Periodontal Disease Tooth Loss and Gum Disease
- Publish Date: 2009/04/11 - (Rev. 2017/02/02)
- Author: Thomas C. Weiss
- Contact : Disabled World
Outline: Periodontal diseases periodontitis and gingivitis are serious infections if untreated they can eventually lead to the loss of teeth.
Periodontal disease is something that people do not usually begin to show signs of until they reach the age of thirty or forty years. When periodontal disease does begin to show up, men are more likely to develop it than women. While teenagers rarely develop periodontal disease, they may develop gingivitis, which is a milder form of gum disease.
Periodontal Disease and Receding Gums
Gum disease is something that develops when plague builds up along and underneath a person's gum line. Periodontal diseases such as Periodontitis and gingivitis are serious infections; if they remain untreated they can eventually lead to the loss of teeth. The term, 'periodontal,' means, 'around the tooth.' Periodontal disease is a form of chronic, bacterial infection that affects a person's gums and the bone that supports their teeth, and can affect only one of their teeth or all of them. The disease starts when the bacteria present in plaque causes a person's gums to become inflamed.
Gingivitis causes a person's gums to become swollen, red and bleed more easily. The person may not experience any discomfort at this point. Gingivitis is commonly caused by lack of proper oral hygiene, leading to plague buildup. Other things that can lead to gingivitis are aging, smoking, diabetes, systemic diseases, genetic predisposition stress, puberty, nutrition, pregnancy, substance abuse, hormonal fluctuations, HIV, and some medications.
Bacteria in plaque can both cause infection and irritate the person's gums. The human body produces an immune system response against bacteria, causing the gums to inflame. Persons with gingivitis commonly have little to no discomfort, so it is important to recognize symptoms of gingivitis like swollen, red or bleeding gums. Gingivitis is a reversible condition with proper dental treatment and home oral care. Untreated gingivitis can lead to periodontitis.
Gingivitis that is left untreated has the potential to advance to periodontitits. Over time, plague may spread and grow below a person's gum line. The bacteria present in plaque releases toxins that irritate the person's gums; these toxins simulate a chronic inflammatory response in which the person's body essentially turns on itself - their tissues and the bone that supports their teeth begin to break down and destroy themselves. The person's gums separate from their teeth, creating pockets which then become infected. As periodontal disease progresses, these pockets deepen, and more gum tissues and bone become destroyed. The symptoms of this process are oftentimes very mild, but a person's teeth can become loose, and they may eventually have to be removed. There are some different forms of periodontitis. The more common forms include:
- Aggressive Periodontitis: Happens in people who are otherwise healthy. Common features include rapid attachment loss and bone destruction and familial aggregation.
- Chronic Periodontitis: Results in inflammation within the supporting tissues of the person's teeth; includes progressive attachment and bone loss. Chronic periodontitis is the most frequently occurring form of periodontitis and is characterized by pocket formation and/or recession of the gingiva. It is happens most often in adults, but can happen at any age. Progression of attachment loss usually happens slowly, but periods of rapid progression may occur.
- Periodontitis as a manifestation of systemic diseases: Many times begins at a young age. Systemic conditions such as respiratory disease, heart disease, and diabetes are associated with this kind of periodontitis.
- Necrotizing Periodontal Disease: An infection marked by necrosis of gingival tissues, periodontal ligament and alveolar bone. Lesions are usually observed in individuals with systemic conditions such as HIV infection, malnutrition and immuno-suppression.
Some of the questions you can ask yourself in order to find out if you are being affected by some form of periodontal (gum) disease might be:
How old are you?
The chances of developing periodontal disease increase as you age. Studies have indicated that older people have the highest rates of periodontal disease and need to do more to maintain good oral health.
Are you female or male?
Studies have also suggested that there are genetic differences between men and women which affect the risk of developing gum disease. Women tend to take better care of their oral health than men do. Women's oral health is not markedly better than men's. Hormonal fluctuations throughout a woman's life can affect many tissues, including gum tissue.
Do your gums ever bleed?
Bleeding gums can be one of the signs of gum disease. If your hands bled every time you washed them, for example, you would know something was wrong. If you are a smoker, your gums may not bleed.
Are your teeth loose?
Periodontal disease is a serious inflammatory disease that is caused by a bacterial infection, and leads to destruction of the attachment fibers and supporting bone that hold your teeth in your mouth. Left untreated, teeth can become loose and fall out.
Have your gums receded, or do your teeth look longer?
One of the warning signs of gum disease includes gums that are pulling away from the teeth, making a person's teeth look longer than before.
Do you smoke or use tobacco products?
