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Periodontitis, The Leading Cause of Gum Disease

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.

By Laura Minsk, DMD

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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