Periodontal diseases which attack the gums, bone and ligaments
that support the teeth are a leading cause of tooth loss
in adults. In fact, more than half of all people over
the age of 18 have at least the early stages of some type
of periodontal disease.. By age 35, three out of four
people are affected. Periodontal diseases can strike at
any age, however. Even children as young as five or six
can have signs of some of these diseases. Periodontal
diseases are usually painless, and they may develop slowly
or progress quite rapidly. Without regular checkups, you
may not be aware that you have a periodontal disease until
your gums and bone have been damaged to the point where
tooth loss is inevitable.
Periodontal diseases can be prevented, however. It's important
to understand what causes them, practice good oral health
care habits and see your dentist on a regular basis.
The Causes of Periodontal Diseases
Periodontal diseases are caused by certain types of bacteria
in plaque, the sticky, colorless film of bacteria that
constantly forms on your teeth. These bacteria create
toxins which irritate the gums and result in the breakdown
of the attachment of gum tissues to your teeth. Over time,
these toxins can destroy gum tissues and lead to bone
loss.
In addition, plaque that is not removed from your teeth
can combine with other materials and harden into a rough,
porous deposit called calculus or tartar. Calculus on
the surface of your teeth, above the gum line, may not
contribute to periodontal diseases. Calculus on the root
surface below the gums, however, makes removal of new
plaque and bacteria more difficult. And unlike plaque
which you can remove, only a dentist or dental hygienist
can remove calculus.
Although periodontal diseases are caused by plaque, other
factors can increase the risk, severity and speed of the
condition's development. These factors include:
- Smoking or chewing tobacco
- Poorly fitting bridges, badly aligned teeth or
defective fillings
- Habits such as clenching or grinding your teeth
- Poor or unbalanced diets
- Pregnancy or the use of oral contraceptives
- Systemic diseases such as diabetes
- Use of some types of medications
Types of Periodontal Diseases
There are many types of periodontal diseases, but the
most common types are gingivitis and adult periodontitis.
Gingivitis is the earliest stage and affects gum tissue
only. At this stage, the disease can still be treated
and reversed. Left unchecked, however, gingivitis can
lead to more serious problems. Periodontitis is the
more advanced stage of periodontal diseases. Gums, bone
and other structures that support the teeth can become
so severely damaged that teeth become loose and fall
out. At this point, complex treatments may be required
to prevent tooth loss.
Preventing Periodontal Diseases
You can avoid periodontal diseases and keep your teeth
and gums healthy by taking proper care of them. First,
keep your teeth clean by brushing thoroughly at least
twice a day to remove plaque. Use a soft bristled toothbrush
that is in good condition. Worn-out or hard bristled
brushes can injure your gums. Use dental floss to help
remove plaque between teeth. Gingivitis can often be
reversed by regular daily brushing and cleaning between
teeth. Fluoride toothpastes and mouth rinses are recommended
to help prevent tooth decay. Dr. Jaffe may also suggest
the use of an antimicrobial rinse as an effective supplement
to your daily oral hygiene regimen.
Next, eat a healthy balanced diet consisting of foods
from the basic food groups. These foods will help to
provide adequate proteins, carbohydrates, fats vitamins,
minerals, and water.
Third, be sure to schedule regular checkups with your
dentist. Professional cleaning is essential to preventing
periodontal diseases. Call the office immediately if
you notice any of the following warning signs:
- Gums that bleed easily
- Red, swollen or tender gums
- Gums that have pulled away from the teeth
- Pus between the teeth and gums when the gums are
pressed
- Persistent bad breath or bad taste
- Permanent teeth that are loose or separating
- Any change in your bite or the way your teeth fit
together
- Any changes in the fit of your partial dentures
You may be suffering from periodontal disease without
any of these signals, however, so it's important to
see your dentist regularly.
Treating Periodontal Diseases
Treatment depends on the type of disease and the extent
to which it has progressed. Regardless of the treatment
plan, however, good daily oral hygiene is essential
to the success of any periodontal therapy.
The first step is usually a thorough cleaning which
may include "scaling" to remove plaque and
calculus deposits below the gum line. Tooth roots may
also be "planed" to smooth the root surface
to allow gum tissue to heal. Antibiotics or irrigation
with antimicrobial agents or rinses may be recommended
to help control the growth of bacteria which cause periodontitis.
Medications placed under the gum tissue against the
tooth root enhance healing. Conservative scaling with
chemotherapeutic agents is the preferred initial periodontal
therapy.
In some cases surgery may be required when deeper pockets
are found. It is difficult for the dentist or hygienist
to thoroughly remove plaque and calculus form deep pockets,
and patients can rarely keep them clean and free of
plaque. Allowing these deep pockets to go untreated
can result in infection and bone damage. When pockets
are deep and bone has been destroyed, "flap surgery"
may be required to provide access to the roots in order
to remove plaque, calculus and damaged tissue. This
technique involves lifting the gum away and suturing
it back in place or into a new position that will be
easier to keep clean. Bone surgery is sometimes used
in conjunction with flap surgery to reshape the bone
around the tooth.
Surgical procedures to correct areas of moderate to
severe recession may be indicated. Good daily oral hygiene
is a key element of any treatment of periodontal disease.
The office will also schedule appointments at regular
intervals as part of your treatment plan to assure that
you are maintaining a satisfactory level of oral hygiene
to remove any accumulated plaque or calculus and be
sure that your periodontal disease remains under control.
Remember, periodontal diseases can be avoided by brushing
and cleaning your teeth daily, eating a balanced diet,
and regular maintainance appointments.
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