Periodontal Disease

What is America's No. 1 oral health issue? Periodontal disease, often called the silent dental disease because you may not know you have it. It is rarely painful, and the most recognizable sign is bleeding gums that almost everyone ignores. Although it can occur at any age, 75% of adults have some degree of gum disease.

Periodontal (gum) diseases, including gingivitis and periodontitis, are serious infections that, left untreated, can lead to tooth loss. The word periodontal, comes from Latin, and literally means "around the tooth." Periodontal disease is a chronic bacterial infection that affects the gums and bone supporting the teeth. Periodontal disease can affect one tooth or many teeth. It begins when the bacteria in plaque (the sticky, colorless film that constantly forms on your teeth) causes the gums to become inflamed.

In the mildest form of the disease, gingivitis, the gums redden, swell, and bleed easily. There is usually little or no discomfort. Gingivitis is often caused by inadequate oral hygiene. Gingivitis is reversible with professional treatment and good oral home care. Untreated gingivitis can advance to periodontitis. With time, plaque can spread and grow below the gum line. Toxins produced by the bacteria in plaque irritate the gums. The toxins stimulate a chronic inflammatory response in which the body, in essence, turns on itself, and the tissues and bone that support the teeth are broken down and destroyed. Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. Often, this destructive process has very mild symptoms. Eventually, teeth can become loose and may have to be removed.

According to the American Dental Association, if you notice any of the following signs of gum disease, you should see your dentist immediately: Gums that bleed when you brush your teeth. Red, swollen, or tender gums. Gums that have pulled away from the teeth. Bad breath that doesn't go away. Pus between your teeth and gums. Loose teeth. A change in the way your teeth fit together when you bite. A change in the fit of partial dentures.

A dentist and dental hygienist will work as a team in diagnosing and "co-diagnosing" your gingival health. A full mouth series of x-rays and periodontal screening will be performed by the dental hygienist. This will determine the health of the gingiva (gums). Treatment for gum disease can be as simple as a correction in oral hygiene and homecare with more frequent recare appointments, to having the tooth and root surfaces "scaled and root planed" (the deeper pockets under the gumline are cleaned using anesthesia) or to being referred to a periodontist (a dentist that specializes in periodontal disease) for possible surgery. Also, the FDA has recently approved new medications which can be taken orally or placed under the gumline to reverse the soft tissue destruction in many cases. These techniques may be successful when combined with scaling and root planing followed by frequent visits to the dentist.