GINGIVITIS & PERIODONTAL (GUM) DISEASE

Gingivitis is a bacterial infection that affects the gums when the toxins contained in plaque begin to irritate and inflame the gum tissues. Gingivitis often leads to periodontal (gum) disease, which is a common inflammatory condition that affects the supporting and surrounding soft tissues of the tooth.

Gingivitis often leads to periodontal (gum) disease, which is a common inflammatory condition that affects the supporting and surrounding soft tissues of the tooth. Once this bacterial infection colonizes in the gum pockets between the teeth, it becomes much more difficult to remove and treat.  

Gum disease is a progressive condition that eventually leads to the destruction of the connective tissue and jawbone. If left untreated, it can cause shifting teeth, loose teeth, and eventually, tooth loss. It is the leading cause of tooth loss among adults in the developed world and should always be promptly treated.

When left untreated, gingivitis can spread to below the gum line. When the gums become irritated by the toxins contained in plaque, a chronic inflammatory response causes the body to break down and destroy its own bone and soft tissue. 

There may be little or no symptoms as periodontal disease causes the teeth to separate from the infected gum tissue. Deepening pockets between the gums and teeth are generally indicative that soft tissue and bone is being destroyed by periodontal disease.

SIGNS OF GUM DISEASE

If you experience any of these signs and symptoms, it’s important to schedule an appointment with our practice without delay:

  • BLEEDING WHILE EATING OR BRUSHING – Unexplained bleeding while consuming food or during the course of daily cleaning is one of the most common signs of periodontal infection.

  • BAD BREATH – Continued bad breath that persists when a rigorous oral hygiene program is in place can be indicative of periodontitis, gingivitis or the beginnings of an infection in the gum tissues.

  • LONGER-LOOKING TEETH & GUM RECESSION – Periodontal disease can lead to gum recession. The toxins produced by bacteria can destroy the supporting tissue and bones, thus making the teeth look longer and the smile appear more “toothy.”

  • LOOSE TEETH – As this disease progresses and attacks the jawbone, (the anchor holding the teeth in place) the teeth may become loose or be lost altogether.

  • PAIN, REDNESS OR SWELLING – A periodontal infection may be present if the gums are swollen, red or painful for no apparent reason.

  • GANGRENE IN THE TISSUES – Gangrene is hard to self-diagnose but the dentist and periodontist will check for its presence in the soft tissues, alveolar bone and periodontal ligament.

  • RELATED HEALTH CONDITIONS – Heart disease, diabetes, osteopenia and osteoporosis are highly correlated with periodontitis and periodontal infections. The bacteria infection can spread through the blood stream and affect other parts of the body.

  • PUS – Pus oozing from between the teeth is a definitive sign that a periodontal infection is in progress. The pus is a result of the body trying to fight the bacterial infection.

PERIODONTAL EXAMINATION & DIAGNOSIS

Periodontal disease is diagnosed by your dentist or dental hygienist during a periodontal examination, which 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 probe helps indicate if pockets are deeper than they should be, and if they are progressing.

Your dentist or hygienist will use pocket depths, amount of bleeding, inflammation and tooth mobility 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 tartar. As tartar 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 OF GUM DISEASE

It is of paramount importance to halt the progression of periodontal disease before it causes further damage to the gum tissues and jawbone. The dentist will initially assess the whole mouth in order to ascertain the progress of the disease. When a diagnosis has been made, the dentist may treat the bacterial infection with antibiotics in conjunction with nonsurgical or surgical treatment, or both. Common treatments for periodontal disease include:

  • SCALING AND ROOT PLANING – To preserve the health of the gum tissue, the bacteria and tartar that initially caused the infection must be removed. The gum pockets will be cleaned and treated with antibiotics as necessary to help alleviate the infection. A prescription mouthwash may be incorporated into daily cleaning routines.

  • LASER TREATMENT – This can be used to reduce the size of the pockets between the teeth and the gums.

  • TISSUE REGENERATION – When the bone and gum tissues have been destroyed, regrowth can be actively encouraged using grafting procedures. A membrane may be inserted into the affected areas to assist in the regeneration process.

  • POCKET ELIMINATION SURGERY – Pocket elimination surgery (also known as flap surgery) is a surgical treatment that can be performed to reduce the pocket size between the teeth and gums. Surgery on the jawbone is another option to eliminate indentations in the bone that foster the colonization of bacteria.

  • DENTAL IMPLANTS – When teeth have been lost due to periodontal disease, the aesthetics and functionality of the mouth can be restored by implanting prosthetic teeth into the jawbone. Tissue regeneration procedures may be required prior to the placement of a dental implant to strengthen the bone.

COMMON CAUSES OF GUM DISEASE

There are genetic and environmental factors involved in the onset of gum disease, and in many cases, the risk of developing periodontitis can be significantly lowered by taking preventive measures.

 

Most Common Causes of Gum Disease:

POOR DENTAL HYGIENE – Preventing dental disease starts with good oral hygiene and a balanced diet. Prevention also includes regular dental visits which include exams, cleanings and X-rays.

TOBACCO USE – Research shows that smoking and tobacco use are some of the most significant factors in the development and progression of gum disease. In addition to smokers experiencing a slower recovery and healing rate, they are far more likely to suffer from tartar build-up, deep pockets in the gum tissue and significant bone loss.

GENETIC PREDISPOSITION – Despite practicing rigorous oral hygiene routines, as much as 30% of the population may have a strong genetic predisposition to gum disease. These individuals are six times more likely to develop periodontal disease than individuals with no genetic predisposition. Genetic tests can be used to determine susceptibility and early intervention can be performed to keep the oral cavity healthy.

PREGNANCY & MENOPAUSE – Hormonal changes experienced by the body can cause the gum tissue to become more sensitive, rendering them more susceptible to gum disease.

CHRONIC STRESS & POOR DIET – Stress lowers the ability of the immune system to fight off disease which means bacterial infection can beat the body’s defense system. Poor diet or malnutrition can also lower the body’s ability to fight periodontal infections, as well as negatively affecting the health of the gums.

DIABETES & UNDERLYING MEDICAL ISSUES – Many medical conditions can intensify or accelerate the onset and progression of gum disease including respiratory disease, heart disease, arthritis and osteoporosis. Diabetes hinders the body’s ability to utilize insulin, which makes the bacterial infection in the gums more difficult to control and cure.

GRINDING TEETH – The clenching or grinding of teeth can significantly damage the supporting tissue surrounding the teeth. Grinding one’s teeth is usually associated with a “bad bite” or the misalignment of the teeth. When an individual is suffering from gum disease, the additional destruction of gum tissue from grinding can accelerate the progression of the disease.

MEDICATION – Many drugs (including oral contraceptive pills, heart medicines, anti-depressants and steroids) affect the overall condition of teeth and gums, making them more susceptible to gum disease. Steroid use promotes gum overgrowth, which makes swelling more commonplace and allows bacteria to colonize more readily in the gum tissue.