Gum Disease: Serious But Treatable - Although gum disease is terribly pervasive, it's also preventable. Conservative estimates report that up to 80% of people unknowingly have some amount of chronic gum disease.

Gum Disease: Serious But Treatable

At least 80% of the population has some degree of gum disease and most don’t know it. Gum disease is responsible for up to 70% of adult tooth loss, and it does not give clear warning signs that an untrained eye would notice. A Periodontist must do a thorough and complete examination to detect it; especially in it’s early stages. Gum disease is similar to high blood pressure, or heart disease, by the time the person who has it notices symptoms it is in its advanced stages.

Gum disease has been implicated as a causative factor in heart disease, stroke, diabetes, pre-mature births, and low birth weight. It is an infection of the gums and jawbones. The bacteria, and chemical by-products of your bodies attempt to fight the bacteria, can enter the blood stream and cause serious problems in distant parts of the body. It is critical to have the teeth cleaned and a thorough examination a minimum of twice a year, and it is critical that you do a thorough job at home cleaning the teeth twice daily. The good news is that gum disease can be treated and prevented. Today there are numerous aids available to help us, which include special toothbrushes, toothpastes, rinses and even prescription medications can help. A periodontist can decide the appropriate treatment method only after examination of your condition.

Periodontal Maintenance

Periodontal disease is an infection of the gums and supporting structures of the teeth caused by bacteria. If left untreated, gum disease will gradually destroy the support of your natural teeth. Various disease entities require different treatment approaches. Dental plaque is the primary cause of gum disease in genetically susceptible individuals. Daily brushing and flossing will prevent most periodontal conditions.

Why is oral hygiene so important?

Adults over 35 lose more teeth from gum disease (periodontal disease) than from cavities. Three out of four adults are affected at some time in their lives. The best way to prevent cavities and periodontal disease is by proper daily tooth brushing and flossing.

Periodontal disease and decay are caused by bacterial plaque. Plaque is a colorless film that sticks to your teeth at the gum line, and it constantly forms on teeth. If not carefully removed by daily brushing and flossing, plaque hardens into a rough, porous substance known as calculus (or tartar).

Periodontal Disease

The bacteria found in plaque produces toxins or poisons that irritate the gums and may cause them to turn red, swell, and bleed. Prolonged irritation can cause the gums to separate from teeth, which creates pockets (spaces) where the bacteria can spread rapidly. As periodontal diseases progress, the supporting gum tissue and bone that holds teeth in place deteriorate. If left untreated, this leads to tooth loss. Gum disease has also been linked to stroke, heart attack, and complications for diabetics and pregnant women.

Preventing Gum Disease

The best ways to prevent gum disease is effective daily brushing and flossing, as well as regular professional examinations and cleanings. Unfortunately, even with the most diligent home dental care, some people still develop some form of periodontal disease. Once the disease starts, professional intervention is necessary to prevent progression.

Other important factors affecting the health of your gums include:

Smoking

Diabetes

Stress

Clenching and grinding teeth

Medication

Poor nutrition

Periodontal Treatment

The most beautiful smile won't last unless you maintain the health of supporting gum tissues. Red, swollen, and inflamed gums may indicate gum disease, the leading cause of tooth loss in the United States. Fuller Periodontics and Implant Dentistry offers periodontal treatment, including scaling, root planing, Arestin antibiotic, and soft tissue reduction to stop gum disease, remove damaged tissues, and restore healthy gums.

We meticulously monitor changes in your gum health with computerized record keeping that leaves no room for oversight. In the past, delivering deep, effective cleaning to patients with gum tissue damage was difficult. However, new non-surgical treatments, including Ultrasonic Scalers and a wide variety of irrigants, have proven highly effective for eradicating and preventing recurrence of periodontal disease.

Diagnosis

Periodontal disease is diagnosed by your dentist or dental hygienist during a periodontal examination. This type of exam should always be part of your regular dental check-up.

A periodontal probe (small dental instrument) is gently used to measure the sulcus (pocket or space) between the tooth and the gums. The depth of a healthy sulcus measures three millimeters or less and does not bleed. The periodontal probe helps indicate if pockets are deeper than three millimeters. As periodontal disease progresses, the pockets usually get deeper.

