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Posts for tag: periodontal disease

AvoidBoneLossaroundToothRootsthroughRegularDentalCare

Periodontal (gum) disease is a serious matter. Not only can it wreak havoc with your gums, it could also cause bone loss in the jaw that supports your teeth.

Gum disease is a bacterial infection that originates from a thin film of food particles on tooth surfaces called plaque. If you're not diligent about removing plaque through daily brushing and flossing, it can become a feeding ground for certain strains of bacteria that trigger gum infections. Left untreated, the disease can advance deeply into the teeth's supporting structures.

We're particularly concerned about furcations, the specific locations where multiple roots of a tooth fork or separate. When these locations become infected we call it a furcation involvement or invasion. The bone along the furcation will begin to deteriorate and dissolve, following a progression of stages (or classes) we can measure by probing the gum tissue or through x-ray evaluation:

  • Class I: the furcation feels like a groove, but without any noticeable bone loss;
  • Class II: a depression of about two or more millimeters develops indicating definite bone loss;
  • Class III:  bone loss now extends from one side of the root to the other, also known as “through and through.”

Treating furcation involvements can prove challenging because the infection is usually well below the gum line (sub-gingival). As with all gum disease treatment, our primary approach is to remove all plaque and calculus (hardened plaque deposits) where we find it, including around the roots. We typically use specially shaped instruments to clean the root surfaces. We can also employ an ultrasonic device that loosens plaque and calculus with high-frequency vibrations and flushed away with water.

Sometimes, we may need to surgically access involved furcations to clean them and stimulate bone growth with grafting. We can also use surgery to make the areas easier to clean — both for you and for us during your regular office cleanings — to prevent reoccurrences of infection.

Of course, preventing gum disease in the first place is your best defense against oral problems like furcation bone loss. Be sure you brush and floss every day, and visit us for thorough cleanings at least twice a year (unless we recommend more). This will help make sure not only your gums, but the bone that supports your teeth stays healthy.

If you would like more information on treating periodontal (gum) disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “What are Furcations?

DontletPeriodontalDiseaseCauseYourGumstoRecede

Although your smile wouldn't be the same without them, there's more to your gums than their looks. Besides helping to hold your teeth in place, they're also an important protective barrier for their roots.

Unfortunately, gums aren't immune to disease, especially periodontal (gum) disease. This bacterial infection, triggered by built-up dental plaque on teeth due to insufficient oral hygiene, can cause the gum tissues to detach from teeth and shrink back (recede). This can make your teeth more sensitive to hot or cold foods and beverages, as well as put them at even greater risk for tooth decay.

To treat gum recession, our first priority is to stop any ongoing gum disease through aggressive plaque removal. Depending on severity, this could require clinical procedures like scaling or root planing to remove plaque and tartar (hardened plaque deposits) at or below the gum line. This is especially crucial for improving gum tissue healing and stimulating potential reattachment.

Revitalizing gum tissues this way naturally has a better chance of occurring if we're able to prevent recession before it reaches the roots. If that does happen and we have sufficient gum tissue attachment remaining, we may need to give the gum tissue a helping hand through gum grafting surgery. There are a number of techniques depending on the circumstances, but they all use either tissue from another location in the patient's mouth or prepared tissue from another human donor. This type of surgery requires great skill and expertise, not to mention an aesthetic sense, to achieve a result that's both functional and attractive.

Other than daily brushing and flossing, the most important thing you can do for gum health is to see us as soon as you notice any signs of gum problems like swelling, bleeding or tooth sensitivity. The sooner we can diagnose and begin treating the problem, the less likely any gum recession will have a long-term impact on your health.

If you would like more information on gum health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Gum Recession.”

YourCaseofGingivitisCouldDevelopintoSomethingMoreHarmful

That bit of gum bleeding after you brush, along with redness and swelling, are strong signs you have gingivitis, a form of periodontal (gum) disease. Without treatment, though, your gingivitis could turn into something much more painful and unsightly — a condition commonly known as “trench mouth.”

Properly known as Acute Necrotizing Ulcerative Gingivitis (ANUG), the more colorful name arose from its frequent occurrence among soldiers during World War I. Although not contagious, many soldiers contracted it due to a lack of means to properly clean their teeth and gums and the anxiety associated with war. Inadequate hygiene and high stress still contribute to its occurrence today, along with smoking, medications that dry the mouth and reduced disease resistance — all of which create a perfect environment for bacterial growth.

ANUG can arise suddenly and be very painful. The cells in the gum tissue begin to die (“necrotizing”) and become swollen (“ulcerative”), especially the small triangle of gum tissue between the teeth called the papillae, which can appear yellowish. Patients also encounter a characteristic foul breath and taste. Untreated, ANUG can damage tissue and contribute to future tooth loss.

