Gum Disease Dr L’s Simply Explanation
Your teeth are surrounded by gums. Think of it like a shirt collar or turtle neck collar around your neck. If you loosen your shirt, dust and pollen can get into and around your neck. The tooth is very similar to this example. Saliva, food, and germs get into the pockets of your teeth and can progress into deep areas that cannot be effectively cleaned out by the best of home care. Our periodontal program will help to decrease these pockets and help to get your gums healthy again.
“Reason why patients need to go to a dental professional to have their teeth cleaned regularly.”
HOW DOES PLAQUE AND TARTAR CAUSE GUM DISEASE?
In order to understand the mechanics of gum disease you must first understand what roles plaque, tarter, saliva and home care play in relation to gum disease.
As an example, have you ever scratched the surface of your tooth with your fingernail and noticed that you have removed a soft substance? The proper term for this naturally occurring soft substance is plaque. Everyone forms plaque on their teeth at a different rate.
To understand the role that saliva plays in the formation of gum disease please note the following. It’s a fact that if a tooth were to sit on the counter for a few days, without contact with salivary the tooth will become brittle. This happens because saliva continuously hardens and mineralizes your tooth structure. This process keeps your teeth strong and cavity resistant. (As a side note. for this reason, it’s important to inform your dentist if you notice that your mouth has recently become more dry. or if for whatever reason, you begin to mouth breath more then you normally do. Often dry mouth is cause by medications.)
Unfortunately, there is a side effect of this mineralization process. The soft, squishy plaque previously mentioned also becomes mineralized or hardened by your saliva. This is how bacterial plaque is transformed into the hard rock like substance called tartar (or calculus), which creates a home for microorganisms that cause gum disease! If tartar is not removed it will cause dental gum disease (gingivitis is gum disease without bone loss and periodontitis is gum disease with bone loss)! Certain anatomical locations of each person’s mouth have more salivary glands. Since each patient excretes varying amounts of saliva with different degrees of mineral content (like the octane of premium gas vs. octane of regular gas), consequently each patient forms plaque and tarter at their own rate. Therefore, our dental team customize and teach preventative techniques to our patients so they learn to focus their oral hygiene efforts in specific areas were gum disease forms. Further more, we customize the time intervals between each visit for every individual patient.
In summary if your plaque hardens on average more quickly then most, you will need to work more diligently at home care to remove the plaque before it hardens. Unfortunately, without good home care, once the tartar has formed, only the dentist can remove it. Subsequently these patients who form more calculus will need to be seen for more frequent dental visits.
To further understand gum disease, unremoved tartar next to or under the gum collar, is similar to having a sharp irritating thorn under your gum tissues. This results in gum inflammation and bleeding. If left untreated, the gum inflammation will cause irreversible jaw bone resorption. In fact, organisms live in the tarter and secrete exotoxins, or byproducts of their metabolism, into the space between the tooth and gum tissue. These exotoxins cause the tooth supporting tissue, the gum tissues and jawbone, to slowly dissolve and retreat. This results in gum attachment loss and gum tissue pocket formation. Our team uses advanced examination procedures to detect this bone loss intraorally by measuring gingival pocket depths (probings) and comparing bone position with regular intervals of dental x-rays. All of this and other diagnostic information is used to classify your disease state into five periodontal classes. This formal classification allows us to provide customize periodontal therapy that has been well organize to return your mouth to health.
5 Common Societal Facts about Gum Disease
- According to a recent poll of gum disease specialists, their patients who practiced the worst home oral care were overwhelmingly men.
- Nearly half of survey respondents age 65 and older selected the smile as the first thing they notice about people. American Dental Association
- High levels of financial stress and poor coping abilities double your likelihood of developing periodontal disease.
- “It seems clear that gum disease, far from being just an oral health problem, actually represents a significant health risk to millions of people.” — R. Genco, DDS, PHD, Chief Editor, Journal of Periodontology
- 20% of people over age 65 who have never smoked are missing teeth, while 41.3% of daily smokers over age 65 are missing teeth.
Statistics show that the dental profession in general has failed at controlling gum disease.
The surgeon general reports that 75% of Americans have some stage of gum disease.
Most of it is undiagnosed and untreated—even among people who regularly visit the dentist.
At our office we routinely run computers ADA CDT treatment code reports. These reports calculate the amount of gum disease treated at our office verse number of patients seen. We are amazed and happy to report that our statistical percent’s line up with recommended norms for the general population. In other words, we are neither over diagnosing nor under diagnosing.
