Ms. Vatcher, MA
1 October 2002
Why Periodontal Disease Should be a Concern to All.
Periodontal disease is more commonly known as gum disease or gingivitis. This infection is serious enough, that it can lead to tooth loss if left untreated. This chronic infection starts around the tooth and it affects the supporting bone and gums. Periodontal disease can affect anywhere from one tooth to all thirty-two teeth. The disease pathology starts with the plaque that builds up on your teeth everyday.
The plaque build up causes the gums to become red and inflamed. If not properly brushed off, the remaining plaque will also cause the gums to bleed. This stage of periodontal disease is commonly referred to gingivitis, literately meaning swelling of the gums. There is no real pain associated with gingivitis. It is curable with a good dental cleaning and proper brushing and flossing at home. However, if left untreated gingivitis can lead to advanced periodontal disease.
After a person has had untreated gingivitis for some time, plaque starts to grow and spread. It travels down below the gum line and the bacteria produce toxins. These toxins irritate the gums and cause the bodys natural defenses to kick in. When the inflammatory response has been triggered for a while it causes the tissues that support the teeth and bone to break down. The gums begin to pull away from the tooth and a pocket forms.
A pocket is a space between the gums and teeth. The deeper the pocket is (in millimeters), the further the gums are from the tooth, and the more advanced the
Periodontal disease is. A normal pocket depth of a health tooth is between one and three millimeters deep. Gingivitis is 4 millimeters deep. A pocket depth of five to tooth loss is advanced periodontal disease. (Ive seen pockets as deep as 12 millimeters deep) When your dental professional is checking pocket depth, they are performing what is called a perio-chart. Perio-charting should be done annually as a preventative measure of gum disease.
Plaque is the main cause of gum disease, but there are many contributing factors. Smoking is one of them. Most people are aware of the dangers of smoking. Not many people are aware that tobacco use significantly increases a persons chance for periodontal disease. Once diagnosed with periodontal disease, a smokers chance of healing is dramatically decreased. If a smoker does heal from periodontal disease their chances of it reoccurring are high.
Genetics also play a small role in contracting the disease. Its estimate that thirty percent of people with periodontal disease were genetically susceptible. Exposure may also play a role in contracting the disease. People have contracted it from their partners. Pregnancy plays a role as well because when women are pregnant their bodies are generally more susceptible. A pregnant womans gums are also extremely sensitive. Other common contributing factors are stress, types of medications a person has taken (oral contraceptives and anti-depressants), diabetes, poor nutrition and bruxism (clenching and grinding your teeth). These factors can be changed or properly maintained in order to stop contributing to the periodontal disease. It is also important to note that these factors cannot be blamed for the main cause of this disease.
Other problems can arise because of periodontal disease. The obvious is tooth loss. After awhile all gum recession and bone damage will cause the teeth to fall
out. This leads to more dental problems and eventually dentures. Bad breath is often caused by periodontal disease. This is often unpleasant and embarrassing for the person experiencing it. Other problems that periodontal disease contributes to are heart disease and stroke. Thirty percent of heart attack victims and stroke victims have a type of periodontal disease. What happens is the same plaque that builds up on your teeth, gets into the blood stream and clogs the main arteries of the heart and brain. This leads to a heart attack and stroke. Another problem that periodontal disease is associated with is pre-term births. It is estimated that ten percent of all pre-term babies have mothers with periodontal disease. It is easy to understand why prevention and healing of this disease are so important.
Prevention is the key with periodontal disease. Proper brushing and flossing at least twice a day is recommended. If you like electric toothbrushes, my doctor recommends Sonicare. An antiseptic mouthwash, like Listerine is helpful as well. If you are a smoker, quit. You will never be rid of this disease of you continue to smoke. If you are pregnant, make sure you are brushing and flossing everyday. Do the same if you have heart disease. Make an appointment every six months with your dental hygienist. Avoid sugary foods that encourage plaque growth. Suckers and hard candies are the worst because they sit in your mouth. This gives the bacteria and plaque plenty of time to grow. See your dentist regularly and above all make sure you brush and floss twice a day.
If prevention is already too later and youve been diagnosed with periodontal disease there are ways to encourage healing. It is important to start or maintain daily flossing and brushing. Most dentists will prescribe an antibiotic rinsing agent. You may get a referral to see a periodontist. This is a professional trained in the
dentistry of the supporting structures of the teeth. Either the periodontist or your hygienist can provide a deeper cleaning called scaling and root plaining. This hour and a half deep cleaning will cover one of the four quadrants in your mouth. If multiple quadrants are infected, then multiple visits may be necessary. Scaling and root plaining is a pocket reduction procedure. Other types of procedures a periodontal patient may encounter are crown lengthening, which is performed by a periodontist and soft tissue grafts. These procedures are time consuming and expensive.
The cost of treating periodontal disease is high. One scaling and root-plaining appointment can cost around two hundred dollars. Crown lengthening and tissue grafts can easily cost three times as much. Not to mention the cost of prescriptions and lost time. Insurance companies will help on select procedures, but the amount covered varies per plan. The cost of a toothbrush, toothpaste, floss and Listerine is considerably cheaper. To avoid treatment costs, one should do all they can to prevent the infection.
As a trained dental assistant of four years, I have seen my share of mouths. When I first started in this profession I was amazed at how many patient I saw who were educated and well off, and who still had poor hygiene. People now days may be getting better about see the importance of taking care of their teeth, but there are still many out there that need some encouragement. Brushing your teeth is not enough in many cases. Make friends with the floss as well. It may prevent you from contracting periodontal disease. If a person has heart disease and periodontal disease their risk for death increases greatly. This disease isnt something that you can forget about. It needs to be taken seriously or it may come back to haunt you and your wallet later.