Posts for tag: gum disease
Periodontal (gum) disease is a bacterial infection, which if left untreated could cause gum recession, bone loss and eventually tooth loss. Caused mainly by plaque left on tooth surfaces from poor hygiene practices, the deeper the infection spreads below the gum line, the more difficult it is to treat.
One possible scenario involves parts of a tooth’s root structure known as furcations. These are branching forks formed during the early development of teeth with multiple roots where they take different paths from the base of the crown. As gum disease spreads around the root it may cause different degrees of bone loss at the point of the branch.
It’s imperative when treating gum disease to uncover and remove any bacterial plaque or calculus (hardened plaque deposits) found, including below the gum line. To address bacterial plaque at the root level, it’s important to first determine if bone loss has involved the furcations (where the roots separate, also referred to as a “furcation invasion”) and to what degree.
We usually classify this degree of involvement in three classes: Class I, the invasion has created a groove in the furcation, but minimal significant bone loss; Class II, the bone loss has extended into the furcation by at least two millimeters; or Class III, the bone loss extends completely from one end of the furcation to the other (or “through and through”).
Depending on the class, cleaning plaque and calculus from furcations and then maintaining them thereafter can be quite challenging. We may need to use specially shaped hand instruments known as scalers or curettes to reach and clean root surfaces, or ultrasonic scalers that use high-frequency vibrations and streaming water to loosen and flush away plaque debris. It may also prove helpful, though limited, to apply antimicrobials or antibiotics to the area to help limit the levels of bacteria.
Disease damage around furcations may also require surgical treatment to encourage new tissue and bone growth in the area. Surgery can also help make the area more accessible to future cleaning and maintenance, both for you and us. Renewed hygiene practices on your part and regular cleaning and checkups with us will help ensure that the situation involving your tooth roots can be kept under control and your tooth preserved for many years to come.
One of the most important revolutions in healthcare in recent decades is the increasing use of lasers. Now, laser technology is making a showing in dental care for the treatment of periodontal (gum) disease.
Lasers (an acronym for "Light Amplification by Stimulated Emission of Radiation") narrowly focus and amplify light within a small area. First developed in the early 1960s, laser technology rapidly advanced in the ensuing decades with more compact and precise devices that were eventually safe and effective for many types of medical procedures. Its remarkable features are now available for the primary focus of gum disease treatment—removing bacterial plaque.
Plaque is a thin, built-up film of bacteria and food particles on tooth and gum surfaces that serves as a haven for the bacteria that cause gum disease. The continuing presence of plaque and calculus (tartar) enables the infection to thrive and advance within the gum tissues, ultimately damaging them along with supporting bone. As the tissues weaken and bone volume diminishes, the teeth are at greater risk for loss.
It's necessary, therefore, first and foremost to remove all detectable plaque and calculus to stop the infection. This is traditionally done with special hand tools called scalers used to manually remove plaque, or with ultrasonic equipment that vibrates plaque loose to be flushed away with water. These procedures can take numerous sessions and may result in some minor post-procedural discomfort and bleeding during the cleaning.
But lasers specifically designed for plaque removal can minimize tissue damage and resulting discomfort. Because the particular laser light used reacts only with plaque and diseased tissue, it can remove them without disturbing nearby healthy tissue usually more efficiently than traditional scaling. Dentists who've used the technology frequently report less bleeding and higher patient satisfaction.
But before lasers for gum disease treatment are widely adopted, the procedure must undergo further scrutiny. Reports from dentists notwithstanding, not enough research studies have been performed to date that meet the necessary scientific criteria. But if the evidence so far from the field holds up, it's quite possible lasers will one day become a regular part of dental practice for treating gum disease.
If you would like more information on treating gum disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Lasers Versus Traditional Cleanings for Treating Gum Disease.”
September is National Gum Care Month. Did you know that advanced periodontal disease is the number one cause of tooth loss among adults? Periodontal disease refers to any disease that affects the structures that hold the teeth in place, including gums, ligaments and bone. In its earliest stage, called gingivitis, the gums become inflamed. When it progresses to periodontitis, both soft and hard tissues that hold the teeth in place are affected, threatening the integrity of the teeth. Some people are more susceptible to periodontal disease than others. Here are some common risk factors:
Poor oral hygiene. Plaque buildup is the primary cause of gum disease. When life gets busy, we may be less diligent about our oral care. This allows bacteria in the mouth to form a biofilm (plaque), which causes inflammation of the gums.
