Periodontal diseases
Periodontal treatment is necessary when various conditions affect the health of your gums and the regions of your jawbone that hold your teeth in place. Retaining your teeth is directly dependent on proper periodontal care and maintenance. Healthy gums enhance the appearance of your teeth, like a frame around a beautiful painting. When your gums become unhealthy, they can either recede or become swollen and red. In later stages, the supporting bone is destroyed and your teeth will shift, loosen, or fall out. These changes not only affect your ability to chew and speak. They also spoil your smile.
Periodontal diseases are ongoing infections of the gums that gradually destroy the support of your natural teeth. Periodontal disease affects one or more of the periodontal tissues: alveolar bone, periodontal ligament, cementum, or gingiva. While there are many diseases which affect the tooth-supporting structures, plaque-induced inflammatory lesions make up the majority of periodontal issues, and are divided into two categories: gingivitis and periodontitis. While gingivitis, the less serious of the diseases, may never progress into periodontitis, it always precedes periodontitis.
Dental plaque is the primary cause of periodontitis in genetically-susceptible individuals. Plaque is a sticky colorless film, composed primarily of food particles and various types of bacteria, which adhere to your teeth at and below the gum line. Plaque constantly forms on your teeth, even minutes after cleaning. Bacteria found in plaque produce toxins or poisons that irritate the gums. Gums may become inflamed, red, swollen, and bleed easily. If this irritation is prolonged, the gums separate from the teeth causing pockets (spaces) to form. If daily brushing and flossing is neglected, plaque can also harden into a rough, porous substance known as calculus (or tartar). This can occur both above and below the gum line.
If gingivitis progresses into periodontitis, the supporting gum tissue and bone that holds teeth in place deteriorates. The progressive loss of this bone, the alveolar, can lead to loosening and subsequent loss of teeth. Periodontitis is affected by bacteria that adhere to the tooth???s surface, along with a harmful immune response to these bacteria.
Periodontal disease is dangerous in that it is often painless and symptomless. 80% of Americans will be afflicted with periodontal disease by age 45, and 4 out of 5 patients with the disease are unaware they have it. It is important to maintain proper home oral care and regular dentist visits to reduce the risk of obtaining this disease.
Treatment Options
If you've been diagnosed with gum disease, there are a variety of treatment options depending on the details of your situation and the severity of the problem. We always start with the least invasive options, which are non-surgical. However, in more serious cases, surgery may be necessary.
The Body-Mouth Connection
Research has recently proven what dentists have long suspected: that there is a strong connection between periodontal disease and other chronic conditions such as diabetes, heart disease and osteoporosis.
Periodontal disease is characterized by inflammation of the gum tissue, presence of disease-causing bacteria, and infection below the gum line. Infections and bacteria in the mouth can spread throughout the body and lead to a host of problematic health issues. Therefore, maintaining excellent oral hygiene and reducing the progression of periodontal disease through treatment will have benefits beyond preventing gum disease and bone loss. It can also save you from the chance of developing another serious condition.
Preventing Gum Disease
Adults over the age of 35 lose more teeth to gum diseases than from cavities. At least three out of four adults are affected at some time in their life. The best way to prevent cavities and periodontal diseases is by daily thorough tooth brushing and flossing techniques and regular professional examinations and cleanings. Unfortunately, even with the most diligent home dental care, people can still develop some form of periodontal disease. Once this disease starts, professional intervention is necessary to prevent its progress.
Other important factors that can negatively affect the health of your gums include: tobacco usage, stress, clenching and grinding teeth, some medications, and poor nutrition.
Periodontal Disease & Tobacco
You are probably familiar with the links between tobacco use and lung disease, cancer, and heart disease. Current studies have now also linked periodontal disease with tobacco usage. Cases of periodontal disease are more severe in smokers and tobacco-user than those of non-users of tobacco. There is a greater incidence of calculus formation on teeth, deeper pockets between gums and teeth, and a greater loss of the bone and fibers that hold teeth in your mouth. In addition, your chance of developing oral cancer increases with the use of smokeless tobacco.
