Periodontal, or gum disease, is very common in adults. Gum diseases range from simple gum inflammation to serious disease that results in major damage to the soft tissue and bone that support the teeth. In the worst cases, teeth are lost.
What causes gum disease?
Plaque is the primary cause of gum disease. However, other factors can contribute to periodontal disease. These include:
Hormonal changes, such as those occurring during pregnancy, puberty, menopause, and monthly menstruation, make gums more sensitive, which makes it easier for gingivitis to develop.
Illnesses may affect the condition of your gums. This includes diseases such as cancer or HIV that interfere with the immune system. Because diabetes affects the body's ability to use blood sugar, patients with this disease are at higher risk of developing infections, including periodontal disease and cavities.
Medications can affect oral health, because some lessen the flow of saliva, which has a protective effect on teeth and gums.
Bad habits such as smoking make it harder for gum tissue to repair itself.
Poor oral hygiene habits such as not brushing and flossing on a daily basis, make it easier for gingivitis to develop.
Gingivitis is the mildest form of periodontal disease. It causes the gums to become red, swollen, and bleed easily. There is usually little or no discomfort at this stage. Gingivitis is often caused by inadequate oral hygiene. Gingivitis is reversible with professional treatment and good oral home care.
Periodontitis is a set of inflammatory diseases affecting the periodontium, i.e., the tissues that surround and support the teeth. Periodontitis involves progressive loss of the alveolar bone around the teeth, and if left untreated, can lead to the loosening and subsequent loss of teeth.
There are many forms of periodontitis. The most common ones include the following.
- Aggressive periodontitis occurs in patients who are otherwise clinically healthy. Common features include rapid attachment loss and bone destruction and familial aggregation.
- Chronic periodontitis results in inflammation within the supporting tissues of the teeth, progressive attachment and bone loss. This is the most frequently occurring form of periodontitis and is characterized by pocket formation and/or recession of the gingiva. It is prevalent in adults, but can occur at any age. Progression of attachment loss usually occurs slowly, but periods of rapid progression can occur.
- Periodontitis as a manifestation of systemic diseases often begins at a young age. Systemic conditions such as heart disease, respiratory disease, and diabetes are associated with this form of periodontitis.
- Necrotizing periodontal disease is an infection characterized by necrosis of gingival tissues, periodontal ligament and alveolar bone. These lesions are most commonly observed in individuals with systemic conditions such as HIV infection, malnutrition and immunosuppression.
How is gum disease treated?
- A comprehensive cleaning of the teeth - all traces of plaque and tartar are removed (scaling). The procedure may be uncomfortable, especially if the patient's gums are sensitive, or if plaque and tartar build up is considerable.
Antiseptic mouth rinse - this may be in the form of a spray or gel which is generally used for about a month. It helps clear away bacteria. The doctor may prescribe chlorhexidine or hexetidine. A wide range of antiseptic mouth rinses can be purchased OTC (over-the-counter, no prescription required).
- Antibiotics - in some severe cases of periodontitis the dentist may prescribe a short course of antibiotics to help treat infection in the gums.
- Brushing teeth - the dentist will review the patient's tooth-brushing technique, and if necessary, explain how to do this properly.
- Flossing teeth - the dentist will review the patient's flossing technique, and if necessary, explain how to do this properly.
- Fixing dental problems - if there are any misaligned teeth, poorly fitted crowns, bridges or other dental restorations, they will need to be fixed. Removing plaque and tartar when dental restorations are causing problems is more difficult.
Preventing gum disease
People who have had gum diseases should see their dentist at least once a year. When your treatment is over ask your dentist when you should come back.