Periodontitis = Gum Disease + Bone Loss
When gum disease is not treated, it can advance to “periodontitis” (which means advanced gum disease + “bone loss”). In periodontitis, the gums collar or pockets around the tooth get deeper. The deeper the gum pockets become, the more difficult it is for you or your dentist to clear out the bacteria. Over time your gums become swollen & infected. The body’s immune system tries to fight the bacteria in the plaque & rock like tartar that spread and grows deeper into the gum pocket.
Bacterial toxins and the body’s natural response to infection start to break down the bone and connective tissue that hold teeth in place. In advanced stages of gum disease, termed class III & IV, the bones, gums, and tissue that support the teeth are destroyed. It’s a slow silent progression of diseased tissue breakdown that likely will not cause any pain. As we all know, in advanced stages teeth may get loose and you may need gum surgery. For some teeth may need to be replaced by dental implants.
5 Risk Factors for Gum Disease
Smoking
Smoking is one of the most significant risk factors associated with the development of gum disease. Additionally, smoking can lower the chances for successful surgical treatments like success of dental implants, bone grafting, gum surgery, and any dental or medical surgery.
Hormonal changes in girls/women
These changes can make gums more sensitive and make it easier for gingivitis to develop and progress.
Diabetes
People with diabetes are at higher risk for developing infections, including gum disease.
AIDS & Cancer
Diseases such as AIDS and its treatments can also negatively affect the health of gums, as can treatments for cancer.
Medications
There are hundreds of prescription and over the counter medications that can reduce the flow of saliva, which has a protective effect on the mouth. Without enough saliva, the mouth is vulnerable to infections such as gum disease. And some medicines can cause abnormal overgrowth of the gum tissue; this can make it difficult to keep teeth and gums clean.
Genetic susceptibility
Some people are more prone to severe gum disease than others.
Scaler Irregulator After Gum Treatments
In addition to gentle gum care, we use technologies to perform high precision scaling and root planning with maximum comfort to the patient.
The Advantages:
Sterilizes infected areas before treatment.
Ultimate patient comfort.
Irrigator hand piece warms the solution for a soothing treatment.
Faster procedure. Less time in the chair.
Anti Microbial Irrigation during and after scaling.
Gum Disease vs General Health Publications
“Bad gums could be as strong a risk factor for heart attacks as smoking cigarettes, which is to blame for about 40,000 heart-related deaths a year.”
(Daniel Haney, AP Medical Director)
“A new study of fatty deposits lodged in the carotid arteries of stroke sufferers shows that 70% contain bacteria and 40% of that bacteria comes from the mouth.”
(USA Today)
“Men with periodontal disease have a stronger propensity for cardio-vascular disease than men without periodontal disease, with those under 50 with periodontal disease having a greater risk than those over 50.”
(I Periodontal)
“Diabetics with gum disease were three times more likely to have heart attacks then those without gum disease.”
(USA Today)
“Under the surface.are pockets of infection that contain billions of bacteria. If this oozing mess was out where it could be seen, it would be a bone-deep sore the size of the palms of both hands.”
(Daniel Haney, AP Medical Director)
“Women with gum disease are seven to eight times more likely to give birth prematurely to low birth-weight babies.”
(USA Today)
“Bacteria in plaque are linked to lung infections in people with chronic lung diseases such as chronic obstructive pulmonary disease.”
(USA Today)
“It appears that the extent of sites with probing depths >3mm is strongly related to the incidence of total coronary heart disease.”
(Annals if Periodontology, Vol.3, #1, 127-141)
“Studies also suggest that good oral hygiene habits may improve fertility in sub-fertile males.”
(Internet, Dentist: Oral Health and Hygiene)
“It seems clear that gum disease, far from being just an oral health problem, actually represents a significant health risk to millions of people.”
— Dr. R. Genco, DDS, PHD, Chief Editor, Journal of Periodontology
Oral Cancer Detection & Screening
Oral cancer is one of the most deadly kinds of cancer, claiming more lives each year than cervical or skin cancer. To protect our patients, our practice conducts an oral cancer screening for all our new patients and routinely during periodontal recare visits. The oral exam is non-invasive, requires no anesthetic and takes just a few minutes.
If a suspect lesion is found, we will offer a new process known as an oral brush biopsy. An oral brush biopsy allows us to easily determine whether any questionable lesion is cancerous. Results are known quickly with an extraordinary high degree of accuracy. It’s one less thing for you to worry about and early detection could save your life.
The Importance of Early Detection
(Early Detection Saves Lives)
It’s important, to detect cancer at an early stage, when it can be more successfully treated. When cancer is not found early, tumors may grow deep into local tissues and can spread to other parts of the body. This spreading reduces the chances for successful treatment.