Chemicals in tobacco such as nicotine and tar also slow down healing and the predictability of success following periodontal treatment. Quitting smoking and tobacco-use can have innumerous benefits for your overall and periodontal health.
Oral Hygiene
How to Brush
While brushing the outside surfaces of your teeth, position the brush at a 45-degree angle where your gums and teeth meet. Gently move the brush in a circular motion several times using small, gentle strokes. Use some pressure while putting the bristles between the teeth, but not so much pressure that you feel any discomfort. When you are done cleaning the outside surfaces of all your teeth, follow the same directions while cleaning the inside of the back teeth.
To clean the inside surfaces of the upper and lower front teeth, hold the brush vertically. Make several gentle back-and-forth strokes over each tooth. Don't forget to gently brush the surrounding gum tissue.
Next you will clean the biting surfaces of your teeth. To do this, use short, gentle strokes. Change the position of the brush as often as necessary to reach and clean all surfaces. Try to watch yourself in the mirror to make sure you clean each surface. After you are done, rinse vigorously to remove any plaque you might have loosened while brushing.
If you have any pain while brushing or have any questions about how to brush properly, please be sure to call the office.
How to Floss
Periodontal disease usually appears between the teeth where your toothbrush cannot reach. Flossing is a very effective way to remove plaque from those surfaces. However, it is important to develop the proper technique. The following instructions will help you, but remember it takes time and practice.
Start with a piece of floss (waxed is easier) about 18" long. Lightly wrap most of the floss around the middle finger of one hand. Wrap the rest of the floss around the middle finger of the other hand.
To clean the upper teeth, hold the floss tightly between the thumb and forefinger of each hand. Gently insert the floss tightly between the teeth using a back-and-forth motion. Do not force the floss or try to snap it in to place. Bring the floss to the gum line then curve it into a C-shape against one tooth. Slide it into the space between the gum and the tooth until you feel light resistance. Move the floss up and down on the side of one tooth. Remember there are two tooth surfaces that need to be cleaned in each space. Continue to floss each side of all the upper teeth. Be careful not to cut the gum tissue between the teeth. As the floss becomes soiled, turn from one finger to the other to get a fresh section.
To clean between the bottom teeth, guide the floss using the forefinger of both hands. Do not forget the back side of the last tooth on both sides, upper and lower.
When you are done, rinse vigorously with water to remove plaque and food particles. Do not be alarmed if during the first week of flossing your gums bleed or are a little sore. If your gums hurt while flossing you could be doing it too hard or pinching the gum. As you floss daily and remove the plaque your gums will heal and the bleeding should stop.
Caring For Sensitive Teeth
Sometimes after dental treatment, teeth are sensitive to hot and cold. If the mouth is kept clean, this sensation should not last long. However, if the mouth is not kept clean, the sensitivity will remain and could become more severe. If your teeth are especially sensitive, consult with your health care professional. A medicated toothpaste or mouth rinse made especially for sensitive teeth may be recommended.
Choosing Oral Hygiene Products
There are so many products on the market that choosing the right one can be difficult. Here are some suggestions for selecting dental care products that will work for most patients:
- Automatic and "high-tech" electronic toothbrushes are safe and effective for the majority of users. Oral irrigators (water spraying devices) will rinse your mouth thoroughly, but will not remove plaque. You need to brush and floss in conjunction with the irrigator. We see excellent results with the electric toothbrushes “Sonicare” and “Interplak.”
- Some toothbrushes have a rubber tip on the handle that is used to massage the gums after brushing. There are also tiny brushes (interproximal toothbrushes) that clean between your teeth. If these are used improperly you could injure the gums, so be sure to discuss proper use with your health care professional.
- If used in conjunction with brushing and flossing, fluoride toothpastes and mouth rinses can reduce tooth decay by as much as 40 percent. Remember, these rinses are not recommended for children under six years of age.
- Tartar control toothpastes will reduce tartar above the gum line, but because gum disease starts below the gum line, these products have not been proven to reduce the early stage of gum disease.
- Anti-plaque rinses, approved by the American Dental Association, contain agents that may help control signs of early gum disease. Use these in conjunction with brushing and flossing.
Your health care professional is the best person to help you select the right products that are best for you.
