Gum Disease: Gingivitis & Peridontitis

Gum diseasealso called periodontal diseaseis a problem for many people. Periodontal (meaning around the tooth ) disease begins with proliferation of bacteria that form in everyone 's mouth. These bacteria initially appear as plaque a soft, sticky, colorless film carried in the saliva that coats the teeth virtually all the time.

Unless plaque is cleaned and removed regularly by brushing and flossing, it hardens into tartar. That 's when bacterial toxins seep into the gums, causing an inflammation called gingivitis. The gums become red and bleed easily. Left untreated, gingivitis can eat into the bone and connective tissue beneath the gum line. When this happens, periodontal disease can cause acute damage, including the possible loss of teeth.

Dental professionals distinguish between two levels of periodontal disease:

• gingivitis: This is periodontal disease in its earliest, mildest stage. A person with gingivitis generally experiences little discomfort, but the gums redden, swell and bleed. As a result, the gums begin to pull back from the tooth. At this stage damage to tissue and bone has not occurred.
• periodontitis: This is a more advanced form of periodontal disease. It occurs over time, when plaque spreads and grows below the gum line. This is when gum disease can do major damage above and below the gum line.

Why Does Periodontal Disease Occur?

The bacteria in plaque contain numerous toxins that can irritate the gums and cause redness, swelling and bleeding. The body 's natural defense mechanism issues an immune response to these toxins. That 's why gum inflammation occurs; it 's the body 's natural way to fight infection. Without treatment, the toxins ultimately destroy the tissue and bone that anchor teeth in place. Deep pockets of infection around the teeth cause the gums to separate from the teeth. As more gum and bone is destroyed, the teeth begin to loosen.

Causes of Gum Disease

By far, the primary cause of gum disease is the bacteria in plaque. But gum disease has other causes as well:

• tobacco and smoking: Tobacco products and smoking are key contributors to the formation of oral bacteria.
• genetic predisposition: Research indicates that gum disease is inherited from your parents or grandparents. Be especially vigilant about practicing the best oral hygiene possible if periodontal disease runs in your family.
• stress: When we 're under stress, our bodies are already under assault. Therefore, the immune system may be slower to fight infection.
• medications: Some medications, including Dilantin^® and some steroids, can have an adverse effect on your oral hygiene. Inform your dentist of all medications you are currently taking.
• grinding teeth: Clenching or grinding teeth (bruxism) can put tremendous additional pressure on the underlying support tissue and bone, which makes one more susceptible to gum disease.
• diabetes: Diabetics usually run a higher risk of overall body infection and should be especially vigilant with their dental health to minimize gum disease.

Ways to Treat Gum Disease

The extent of the gum disease determines the appropriate course of treatment. Non-surgical procedures can be used to treat gingivitis, when gum disease is at a relatively early stage. If, however, it evolves into periodontitis, surgical treatment might be advised.

Non-Surgical Treatments: A dentist or a periodontist (a specialist in gum diseases) can perform a scaling and root planing procedure to treat gingivitis. This is a very precise, deep cleaning of the tooth 's root surfaces. Scaling and root planing remove plaque and bacterial toxins from the pockets that form under the gum line.

Periodontal Surgery: If the tissue and bone around a tooth are significantly eroded and the tooth is already loosened as a result, periodontal surgery might be appropriate. Periodontal surgery can include the following procedures:

• pocket reduction
• regenerative procedures
• crown lengthening
• soft tissue grafts.

Of course, prevention is the best way to minimize gum disease. Reduce the likelihood that you 'll develop gum disease by adhering to these practices:

• Brush your teeth thoroughly, at least twice a day, for a minimum of two minutes each time. Scrub your tongue, too. Floss at least once daily.
• Examine your gums regularly for swelling, redness or bleeding.
• Visit your dentist regularly for check-ups and for a cleaning. Along with a cavity check, make sure your dentist does a thorough periodontal screening.

Resources

Margolis, S., ed. (reviewed 2004, April). What is periodontal disease? Health A to Z.

American Academy of Periodontology. (nd). Periodontal (gum) disease.