Bleeding Gums, Stop the Battle of Gum Disease
You probably know people who are always pushing hard, taking every opening, never giving up. That describes gum disease. It's relentless, ongoing, and bleeding gums aren't the worst of it.
That's why, when you're diagnosed with periodontal disease, it seems you're in the dentist's office all the time. And it isn't far from the truth, because you'll need to be as focused and relentless as the gum disease in order to defeat it.
Your dentist can tell you all you need to know about treatment. As your care proceeds, you'll learn even more. Your dentist will use the most advanced treatments available to treat your bleeding gums, and you'll continue your care at home, every day.
Periodontal treatment seems endless because the gum disease process is ongoing. While we're containing bacterial infection in one part of your mouth, your dentist will also try to stop it from gaining control in another area. It's a constant battle, one you're a key part of.
The first step is determining if you have periodontal disease. Millions of Americans suffer with gum disease, so if you do, you're not alone. And even with constant attention, periodontal disease can keep recurring, again and again.
So it's important that you keep every appointment. Your dental professionals will do their best to accommodate your schedule, but remember, gum disease doesn't cut you any slack and often gives no advance warning. So if you want to avoid bleeding gums, you'll have to make the commitment to see your dentist, often.
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Periodontal Disease: Preventing Tooth And Bone Loss
The best way to control periodontal disease and to help prevent tooth loss is with early detection and treatment. Three out of four people are afflicted by periodontal disease at some point in their lives, so everyone should be tested. After reviewing a patient's dental and medical history, the dental care provider or periodontist will conduct a thorough clinical intraoral exam called a periodontal charting.
This consists of taking a series of measurements around each tooth. Unless the gums are very inflamed and sensitive, the periodontal charting causes minimal discomfort.
The space between the gum and the tooth is measured using a periodontal probe. This space is called the probing or pocket depth. In a healthy mouth, this space should be between 0 and 3 millimeters.
The amount of recession or loss of gum around each tooth is measured. In healthy mouths, the gum tissue should be at the junction of where the crown of the tooth meets the root. The two measurements (pocket depth and recession) are then added to calculate the amount of attachment loss around each tooth. The greater the amount of attachment loss, the more advanced the periodontal disease.
While completing the periodontal charting, a dentist will evaluate the conditions of an individual's gums. Healthy gums are pale pink, firm, and immobile. The gums should not bleed during the probing exam. Bleeding gums during this exam are a sign of gum inflammation, gingivitis or periodontitis.
The dentist will also measure tooth mobility. Under normal functional conditions, teeth should not move. Tooth mobility is a sign that there has been bone loss around the teeth or that the biting forces are too strong. If so, the dentist may also assess a patient's occlusion, or bite. If the bite has changed or if the forces on the teeth are too strong, there may be an acceleration of bone loss around the teeth.
A full mouth series of X-rays (approximately 20 films) are also indispensable in a periodontal examination.
In addition to identifying areas with cavities, bone infection, tumors, or developmental abnormalities, X-rays help reveal if bone loss has resulted from periodontal disease. The crest of the teeth's supporting bone is normally 2 mm below where the crown of the tooth meets the root. A greater distance indicates a history of bone loss.
Although bacterial samples are not usually taken for diagnosis of periodontal disease , under certain circumstances, it may be necessary to take a bacterial culture from a plaque sample. This is especially valuable to help detect sites at high risk for disease progression or if conventional treatment is not working.
The culture is analyzed in a laboratory for the presence of certain bacteria that are known to contribute to gum disease. Actually, of the more than 300 different types of bacteria normally found in the mouth, there are only about 13 that are known to be associated with causing periodontal disease. After identifying the specific disease-causing bacteria, the laboratory can test to determine what antibiotics they are susceptible to.
Depending on the risk factors (see article " Risk Factors for Periodontal Disease") involved and a person's specific situation, other tests may also be required. Under certain circumstances, a dentist may require diagnostic casts (molds of one's teeth), medical laboratory tests, medical consultation, or genetic testing.
After completing the periodontal examination, the dentist will be able to discuss with the patient the diagnosis, treatment alternatives, potential complications, and expected results. The key to long-term periodontal health is early diagnosis and treatment. Because everyone is at risk of developing periodontitis, everyone should be routinely tested.
By Laura Minsk, DMD