Your dentist or hygienist will use pocket depths, amount of bleeding, inflammation, tooth mobility, etc., to make a diagnosis that will fall into a category below:

Gingivitis

Gingivitis is the first stage of periodontal disease. Plaque and its toxin by-products irritate the gums, making them tender, inflamed, and likely to bleed.

Periodontitis

Plaque hardens into calculus (tartar). As calculus and plaque continue to build up, the gums begin to recede from the teeth. Deeper pockets form between the gums and teeth and become filled with bacteria and pus. The gums become very irritated, inflamed, and bleed easily. Slight to moderate bone loss may be present.

Advanced Periodontitis

The teeth lose more support as the gums, bone, and periodontal ligament continue to be destroyed. Unless treated, the affected teeth will become very loose and may be lost. Generalized moderate to severe bone loss may be present.

Treatment

Periodontal treatment methods depend upon the type and severity of the disease. Your dentist and dental hygienist will evaluate for periodontal disease and recommend the appropriate treatment.

Periodontal disease progresses as the sulcus (pocket or space) between the tooth and gums gets filled with bacteria, plaque, and tartar, causing irritation to the surrounding tissues. When these irritants remain in the pocket space, they can cause damage to the gums and eventually, the bone that supports the teeth!

If the disease is caught in the early stages of gingivitis, and no damage has been done, one to two regular cleanings will be recommended. You will also be given instructions on improving your daily oral hygiene habits and having regular dental cleanings.

If the disease has progressed to more advanced stages, a special periodontal cleaning called scaling and root planing (deep cleaning) will be recommended. It is usually done one quadrant of the mouth at a time while the area is numb. In this procedure, tartar, plaque, and toxins are removed from above and below the gum line (scaling) and rough spots on root surfaces are made smooth (planing). This procedure helps gum tissue to heal and pockets to shrink. Medications, special medicated mouth rinses, and an electric tooth brush may be recommended to help control infection and healing.

If the pockets do not heal after scaling and root planing, periodontal surgery may be needed to reduce pocket depths, making teeth easier to clean. Your dentist may also recommend that you see a Periodontist (specialist of the gums and supporting bone).

Maintenance

It only takes twenty four hours for plaque that is not removed from your teeth to turn into calculus (tartar)! Daily home cleaning helps control plaque and tartar formation, but those hard to reach areas will always need special attention.

Once your periodontal treatment has been completed, your dentist and dental hygienist will recommend that you have regular maintenance cleanings (periodontal cleanings), usually four times a year. At these cleaning appointments, the pocket depths will be carefully checked to ensure that they are healthy. Plaque and calculus that is difficult for you to remove on a daily basis will be removed from above and below the gum line.

Your First Visit to Fuller Periodontics

If you’ve always dreaded going to the dentist, get ready to change your thinking. Our friendly staff will make you feel right at home and help you relax so that you can receive the dental treatment you deserve, without stress.

At your first visit, we’ll get to know you, find out your concerns, problem areas, and anxieties about dental treatment. You can settle back into our comfortable leather chairs and listen to the music or even a television program of your choice . Using our digital X-rays and manual measurements, we’ll get a thorough look at the interior of your mouth. You’ll see, too, on our convenient chairside monitors.

Either Dr. Fuller, Dr. Dettbarn, or our gentle hygienist will check your teeth and gums for signs of gum disease or damage, then clean your teeth to bring back their pearly shine. Dr. Fuller or Dr. Dettbarn will check your teeth for decay, bite analysis, and perform an oral cancer screening, We will then establish a comprehensive treatment plan and will decide together on the best course of action.

Your oral health care means as much to us as it does to you. Please call for an appointment today. (406) 651-GUMS (4867).