With early detection and timely treatment, deaths from oral cancer could be dramatically reduced. The five-year survival rate for those with localized disease at diagnosis is 76 percent compared with only 19 percent for those in which cancer has spread to other parts of the body.
Early detection of oral cancer is often possible. Tissue changes in the mouth that might signal the beginnings of cancer often can be seen and felt easily.
SO WHAT, ITS JUST GUM DISEASE….Can’t you Just Clean My teeth?
Periodontal disease is a serious infection. Evidence now links gum disease to a variety of health concerns, including heart disease, stroke, diabetes and other degenerative diseases that are life threatening *. It’s not just about your teeth anymore! Periodontal disease can be a disfiguring disease. (The surgeon general states that you cannot have good overall health with out good oral health). Your gums swell in size and become very red and angry looking. They may bleed very readily. Your teeth may shift and dark spaces between your teeth may start showing. The teeth then become loose and may need to be removed or fall out.
Early detection as with other diseases is the key to successful treatment. Your dental professional will routinely perform a gum disease screening exam. This is recommended at least once a year by the American dental association. The results of this exam will determine your periodontal status or case type. If you have periodontal disease your treatment will be personalized for you and your level of infection. A routine cleaning is not enough by itself to treat periodontal disease.
It’s Not Just a Cleaning!
Prevention should serve as a lifestyle pattern for total health, not the least of which is dental health. Prevention in dentistry leads to improved long-term oral health and reduced dental costs. It encourages a bright smile, fresh breath, and an overall good feeling of personal security. Prevention is your insurance policy toward a healthier, pain-free, debt-free lifestyle.
Our dental hygienist can provide excellent services to assist in the maintenance of your overall dental health. Your cooperation with her can serve to increase your knowledge of your present oral condition. When you keep your appointment with your hygienist, the following benefits will result:
- Our dental hygienist will customize a personal home and preventive maintenance program for you, and inform you of those dental products, which are appropriate for your particular needs. You will be instructed in the proper methods of tooth brushing, flossing, and adjunctive dental health devices.
- Your entire mouth will be thoroughly and carefully examined for gum disease, growths, lesions, and any abnormalities that would affect your general health.
- Your teeth will be cleaned and polished to remove plaque and tartar both above and below the gumline, eliminating bacteria that lead to cavities, bad breath, and gum disease.
- Fluoride will be applied to teeth to prevent decay (for children), and root sensitivity/root cavities for adults.
- Sealants can be easily applied to the chewing surfaces of children’s teeth as a protection against future decay.
Dental disease is a silent invader, presenting itself in various forms (puffy, bleeding gums, cavities, oral cancer, abscesses). Although your mouth may appear to be in good health at this time, stresses, body changes, life changes, medications, illness, and age can tax your immune system. Maintaining regular re-care appointments with your dental hygienist and follow-ups with your dentist offers you the assurance that any problems in regard to your oral care will be addressed immediately.
Taking care of tomorrow ‘s problems today will give you tremendous peace of mind.
If you have postponed or missed your last hygiene maintenance appointment, remember: it’s not just a cleaning, it’s an INVESTMENT in your overall health!
About Your, Soft Tissue Management Program
Fifty percent of gum disease is eliminated with the clinical dental therapy, like deep cleanings and regular periodontal maintenance. On the other hand, modern day research has established that the other 50% of the cure is accomplished by means of patient compliance with professional in-office evaluation and patient home care training. For this reason, we advise that you absolutely follow the proven soft tissue management program.
In order to effectively evaluate your progress, you must consistently follow up with your periodontal maintenance appointments at exactly 3-month intervals. In other words, our team will need to compare a 3-month interval to the next 3-month interval. In fact, if you are not consistent, your soft tissue management program will not be as effective and it’s more likely the gum disease will reoccur.
To help you stay consistent, we offer a “pre-appointment system.” You will be presented with the opportunity to reserved appointment times that are most convenient for your schedule. Remember, you will receive an appointment reminder postcard 2 weeks in advance of this appointment. If you realize you are not able to keep the appointment when you receive the reminder, please give us a call.
You need to commit for at least for one year!!! Then the tooth supporting gums and bone will have healed and be more stable.
At our office gum surgery will always be the last resort. Our goal for your treatment is to keep your mouth fresh & healthy!
