Local Dental Care - Dental Gum Disease

Periodontists and Periodontics 101, Dental Specialties

Periodontics is one of the eight dental specialties recognized by the American Dental Association. Periodontists specialize in Periodontal work. Periodontal comes from two Greek words that mean "around the tooth." The periodontium refers to the anatomical structures around teeth: the gum, bone, and the periodontal ligament that attaches the tooth to the bone.

Periodontists are dentists that have three additional years of training to specialize in the prevention, diagnosis, and treatment of the diseases that affect the gums and supporting structures of the teeth. Periodontists also are experts in the placement and treatment of dental implants.

Periodontal disease is the major cause of tooth loss in adults. According to the American Dental Association, three out of four Americans over age 35 have some form of periodontal disease. Gingivitis is the mildest form of periodontal disease and the most common infection in the world. But if left untreated, it can progress to periodontitis -- the loss of bone and tissues that support the teeth.

Periodontal diseases can be localized to a few teeth or generalized, in which most of the teeth are affected. It can affect people of all ages and without proper periodontal treatment, this disease can result in tooth loss and even complications of systemic diseases.

There are several different forms of periodontal disease. Each can progress at different rates. The same disease can have periods when it develops slowly and others when it progresses quite rapidly. Most of the time, periodontal diseases are painless. But they may have acute episodes that result in severe pain and a dental emergency.

The rate of periodontal disease progression is dependent on a multitude of factors, including the presence of certain risk factors that make people more susceptible to periodontal breakdown.

All periodontal disease is caused by an accumulation of bacteria at and below the gum line. The bacteria release toxic substances that trigger the breakdown of the gum and bone. The gums become red, swollen, and bleed easily. The gum tissue then separates from the teeth, forming a gap called a periodontal pocket or exposing the root surface in what is called recession.

The body responds to the bacteria 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. The teeth can start moving and shifting and eventually if there is advanced bone loss, the teeth can be lost.

Periodontal diseases are treated in three phases by periodontists. The first is to stop the disease activity and progression of bone loss. In the early stages of periodontal disease, scaling and root planning may be the only treatment needed.

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. During this phase of treatment, the periodontist will review the oral hygiene technique, and give advice on the modification of certain risk factors associated with periodontal disease.

If the periodontal disease is more advanced, surgical treatment may be indicated. The purpose of this phase of treatment is to create an environment that is more amenable to health and, if possible, regenerate some of the bone that was lost to the disease.

In some forms of periodontitis, antibiotic treatment may be indicated. 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 disease that, like many other chronic diseases, has to be closely monitored, even after active treatment. The maintenance or third phase is crucial to the success of any treatment.

Daily brushing and flossing is essential in controlling the ever-developing plaque. So is periodic periodontal maintenance care with a Periodontists scaling of the teeth. The periodontal status has to be closely monitored so that changes can be identified and treated as early as possible.

Everyone should be routinely screened for periodontal disease. All periodontists are qualified in detecting and treating the early stages of periodontal disease, but if you suspect that you are at risk, or you know you have periodontal disease, you may want to see a periodontist who has extensive advanced training in the diagnoses and treatment of periodontal diseases.

With today's Periodontists knowledge about periodontal diseases and the new advances in treatment, you can expect to keep your teeth for a lifetime and ward off the effects that periodontal disease may have on your overall health.

By Laura Minsk, DMD

Gum Disease and Early Diabetes Detection

In many cases it's the dentist - and not the physician - who has the first opportunity to detect diabetes early, because diabetics are especially prone to dental health problems.

Swollen, tender, receding and bleeding gums, loose teeth, and a sore tongue may not just be signs of poor dental hygiene. They may be danger signals for diabetes, too.

If you have any of these symptoms, you may be one of the estimated 11 million people in North America who already have diabetes, or you may be one of the 600,000 who will be diagnosed this year.

Diabetes occurs when a gland called the pancreas fails to produce sufficient amounts of the hormone, insulin, to regulate blood sugar levels. In other words: Diabetics have too little insulin and too much sugar in their blood.

When this happens, the body tissue can't convert the sugar it needs into energy. The blood stream then fills with this unused sugar and the result is diabetes - a disease medical journals often describe as the "forever" disease.

A serious illness which respects neither age, sex, race nor income level, diabetes is the leading cause of blindness in people 20 to 65 years old and can lead to kidney failure, heart attacks and even death.

But outside the dental community, few people realize that diabetics have more than their share of tooth and periodontal (gum) problems. This fact is especially true for undiagnosed diabetics or those who have failed to control their disease adequately with insulin and/or diet and exercise.

Periodontal disease among diabetics progresses rapidly, recurs frequently, and heals slowly. The resistance to treatment can lead to loosened teeth and premature tooth loss.

Your regular dental office visits provide the best chance for early detection of many health problems, including diabetes. If you have a diabetic tendency, your dentist may very well refer you to your physician - another good reason to keep your prescribed dental recall and dental cleaning appointments faithfully!

If you are diabetic, it's important that you keep your dental health history up-to-date, exercise regularly, and eat a diet that provides good nutrition:

• Have regular meals and snack times. Don't skip meals.
• Avoid sweets (cake, candy, pie, ice cream).
• Limit use of animal fats and trim fat off meats. Avoid butter, cream, egg yolks.
• Bake and broil rather than fry foods.
• Don't use alcohol, wine, or beer without your doctor's permission.
• See your dentist regularly so small dental problems can be taken care of with a local anesthetic.

Teeth don't heal themselves, so small problems turn into big ones if left untreated. Major oral surgery requires a general anesthetic which means "no food prior to surgery" - a problem for diabetics.

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.