Fortunately, antibiotics and other treatments are quite effective in eradicating bacteria that cause the disease, so if caught early it’s completely reversible. We start with a complete examination to confirm the diagnosis and rule out other possible causes. We then attempt to relieve the pain and inflammation with non-steroidal, anti-inflammatory drugs like aspirin or ibuprofen and begin antibiotic treatment, most notably Metronidazole or amoxicillin. We may also prescribe a mouthrinse containing chlorhexidine and mild salt water rinses to further reduce the symptoms.

We must also treat any underlying gingivitis that gave rise to the more acute disease. Our goal here is remove any bacterial plaque and calculus (hardened plaque deposits) that have built up on tooth surfaces, particularly below the gums. Only then can we fully bring the disease under control.

It’s also important you become more consistent and effective with daily brushing and flossing, quit smoking, reduce undue stress, and get better rest and nutrition. Establishing these new habits and lifestyle changes will help ensure you’ll never have to experience trench mouth again.

If you would like more information on ANUG and other periodontal gum conditions, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Painful Gums in Teens & Adults.”

5WarningSignsYouMayHaveGumDisease

Periodontal (gum) disease, a bacterial infection caused by plaque, is one of the most prevalent and destructive dental conditions. Left untreated it can eventually lead to tooth and bone loss.

Although people are often unaware they have gum disease, there are a few warning signs to look for. Here are five gum disease signs that should prompt a dental visit.

Gum Swelling and Redness. Like all infections, gum disease triggers an immune system response that releases antibodies into the gums to attack the bacteria. The ensuing battle results in inflammation (swelling) and a darker redness to the gum tissues that don’t lessen with time.

Gum Bleeding. It isn’t normal for healthy gum tissue, which are quite resilient, to bleed. In a few cases, bleeding may indicate over-aggressive brushing, but more likely it means the tissues have weakened to such an extent by infection they bleed easily.

Tooth Sensitivity. If you notice a shot of pain when you eat or drink something hot or cold or when you bite down, this could mean infected gums have “drawn back” (receded) from the teeth. Gum recession exposes the tooth roots, which are more sensitive to temperature and pressure changes in the mouth.

An Abscess. As weakened gum tissues detach from the tooth, the normally thin gap between them and the tooth deepens to form a void known as a periodontal pocket. This often results in an abscess where pus collects in the pocket and causes it to appear more swollen and red than nearby tissues. An abscess needs immediate attention as bone loss is greatly accelerated compared to normal gum disease.

Tooth Looseness or Movement. As diseased gum tissue causes loss of gum and bone attachment, the affected teeth will start to feel loose or even move to a different position. This is a late and alarming sign of gum disease — without immediate intervention, you’re in danger of losing the tooth.

If you encounter any of these signs, contact us for an examination as soon as possible. The sooner we can diagnose gum disease and begin treatment, the less damage it will cause — and the better your odds of regaining healthy teeth and gums.

If you would like more information on gum disease, please contact us to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Warning Signs of Periodontal (Gum) Disease.”

YouMayNeedYourGumsCheckedMoreFrequentlyAfterGumDisease

After a dental examination revealed you had periodontal (gum) disease, you began undergoing treatment. Now after several cleaning sessions, the infection has subsided and your gums have returned to a healthy shade of pink.

But your gum care isn’t over — depending on the infection’s severity you may need to visit us more often than the normal six months between regular checkups.

Gum disease arises from dental plaque, a thin film of bacteria and food remnants built up on tooth surfaces due to poor oral hygiene. The bacteria cause an infection in the gums, which initiates a response from the body’s immune system that triggers inflammation.

Without proper treatment, periodontitis can come back in which the infection spreads deeper below the gum line. Pockets of infection can reoccur as gum tissues weaken and lose their attachment to teeth. This continuing damage can ultimately lead to both tooth and bone loss.

To stop the disease it’s necessary to remove all the infection-causing plaque and calculus (hardened plaque deposits) from tooth surfaces, including around the roots. This is performed manually and could require surgery once again to access areas below the gum line.

To guard against this it’s necessary for you to undergo regular periodontal maintenance (PM). Besides cleaning, PM gives us an opportunity to check for signs of returning gum disease and, if found, plan for another round of treatment.

Although not written in stone, the interval between PM appointments that seems the most effective for preventing recurrence is every three months. In cases of advanced, aggressive gum disease, appointments may need to occur at even shorter intervals, for example every two months.

PM for susceptible patients with decreased resistance to disease require extra time and effort for the hygienist, along with a renewed daily hygiene habit of effective brushing and flossing by you to keep the disease at bay. But preventing another occurrence of gum disease and its consequences is well worth this extra attention for the health of your teeth and gums.

If you would like more information on dental care after gum disease treatment, please contact us or schedule an appointment for a consultation.