Gum Disease

Being diagnosed with periodontal (gum) disease is very common among adults in the U.S.  The effects of periodontal disease can range from something simple, like gum inflammation, to more serious issues that results in major damage to the soft tissue and bone that support the teeth.

The good news is that you have options. How you gum disease progresses or heals depends a great deal on how well you care for your teeth and gums every day, through regular brushing and flossing habits.

What causes gum disease?

The human mouth is full of bacteria. The combination of bacteria, mucus and other partciles constantly form a sticky, colorless “plaque” on teeth. Regular brushing and flossing help get rid of plaque. Plaque that is not removed can form a “tartar” that brushing can’t clean. Only professional cleaning by a dentist or dental hygienist can remove tartar.

Gingivitis

The longer plaque and tartar remain on teeth without treatment, the more harmful they become. The bacteria eventually causes inflammation of the gums called “gingivitis”. With gingivitis, gums become red, swollen and can bleed easily. Gingivitis is a mild form of gum disease, and can usually be reversed with daily flossing and brushing, and regular teeth cleaning by a dentist or dental or hygienist. This level of gum disease does not usually include bone loss or tissue holding teeth in place.

Periodontitis

Gingivitis that is not treated in a timely manner can progress to periodontitis, which means inflammation around the tooth. At this stage of gum disease, gums pull away from the teeth and create spaces called pockets, than can become infected. The body’s immune system fights the bacteria as the plaque spreads and grows beneath the gum line. The body’s natural response to infection as well as bacterial toxins start to break down the connective tissue and bone that holds the teeth in place. If not treated at this stage, bones, gums, and supportive tissue are destroyed. The teeth may become loose and have to be removed.

Risk Factors:

  • Smoking
  • Hormonal changes in girls/women
  • Diabetes
  • Other illnesses
  • Medications
  • Genetic susceptibility

How do I know if I have gum disease?

Common symptoms of gum disease include:

  • Red or swollen gums
  • Bad breath that won’t go away
  • Tender or bleeding gums
  • Painful chewing
  • Loose teeth
  • Sensitive teeth
  • Receding gums or longer appearing teeth

Any of these symptoms may indicate a more serious problem, which should be checked out by a dentist.
How is gum disease treated?

The main goal of any dental treatment is to control the infection.  The length and type of treatment depends on the extent of the gum disease. All types of treatment require that the patient keep up daily dental care at home. The dentist may suggest changing certain lifestyle behaviors as a way to improve the outcome of the treatment.

Deep Cleaning

Dentists, periodontists or dental hygienists remove plaque through a deep-cleaning method called scaling and root planning. Scaling is the process where tartar is scraped off the teeth from above and below the gum line. Root planing removes rough spots on the tooth root where germs gather, and helps remove bacteria that contribute to the disease.  Some cases may warrant using a laser to remove plaque and tartar. This procedure often results in less bleeding, swelling and discomfort compared to traditional deep cleaning methods.

Medications

Medications may be used with treatments that include scaling and root planing, but cannot always take the place of surgery. The dentist or periodontist may suggest surgical treatments depending on how far the disease has progressed.

Medications

What is it?

Why is it used?

How is it used?

Prescription antimicrobial mouthrinse

A prescription mouthrinse containing an antimicrobial called chlorhexidine

To control bacteria when treating gingivitis and after gum surgery

It’s used like a regular mouthwash.

Antiseptic chip

A tiny piece of gelatin filled with the medicine chlorhexidine

To control bacteria and reduce the size of periodontal pockets

After root planing, it’s placed in the pockets where the medicine is slowly released over time.

Antibiotic gel

A gel that contains the antibiotic doxycycline

To control bacteria and reduce the size of periodontal pockets

The periodontist puts it in the pockets after scaling and root planing. The antibiotic is released slowly over a period of about seven days.

Antibiotic microspheres

Tiny, round particles that contain the antibiotic minocycline

To control bacteria and reduce the size of periodontal pockets

The periodontist puts the microspheres into the pockets after scaling and root planing. The particles release minocycline slowly over time.

Enzyme suppressant

A low dose of the medication doxycycline that keeps destructive enzymes in check

To hold back the body’s enzyme response — If not controlled, certain enzymes can break down gum tissue

This medication is in tablet form. It is used in combination with scaling and root planing.

Oral antibiotics

Antibiotic tablets or capsules

For the short term treatment of an acute or locally persistent periodontal infection

These come as tablets or capsules and are taken by mouth.

Source: National Institute of Dental and Craniofacial Research


Surgical Treatments for Gum Disease

Flap Surgery

If inflammation and deep pockets remain after treatment with deep cleaning and medications, surgery may be necessary. This surgery, a very common treatment for gum disease, involves lifting back the gums and removing the tartar. The gums are then sutured back in place so that the tissue will fit snugly around the tooth again. After surgery the gums heal and then fit more tightly around the tooth. This will sometimes result in teeth appearing longer.

Bone and Tissue Grafts

Bone and tissue grafts help to regenerate any bone or gum tissue lost to periodontitis.  Bone grafting is when natural or synthetic bone is placed in the area of bone loss, and can help promote bone growth.  A technique used alongside bone grafting is guided tissue regeneration. For this procedure, a small piece of mesh-like material is inserted between the bone and gum tissue. This material keeps the gum tissue from growing in the area where the bone should be, so the bone and connective tissue can regrow. Proteins that help your body naturally regrow bone, called growth factors, may also be used. In cases where gum tissue has been lost, a soft tissue graft may be suggested. This procedure uses synthetic material or tissue taken from another area of your mouth to cover exposed tooth roots.

How can I keep my teeth and gums healthy?

  • Brush your teeth twice a day
  • Floss regularly to remove plaque from between teeth
  • Visit the dentist routinely for check-ups and professional cleaning
  • Don’t smoke

 

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