Heredity: Some people are genetically more predisposed to gum disease. Look at your family history. Have any of your relatives had gum disease or lost their teeth?
Pregnancy. Gums are sensitive to hormone fluctuations, and it is not uncommon for pregnant women to experience an inflammation of the gums known as “pregnancy gingivitis.” Gingivitis — characterized by red, swollen gums that bleed easily — is the beginning stage of gum disease.
Age: The chance of developing gum disease increases with age. Over 70% of Americans 65 and older have periodontitis, an advanced form of gum disease, according to the U.S. Centers for Disease Control and Prevention. This may be influenced by other diseases, medications that cause dry mouth, or other causes of plaque buildup.
Diet: Eating too many simple carbohydrates (those found in sugar, white bread, white rice and mashed potatoes, for example) is linked to chronic inflammation in the body, which increases the risk of gum disease.
Smoking: Smoking is a significant risk factor for the development and progression of gum disease. Since nicotine constricts blood vessels, smokers may not see the typical symptoms such as red, puffy, bleeding gums, so the disease may cause damage before smokers realize there is a problem with their gums.
Diabetes: Uncontrolled diabetes puts you at higher risk of periodontal disease. Not only can diabetes make gum disease worse, gum disease can make diabetes symptoms worse.
Our aim is not to scare you but to help you become aware of factors that can increase your risk of gum disease. Many of these factors are not under your control. However, you can do your part to prevent gum disease by staying on top of the things you can control. Let us know about any new medications you are taking, eat a balanced diet rich in complex carbohydrates and other nutrients and, if relevant, manage your diabetes and explore programs that will help you quit smoking.
Fortunately, good oral hygiene and regular professional cleanings can turn early gum disease around, so if you have any of the risk factors that contribute to periodontal disease, be extra diligent about your oral hygiene routine. And make sure you come in for regular dental checkups and cleanings. If you show signs of gum disease, we may recommend that you come in for more frequent cleanings.
Are bleeding gums something you should be concerned about? Dear Doctor magazine recently posed that question to Dr. Travis Stork, an emergency room physician and host of the syndicated TV show The Doctors. He answered with two questions of his own: “If you started bleeding from your eyeball, would you seek medical attention?” Needless to say, most everyone would. “So,” he asked, “why is it that when we bleed all the time when we floss that we think it’s no big deal?” As it turns out, that’s an excellent question — and one that’s often misunderstood.
First of all, let’s clarify what we mean by “bleeding all the time.” As many as 90 percent of people occasionally experience bleeding gums when they clean their teeth — particularly if they don’t do it often, or are just starting a flossing routine. But if your gums bleed regularly when you brush or floss, it almost certainly means there’s a problem. Many think bleeding gums is a sign they are brushing too hard; this is possible, but unlikely. It’s much more probable that irritated and bleeding gums are a sign of periodontal (gum) disease.
How common is this malady? According to the U.S. Centers for Disease Control, nearly half of allÂ Americans over age 30 have mild, moderate or severe gum disease — and that number increases to 70.1 percent for those over 65! Periodontal disease can occur when a bacteria-rich biofilm in the mouth (also called plaque) is allowed to build up on tooth and gum surfaces. Plaque causes the gums to become inflamed, as the immune system responds to the bacteria. Eventually, this can cause gum tissue to pull away from the teeth, forming bacteria-filled “pockets” under the gum surface. If left untreated, it can lead to more serious infection, and even tooth loss.
What should you do if your gums bleed regularly when brushing or flossing? The first step is to come in for a thorough examination. In combination with a regular oral exam (and possibly x-rays or other diagnostic tests), a simple (and painless) instrument called a periodontal probe can be used to determine how far any periodontal disease may have progressed. Armed with this information, we can determine the most effective way to fight the battle against gum disease.
Above all, don’t wait too long to come in for an exam! As Dr. Stork notes, bleeding gums are “a sign that things aren’t quite right.” Â If you would like more information about bleeding gums, please contact us or schedule an appointment. You can read more in the Dear Doctor magazine article “Bleeding Gums.” You can read the entire interview with Dr. Travis Stork in Dear Doctor magazine.