Soft Tissue Management (STM) Treatment Program For Patients With Gum Disease
The treatment (root plaining and scaling and a one year series of ongoing therapy & evaluation appointments) consists of professional in-office care that detoxifies the tooth surfaces below the gum line and in between the teeth. Then a medicine will be used to flush out the bacteria that caused this infection. Our commitment to our patients extends well beyond just in office treatment. Recent advancements in diagnostic techniques have led to our modern STM program. This structured STM program will now encompass all forms of individualize prevention. For example, every member of our dental team is trained to understand STM, individualize patient care, and teach our patients home care. We know that 50% of the cure is accomplished by means of patient compliance with professional in-office evaluation and patient home care training. Your home care is evaluated at every visit and goals are set to improve or focus on areas of greatest concern. As a service to all of our patients, our dental team utilizes a personalized hygiene brochure. The hygiene brochure is formally used to review patient home care goals versus clinical notes referencing each patient’s gum tissue health. Our advanced examination procedures assured the ultimate in patient care at every periodontal maintenance recare visit.
When we introduce our STM program to our patients, we clearly explain how significant it is to keep all scheduled appointments. The time interval must be the comparable between all dental maintenance visits. Our doctor and staff will need equal time intervals between your visits in order to accurately mediate and contrast how your gum tissues are responding to various recommendations.
To help you stay consistent, we offer a “pre-appointment system.” Years of scheduling experience have shown pre appointment scheduling to be the best method to maintain crucial comparable time intervals between dental recare appointments. You will be presented with the opportunity to reserve appointment times that are most convenient for your schedule. In addition, you will receive an appointment reminder postcard 2 weeks in advance of this appointment. If you realize that you are not able to keep this reserved time, please give us a call.
Professional and You
Besides your daily home care to remove plaque bacteria, your dental professional will recommend the appropriate interval of maintenance care. You will probably need to increase your hygiene visits from two to maybe three or four times per year to maintain the health achieved through your STM treatment program.
CAN Periodontal Disease be controlled?
Without careful on-going monitoring and treatment, periodontal disease can recur. Your daily care and professional maintenance visits are a commitment to better health.
Why Do I Need Treatment? I Don’t Feel Pain?
Gum disease and tooth caries are often Low-grade infections (slow to progress and chronic in nature) and therefore frequently sub-clinical in nature and subsequently indictable by the dentist.
At times dental disease destroys bone cells or tooth cells so slowly that the body cannot detect the destructive process. For this reason, dental disease has become know as a “silent disease.” Unfortunately, the best example of similar, often undetectable tissue damage is the that caused by the silent disease categorized as chronic cancer. Certainly, gum disease is not cancer, but modern day research has shown the links of gum disease to a variety of general health concerns.
With both undetected, non-painful cancer and bone loss due to chronic gum disease or caries, the cells of the body are damaged at a slow, silent rate.
In order to understand this process, one should recognize that there are two types of infections: acute and chronic. During acute infections, a large number of tissue cells are damaged at one given time. With an acute infection, large amounts of intracellular contents are released from damaged cells into the body and can be detected by our nerve endings (i.e. pain!). Unfortunately, a chronic infection can still destroy the same amount of cells as an acute infection, but over a longer period time. The reason you don’t feel pain from chronic infections is because the body cells are destroyed at a slow rate and over a long period of time. During this time, our nerve endings cannot detect the continuous small amount of cell content that is released. Yes, chronic gum disease is not likely to be debilitating over night, but its affects are irreversible and progress in severity.
Pregnancy Fact Sheet
Please note that pregnancy, the after effects of pregnancy, and changes in hormones place you in a higher risk group for periodontal disease. In fact, “women with gum disease are seven to eight times more likely to give birth prematurely to low birth- weight babies.” (USA Today, April 14 1998). For this reason, it is more necessary for you to have regular preventative maintenance. Regular dental care will ultimately prevent the need for more aggressive and expensive dental procedures.
This note was written to inform you! Our dental team is truly committed to the current research that protects the mothers in our practice from health concerns. Unfortunately, I have seen many of my patients, including my wife, who have been surprised by this abrupt change in gum tissue health during and after pregnancy. Yes, many of these patients have had consistent, regular dental care for years. Then, during and after pregnancy, they had to “step up” their attention to prevent disfiguring affects of gum disease.
We follow the updated guidelines set by the American Dental Association for recare intervals for our pregnant patients.
Ideal Periodontal Recare Visit intervals:
- Before Getting Pregnant
- In Your Middle Trimester
- And Soon After Birth.
Also it’s important to inform our office if you are trying to get pregnant so that we can evaluate your periodontal class type and home care relative to possible pre pregnancy gum tissue therapy. Don’t be alarmed if you are already pregnant. We have an excellent (STM) preventative periodontal program especially for our pregnant patients.