Dental Exam Summary

A comprehensive dental exam will be performed by your dentist at your initial dental visit. At regular check-up exams, your dentist and hygienist will include the following:

Medical history review: Knowing the status of any current medical conditions, new medications, and illnesses, gives us insight to your overall health and also your dental health.
Examination of diagnostic x-rays (radiographs): Essential for detection of decay, tumors, cysts, and bone loss. X-rays also help determine tooth and root positions.
Oral cancer screening: Check the face, neck, lips, tongue, throat, tissues, and gums for any signs of oral cancer.
Gum disease evaluation: Check the gums and bone around the teeth for any signs of periodontal disease.
Examination of tooth decay: All tooth surfaces will be checked for decay with special dental instruments.
Examination of existing restorations: Check current fillings, crowns, etc.
Removal of calculus (tartar): Calculus is hardened plaque that has been left on the tooth for sometime and is now firmly attached to the tooth surface. Calculus forms above and below the gum line, and can only be removed with special dental instruments.
Removal of plaque: Plaque is a sticky, almost invisible film that forms on the teeth. It is a growing colony of living bacteria, food debris, and saliva. The bacteria produce toxins (poisons) that inflame the gums. This inflammation is the start of periodontal disease!
Teeth polishing: Removes stain and plaque that is not otherwise removed during toothbrushing and scaling.
Oral hygiene recommendations: Review and recommend oral hygiene aids as needed (electric dental toothbrushes, special cleaning aids, fluorides, rinses, etc.).
Review dietary habits: Your eating habits play a very important role in your dental health.

Professional Dental Cleaning

Professional dental cleanings (dental prophylaxis) are usually performed by Registered Dental Hygienists. Your cleaning appointment will include a dental exam and the following:

Removal of calculus (tartar): Calculus is hardened plaque that has been left on the tooth for some time and is now firmly attached to the tooth surface. Calculus forms above and below the gum line and can only be removed with special dental instruments.

Removal of plaque: Plaque is a sticky, almost invisible film that forms on the teeth. It is a growing colony of living bacteria, food debris, and saliva. The bacteria produce toxins (poisons) that inflame the gums. This inflammation is the start of periodontal disease!

Teeth polishing: Remove stain and plaque that is not otherwise removed during tooth brushing and scaling.
Oral hygiene recommendations: Review and recommend oral hygiene aids as needed. (Electric toothbrushes, special periodontal brushes, fluorides, rinses, etc.)

Why do I need both types of X-rays?

Panoramic X-rays show a view of your entire mouth in one film (picture); periapical, or bitewing X-rays give a more detailed view of one small area, including cavities between teeth. Dr. Fuller and Dettbarn use the two types of digital X-rays together to get a clearer understanding of what's happening overall in your mouth.

Gum Disease Raises Stroke Risk

By Penny Stern, MD

NEW YORK (Reuters Health) - Gum disease, apart from being unsightly and uncomfortable, might significantly increase a person's risk of stroke, according to results of a national study.

Dr. Tiejian Wu from the State University of New York at Buffalo and colleagues examined the link between gum disease, or periodontitis, and risk of having a stroke in nearly 10,000 adults who participated in a large health survey between the early 1970s and 1992.

``We found that periodontitis was associated with an increased risk of stroke in a 21-year follow-up of US adults,'' Wu told Reuters Health in an interview.

Gum disease begins insidiously with gingivitis, characterized by swollen gums that easily bleed. Without treatment, the condition progresses to periodontitis, the inflammation of the tissues supporting the teeth. Eventually, bone and tissue loss can result.

What sets the process in motion is the presence of bacteria. It is these bacteria, according to Wu, that get into the bloodstream and can stimulate clotting. And other effects associated with the bacteria can damage the lining of blood vessels. All these events can increase the risk of stroke.

Stroke is characterized by either bleeding in the brain because of a ruptured vessel or impaired blood flow to a part of the brain when a vessel is blocked by a clot.

The investigators were not able to define exactly which bacteria are to blame for the destructive effects of the condition, because this information could not be determined based on the data collected as part of the original survey. But they expect that future research will serve ``to confirm the possible role of specific harmful microorganisms.''

So while Wu cautioned that ``the cause-effect relation is not conclusive at this point,'' he said that these findings indicate ``people may need to pay more attention to their oral health, as it may influence their systemic health.''

SOURCE: Archives of Internal Medicine 2000;160:2749-2755.

IGood oral hygiene practices and periodontal cleanings are essential in maintaining dental health and keeping periodontal disease under control!

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Patient of Ours with Severe Periodontal Inflammation

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