WHAT IS GUM DISEASE?

Periodontal (gum) disease is an inflammation or infection of the gums and bone that support the teeth. It's caused by the bacteria in the plaque (the sticky, nearly colorless film) that constantly forms on your teeth. Periodontal disease is the leading cause of tooth loss in adults, affecting three out of four people at some point in life, but it can be treated successfully if detected in time.

Treating and preventing gum disease bring great health benefits. By retaining your natural teeth, you can chew more comfortably and enjoy better digestion. You can have a healthy smile, a natural asset to your appearance. You can save money and avoid discomfort by preventing future dental problems. For looking good and feeling good, nothing works better than your natural teeth.

WHAT ARE THE SYMPTOMS?

• Gums that bleed during brushing or flossing
• Changes in the way your teeth fit together when you bite
• Teeth that have shifted or loosened
• Red, puffy gums
• Gum tenderness or pain
• Persistent bad breath or a bad taste in your mouth
• Teeth that look longer because your gums have receded
• Gums that have separated from your teeth

WHAT CAUSES GUM DISEASE?

Many kinds of bacteria live and grow in a healthy mouth. Some cause tooth decay. Others form a sticky, colorless film (plaque) on teeth and gums. As it accumulates, plaque appears as a soft, whitish coating. It forms constantly, but can be controlled by proper, twice daily, flossing and brushing. In addition, twice yearly professional cleanings by our hygienists remove the plaque from places that your toothbrush can't reach. If not removed regularly, plaque can harden into tartar (calculus). This rough yellowish or brown (or even black) deposit makes the bacteria-laden plaque hard to remove, and so usually leads to periodontal disease.

Although plaque is the primary cause of periodontal disease, other factors can affect the health of your gums.

Lifestyle decisions such as poor diet and smoking definitely influence your oral health. A diet low in nutrients can diminish your body's efforts to fight infection. Stress can also affect your ability to ward off disease. Those who smoke or use tobacco often have more irritation to gum tissues than those who do not.

Health conditions are another important influence. Diseases that interfere with the body's protective immune system, such as leukemia and AIDS in their later stages, may worsen the condition of the gums. In uncontrolled diabetes, where the body is more prone to infection, gum disease is usually more severe or harder to control. In addition, some people just naturally form plaque easier and more quickly than others.

Hormone changes during pregnancy increase the blood supply to certain tissues in the body, including the gums. As a result, 30 to 60 percent of pregnant women experience red, tender or bleeding gums. Pre-existing gum disease, even in early stages, can make these symptoms more severe.

Naturally, the healthier you are, the easier it is for your body to recover from any disease, including those affecting the mouth.

Be sure to keep our office informed about any changes in your health. Also, discuss any medications you are taking. Some drugs, such as oral contraceptives, antidepressants and certain heart medications, can affect your oral health.

HOW IS IT DIAGNOSED?

During your regular check-up our hygienist will inspect the color and firmness of the gums and test the teeth for looseness. She will also check the way your teeth fit together when you bite. During your periodontal examination, a small measuring instrument is gently inserted between the tooth and gum to measure the depth of the pockets. As gum disease progresses, pockets get deeper. A periodontal exam is a vital part of our complete dental examination for adults. X-rays may be taken to evaluate the bone supporting the teeth.

PERIODONTAL DISEASE MAY PROGRESS

Even if you have no noticeable symptoms, periodontal disease could be damaging the supportive tissues that form the foundation for your teeth. Without regular professional cleaning and exams, gingivitis, a mild form of the disease, may progress to periodontitis, which in turn may lead to advanced periodontitis. A common saying in dentistry is, "Ignore your teeth and they'll go away." Sad, but very true. The earlier you treat periodontal disease, the easier it is to control, and the better chance you have of restoring the health of your mouth and saving your teeth.

STAGES OF PERIODONTAL DISEASE

Gingivitis

If not removed regularly from teeth and gums, bacteria grow out of control and produce toxins that irritate your gums. Calculus along the gumline forms a rough surface on which plaque accumulates, causing more irritation and swelling. You may notice sore, bleeding gums or bad breath. Spaces between gum and tooth (pockets) may exist, but no bone is damaged in this mild, reversible form of periodontal disease. Your hygienist may ask you to come in for a cleaning more than twice a year until this inflammation is under control.

Periodontitis

In the most common form of periodontitis, plaque (and sometimes calculus) is found below the gumline. The gums may feel irritated and be bright red, bleed easily and shrink back (recede). The ligaments break down and the gum detaches and pulls away from the teeth. The pockets deepen and fill with more bacteria. Supportive ligaments and bone start to show damage, resulting in loose teeth. Proper professional treatment, as well as good home care, can usually stop further damage.

Advanced Periodontitis

When periodontitis progresses to the advanced stage, pockets deepen and often become infected. There is often swelling around the root, and you may experience sensitivity to hot or cold or feel pain when brushing your teeth. As bone loss increases, the teeth lose so much support that they fall out or need to be removed to preserve the overall health of your mouth.

A WORD ABOUT INSURANCE COVERAGE FOR CLEANINGS

When you come into our office for a regular dental check up and cleaning, and your gums show no sign of disease, that cleaning is covered at the highest available rate on your insurance plan, often at 100%. Patients often refer to this as a "free" cleaning. Keep in mind that you are paying premiums out of your hard-earned paycheck to pay for these "free" cleanings. The claim is sent to your insurance company under a Preventative Code (D1110). The cleaning that our hygienists do for you every six months is to prevent disease.

When you are diagnosed with Periodontitis (or Perio), we are no longer preventing disease, but treating it. The code for your cleanings now fall under a new category and a code for treating disease. These codes are covered under most insurance plans at 80% less the deductible.

Our hygienists will determine which type of cleaning is best for you. When there is a great deal of hardened tartar on the tooth's crown and roots, the hygienist will need to clean the rough surfaces of the root until they are smoothed, in an attempt to create an environment in which the gums can heal. This often takes four one-hour appointments. Often, patients are asked to come in more often, such as every 3 or 4 months for a cleaning. Insurance only covers 2 cleanings per year, so the extra cleanings are self-pay. Keep in mind, that this is one of the best investments you can make, since that extra cleaning might make the difference between healing or losing some teeth.

If the disease has advanced beyond what we can do in our office, we will refer you to a specialist, a Periodontist, who will discuss your options.