this occurs special toothpastes can be used to minimize discomfort.

Longer term these same exposed root surfaces may be prone to decay as they aren’t as calcified (hard) as the crown of the tooth. But with dietary control and the use of fluoride or “Tooth Mousse” products this side effect can be minimized.

For the long term success good oral hygiene must be maintained. Brushing and the use of inter-proximal brushes or floss on a daily basis are essential. Regular recalls are also required to make sure the gums remain healthy. These recalls are tailor made for each patient.  

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