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What is gum disease?

Disease of the gums and supporting structures of our teeth begin with minerals in our saliva joining with the soft bacterial plaque layer that coats our teeth. Over time the minerals harden the plaque layer to form “tartar” or “calculus” on our teeth. This layer causes inflammation of the tissues around teeth, a process that is known as “gingivitis”. Over time, the inflammation coupled with by-products released by the bacteria erodes the bone and gums that support teeth. This process is known as “periodontitis.” Should these processes not be prevented or managed, they can result in a person losing their teeth! One way we determine the extent of disease is by doing a periodontal evaluation which is a measurement of gum and bone support around teeth and the extent of inflammation. These measurements aid us in developing a plan as to how often you should ideally be getting scaling treatments done.

Periodontal or gum disease is a very common infectious disease. In North America, periodontal disease affects about 75% of adults over the age of 35. Despite the high number of infections, 80% of adults believe that they do not have periodontal disease. Periodontal disease can be painless until well into the advanced stages and is the primary cause of tooth loss in North American adults. Some signs and symptoms of periodontal disease are: bad breath, loose teeth, gums that bleed easily, swollen and/or painful gums, and a bad taste coming from the gums. Calculus which has been hardened on the teeth can become stained over time which can cause teeth to appear darker. Stained calculus cannot be whitened with teeth bleaching products.

In-office treatments for gum and periodontal disease

Dental hygiene is a process whereby the tartar or calculus forming on the teeth and surrounding tissues is removed. This process is known as debridement. When we debride the teeth, we are removing the harmful bacterial layers to keep the tissues surrounding the teeth healthy. Tools used to remove these layers include hand scalers, ultrasonic scalers and prophylactic paste. After debridement of plaque and calculus, one may experience temporary sensitivity of the teeth as well as bleeding of the gums. These are normal after a cleaning and can be resolved with proper post-operative care. Topical or local anesthetics can be administered should you find the scaling an extremely sensitive procedure. Ask your hygienist about this option!

Proper diagnosis is very important in treating gum disease. Treatment for mild to moderate gingivitis is very different from treatments required for advanced periodontal disease where bone loss has occurred. Early signs of gum disease include red and/or puffy gums, and gums that bleed very easily. Early gum disease can be easily treated by professional cleaning and maintenance therapy at home and at our office. Advanced gum disease may require scaling deep below the gum-line and root planing to clean tartar buildup on root surfaces. In more advanced cases referral to a specialist may be necessary for surgical treatment, or in some cases, the only treatment may be to remove affected teeth and possibly to replace them.

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So what?

Researchers have found that women with periodontal disease were 7x more likely to have premature low-birth weight babies than women who were not affected by the disease. Also, people with periodontal disease are 2x as likely to die of a heart attack and almost 3x as likely to suffer a stroke. This data is correlational, not causative, so the link between the two is not completely understood yet, however it is important to know that there is likely a link. Bacteria in the mouth may enter the bloodstream and lead to clogged arteries, blood clots and changes in heart function. Key factors contributing to gum disease are smoking, inadequate brushing, flossing and tartar buildup.

Prevention of gum disease starts at home! Gum disease can normally be controlled by properly brushing with a fluoridated toothpaste at least twice daily (preferably after every meal) and flossing at least once per day to remove plaque biofilm. However, even with good home care, tartar deposits tend to develop on teeth and need to be cleaned professionally in order to help control gum disease. Regular check-ups and cleaning are important in maintaining a strong base for your teeth and body!

Do you want to have the smile of your dreams?