Tobacco use may be one of the most significant risk factors in the development and progression of periodontal disease. Smokers are far more likely than non-smokers to have calculus form on their teeth, have deeper pockets between their teeth and gums, and to lose more of the bone and tissues which support their teeth.
Have you seen a dentist in the last two years?
Brushing and flossing daily helps to keep calculus formation to a minimum, but will not help to prevent it completely. A professional dental cleaning at least twice a year is needed in order to remove calculus from places your toothbrush and floss may have missed.
How often do you floss?
Including flossing as part of your oral care routine may help to reduce the amount of gum disease-causing bacteria found in your mouth, contributing to healthy teeth and gums.
Do you currently have any of the following health conditions?
i.e. Heart disease, osteoporosis, osteopenia, high stress, or diabetes Periodontal disease may be linked to these conditions. The bacteria associated with periodontal disease may travel into the blood stream and present a threat to additional parts of the body. Healthy gums can lead to a healthier body.
Have you ever been told that you have gum problems, gum infection or gum inflammation?
Over the last ten years, research has focused on the role chronic inflammation might play in various diseases, including periodontal, or gum, disease. Information suggests that having a history of periodontal disease makes a person six-times more likely to have periodontal problems in the future. Periodontal disease is often silent; symptoms may not present themselves until an advanced stage of the disease.
Have you had any adult teeth extracted due to gum disease?
The more recently you have lost a tooth because of gum disease, the greater your risk of losing more teeth from the disease. Wisdom teeth, teeth pulled for orthodontic therapy, or teeth that have been pulled due to fracture or trauma, might not contribute to an increased risk for periodontal disease.
Have any of your family members had gum disease?
Bacteria that cause periodontal disease can pass through saliva, meaning the common contact of saliva in families puts both children and couples at risk for contracting periodontal disease from another family member. Up to 30% of the population may be genetically susceptible to gum disease. Irregardless of aggressive oral care habits, these people may be six times more likely to develop periodontal disease.
Symptoms of Periodontal Disease
There are some symptoms of periodontal disease that may not be noticeable by an individual until the disease is advanced. These signs are important to look for and pay attention to. If you notice these signs, please see a dentist; they include:
- Red or swollen gums
- Bad breath that won't go away
- Painful chewing
- Tender or bleeding gums
- Sensitive teeth
- Loose teeth
When you do see a dentist, you can expect some things to happen when you visit. The dentist will ask about your medical history so they can identify any underlying conditions that might be contributing to periodontal disease. The dentist will examine your gums and look for signs of inflammation. They will use a small ruler to both look for and measure any pockets in your gums. The dentist might take some x-rays to find out if you have experienced any bone loss, and may refer you to a periodontist or other specialist who treats gum disease if necessary.
If you require treatment for periodontal disease, there are some different procedures that are available. These forms of treatment include Non-Surgical Treatments, Periodontal Surgery, Laser Treatments, Dental Implants, and Cosmetic Procedures.
Includes scaling and root planing, a careful cleaning of the root surfaces to remove plaque and calculus from periodontal pockets and to smooth the tooth root to remove bacterial toxins, followed by adjunctive therapy - such as local delivery antimicrobials and host modulation, as needed.
The majority of periodontists agree that after scaling and root planing, most people do not require any further active treatment, including surgical therapy. However, most people will require ongoing maintenance therapy to sustain. Non-surgical therapy does have limitations, and when it does not achieve periodontal health, surgery may be required in order to restore periodontal anatomy damaged by periodontal diseases and to promote oral hygiene practices.
Necessary when a periodontist determines that the tissue around your teeth is unhealthy and cannot be repaired with non-surgical treatments. There are four commonly prescribed types of surgical treatments:
- Crown Lengthening
- Regenerative Procedures
- Pocket Reduction Procedures
- Soft Tissue Grafts
Laser Periodontal Therapy
An adjunct to scaling and root planing (SRP) that may improve the effectiveness of this procedure. When lasers are used properly during periodontal therapy there can be less bleeding, swelling and discomfort to the person during surgery. Each laser has different wavelengths and power levels that can be used safely during different periodontal procedures. Damage to periodontal tissues may result if an inappropriate wavelength and/or power level is used during a periodontal procedure.
People who have lost permanent teeth due to periodontal disease or additional reasons might be interested in dental implants. Dental implants are permanent tooth replacements.
A number of Periodontists not only treat periodontal disease, they also perform cosmetic procedures in order to enhance a person's smile. Many times, people who pursue cosmetic procedures notice improvements in function as well. Cosmetic procedures may include Ridge Augmentation, Crown Lengthening, or Soft Tissue Grafts.