According to
information from the American Dental Association,
three out of four Americans over age 35 have some form of periodontal disease,
the major cause of tooth loss and bad breath (halitosis) in adults. Gingivitis is the mildest form of
periodontal disease that, if left untreated, can progress to
periodontitis, the loss of bone
and tissues that support the tooth.
Periodontal disease has three stages, categorized by the extent of bone loss: mild moderate, and advanced. If only one or a few teeth are effected, it is localized. If all the teeth are involved, it is generalized.
Bacteria that accumulate at and below the gum line cause
periodontitis. The
bacteria release toxic substances that trigger the breakdown of the gum and
bone. The body responds with an inflammatory response in which it essentially
turns on itself and destructs the bone and tissues around the teeth. This is the
body's way of warding off infectious agents.
When this happens the gum separates from the teeth, forming a gap called a periodontal pocket. If left untreated,
periodontitis can lead not only to tooth loss but can also aggravate systemic illnesses. The signs of periodontitis may include:
- Bleeding
gums
when brushing or flossing
- Red, tender or swollen gums
-
Bad breath (halitosis) or bad taste
- Receding gums (gums that have pulled away from the
teeth)
- Loose teeth
- Teeth that have migrated from their original positions
- Tooth loss
Very often, however, people are not aware that they should see a periodontics professional because gum disease
can progress without pain. It is possible to not exhibit warning signs and still
have periodontitis. That is why it is very important to have routine periodontal
screenings so that the early signs of the disease can be detected and
treated before it becomes a major problem.
Periodontal Treatment
Periodontitis is treated in three phases. The first phase involves stopping
the disease activity and progression of bone loss. The bacterial deposits
(plaque and tartar) that formed above and underneath the gums need to be removed
and the root surfaces of the teeth smoothed to enhance healing and deter future
plaque retention.
This
periodontal treatment is called scaling and root planing. During this
phase, a dentist will review the patient's oral hygiene
techniques, and give them advice on how to modify certain risk factors
associated with periodontal disease.
If the periodontal disease is more advanced, surgical treatment may be
needed. The purpose of this phase of periodontal treatment is to create an environment
that is more amenable to health and, if possible, bring back some of the bone
that was lost to the disease. In some forms of
periodontitis, antibiotic
treatment may be used. If this is the case, a bacterial culture may be
required to test for harmful bacteria and to establish what antibiotics they are
susceptible to.
Periodontal disease is a chronic condition that, like many others, has to be
closely monitored, even after active treatment.
The third (maintenance) phase is
crucial to the success of any periodontal treatment. Daily brushing and flossing is
essential in controlling ever-developing plaque and bad breath, as is periodic periodontal
maintenance care with a professional scaling of the teeth. Periodontal status
will be closely monitored, so that changes can be identified and treated as early
as possible.
Everyone should be routinely screened for
periodontitis. All
dentists are qualified in detecting and treating the early stages of periodontitis, but if an individual suspects that they are at risk, or they know they
have gingivitis, they may want to see a periodontist who has advanced training in the diagnosis and treatment of periodontal conditions.
