Periodontal Disease: Leading Cause of Adult Tooth Loss
Periodontal disease is a bacterial infection. Without proper dental care the bacteria that are present in plaque can infect the gums (gingivitis) and destroy the bone and tissues that support the teeth in what is called periodontitis-- the leading cause of tooth loss and bad breath (halitosis) in adults. In addition, gum disease has been linked to more serious health threats such as diabetes, cardiovascular disease, respiratory disease, and pre-term, low-birth weight babies.
Is periodontal disease contagious? Can it be passed from one person to another like tuberculosis or meningitis? Can you get periodontal disease by kissing someone who has it? The answer to all these questions is YES.
In a dental care article published in the Journal of the American Dental Association, it was revealed that periodontitis might be passed from parents to children and between intimate partners.
The bacteria that inhabit the periodontal pockets are also present on the oral soft tissues, teeth, tongue and saliva. They can be transferred from one person to another through saliva, intimate kissing, sharing of food, utensils, or toothbrushes, and can result in exposure to saliva that contain the bacteria that cause periodontal disease.
Based on these findings and the fact that periodontal disease has a genetic component, it is recommended that if one family member has periodontitis, all family members see a dental care professional or periodontist for a periodontal screening. Parents need to know that gum disease and halitosis are not just adult health problems and that children can also be affected.
To prevent transmission of periodontitis between family members or intimate partners, it is important to follow proper dental care and oral hygiene techniques that include daily brushing and flossing and to see a dental care provider routinely for professional cleanings and examinations.
By Laura Minsk, DMD
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Smoking and Gum Disease
The systemic risks of tobacco use are well known. Tobacco use can increase the risk for cancer, lung disease, and heart disease. But whether you smoke, dip, or chew tobacco, it also affects the oral cavity in a variety of ways. It contributes to oral cancer, stains the teeth, and contributes to tartar deposits, bad breath, and a loss of taste and smell.
Tobacco use causes inflammation of the soft tissues of the mouth, ulcers, recession, and other oral lesions. Tobacco users are two times more likely to develop periodontitis, and ten times more likely to develop acute necrotizing ulcerative gingivitis (ANUG). They also are more likely to lose teeth than those who don't smoke. Smoking is the number one most significant risk factor in the development and progression of periodontal disease.
Tobacco smoking causes periodontal bone loss that is not related to the amount of gum inflammation or plaque accumulation. Although the periodontal disease may be advanced, the classical signs of gum inflammation (redness, bleeding gums, etc.) are not usually as evident in tobacco smokers. Thus, prevention and early detection are more difficult.
Tobacco smoking has a direct effect on the oral tissues and it can alter the immune response. Although smokers do benefit from periodontal treatment, the healing is often delayed and the results are less predictable. In addition, the success rates of periodontal and implant treatment are reduced in people who use tobacco products. The amount of complications is related to the amount of daily tobacco exposure, and the number of years the person has been exposed.
The use of tobacco products can increase the risk of periodontal disease:
1. It weakens the immune system: Tobacco products suppress the body's ability to fight infection. Carbon monoxide (a major byproduct of cigarette smoke) reduces oxygen concentration and inhibits the movement of white blood cells. This reduces the capacity of the white blood cells to fight bacteria (including the bacteria that cause periodontal disease), and delays healing.
2. It masks signs of infection: Tobacco reduces the ability of blood vessels to carry infection fighting cells, nutrients, and oxygen to the tissues. As a result, the typical signs of periodontal disease (redness, swelling, and bleeding of the gums) are masked. People who smoke may have periodontal disease that is harder to diagnose.
3. It increases calculus formation: Smoking can cause more calculus (tartar) accumulation that if not removed promptly can lead to more plaque build-up and periodontal disease.
4. It reduces healing: Nicotine and other chemicals can be absorbed directly by the root surfaces of the teeth and reduce the ability of cells to reattach to the root surface during healing.
Besides the obvious health benefits of discontinuing tobacco use, quitting can also reduce the risk of oral cancer and the detrimental effects of tobacco on the gums and bone that support the teeth. In addition, another incentive to stop smoking is that former smokers respond similarly to never smokers to periodontal treatment.
Because there is a physical and psychological addiction to tobacco, quitting can be very difficult. But millions of Americans quit smoking every year. There are aids available that reduce the craving for tobacco. These include the use of systemic medications, the nicotine patch, the nicotine gum, the nicotine inhaler, and the nasal spray. See your dentist or physician for aid in stopping tobacco use.
By Laura Minsk, DMD