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How gum disease starts
We fight a battle against bacteria (germs) everyday. Millions of
these microscopic monsters live, work, and play on our teeth in
a soft white substance called plaque. Unwelcome guests, the bacteria
(germs) feed on left over food particles, creating acid as a by-product
of their feasting.
It is this acid that eats into tooth enamel to create cavities.
The very same bacteria also pour out volatile sulfur compounds that
cause bad breath.
Daily brushing and flossing remove plaque bacteria from our teeth,
keeping their populations in check. The problem begins when
we fail to floss or brush correctly . In the areas we miss,
plaque bacteria hardens (calcifies) into tartar. Tartar can no longer
be removed by simple brushing and flossing but can only be removed
by your dentist.
When bacteria turns ugly
Over time, levels of more dangerous types of bacteria build
up within tartar. Mean and vengeful, these bacteria produce toxins
that irritate and inflame the gums. This condition is known as gingivitis,
the first stage of gum disease .
If left untreated, gingivitis progresses to periodontal disease
- a condition where bacteria and their toxins invade not only the
gums, but also the bones and the structures supporting your teeth.
This damages the bones of the jaw and causes teeth to fall out.
Surprisingly, this bacterial invasion is not the only thing that
damages gum tissue. The immune system of your own body ends up contributing
to the destruction of your gums. Normally, your body produces chemicals
called cytokines and collagens that fight off bacterial infection.
If the infection is long-standing, like that associated with gum
disease, these chemicals start to turn against your very own body,
furthering damaging gums, connective tissue, and the bones holding
your teeth in place.
The major health risks of gum disease
Just as skin prevents bacteria from entering your body, healthy
gum tissue acts as a barrier, preventing bacteria from entering
your body. When bacteria destroy gum tissue, as the case in gum
disease, the barrier is no longer effective.
Bacteria now have a direct route into your body!
Bacteria and their toxins enter damaged blood vessels that run through
your gums. Once inside these vessels, they travel through your circulation
where they are capable of causing more severe health problems including:
Premature pregnancies:
Recent research has shown that mothers with periodontal disease
are seven times more likely to deliver preterm, low birth weight
infants. This finding reinforces well-documented observations that
infections during pregnancy increase the risk of premature births.
Genital and urinary tract infections, for instance, dramatically increase
a woman's chance of delivering a premature infant. Like genital and
urinary tract infections, gum disease represents a bacterial infection
of the body. A woman considering pregnancy should visit her dentist
to treat gum disease before pregnancy starts. Read more in our section
women dentalcare
.
Stroke and Heart Attacks:
An ever-growing body of research links advanced gum disease and the
occurrence of heart attacks and strokes. In studies conducted in the
United States , Canada , Great Britain , Sweden , and Germany , researchers
found that people with advanced gum disease also had a 25% to 100%
increased risk of suffering from a heart attack than those without
advanced gum disease. A similar relationship exists between advanced
gum disease and the development of strokes. Read about it in our section
gum &
heart disease .
Theories for the increased risk of heart attack and stroke
include:
- Potential ability of certain bacteria to trigger the clumping
of platelets, forming blood
clots. These blood clots, in turn, could block arteries to the
heart, leading to a heart attack, or block arteries in the brain,
leading to a stroke.
- Inflammatory molecules, produced to fight off the bacterial
invaders, over time, may begin to trigger arteriosclerosis - a
hardening and narrowing of the arteries that can trigger heart
attacks and strokes.
- Bacteria alone may damage the lining of the blood vessels, an
event that could also lead to arteriosclerosis.
TREATMENT
The picture is that of after non-surgical periodontal therapy (i.e.
scaling). The gums have been restored to health. Notice the gums have
receded, exposing the root of the tooth. This is due to the irreversible
bone loss as a result of previous periodontal disease. This can lead
to tooth sensitivity.
Periodontal Scaling : Once gum disease has begun to destroy
the gum and bone around teeth, an ordinary cleaning will not be enough
to stop the progress of the infection. A procedure called periodontal
scaling, which is more extensive and time-consuming than routine cleaning,
becomes necessary. It removes plaque and tartar that are causing
the infection below the gum line.
Root planing smoothes the root surfaces, which
allows the gum tissue to heal and to reattach to the tooth.
Other Surgery : When deep pockets of infection
persist after periodontal scaling, corrective surgery or other treatment
may be needed. Surgical treatment is designed to correct defects
by reshaping or by regenerating new, healthy bone and gums.
Periodontal Surgical Treatments:
There are 2 major perio surgeries: gingivectomy and bone
surgery.
Flap and bone surgery
When gum is inflamed severely (periodontitis), alveolar bone will
be absorbed, and defected. Periodontal ligaments, which connect
between the alveolar bone and the teeth, will disappear. Sever bone
lose will cause tooth moving and missing. Flap and bone surgery
is order to contour the bone, deeply clean the tooth to reduce the
inflammation, and promote bone re-growing and connections firm.
Detailed procedures
1. Presurgical bone defect. Gum inflamed and reddish. (Left)
2. Flap incision to make gum retracted, and the bone shows out.
(Middle)
3. The bone is contoured, and remain tartar is removed. (Right)
4. Gum is sutured back.
5. After periodontal surgery, the bone defect disappears, and gum
becomes healthy pink color
 
Latest Techniques Used in Cases of Tissue & Bone Loss
are GTR (Guided Tissue Regeneration): It is done by using resorbable
& non-resorbable membrane.
GBR (Guided Bone Regeneration): Various bone grafting materials
like: Allografts, Xenografts & Alloplasts are available &
used with or without barriers/membranes.
The simple things to prevent gum disease
While the consequences of gum disease are severe: bleeding
gums, extremely bad breath, lost teeth, increased risk of premature
births, heart attacks, and strokes , gum disease can be easily
prevented.
Flossing and brushing correctly, however, are the cornerstones of
gum disease prevention. Yet, almost everyone fails miserable
at these tasks, making himself or herself susceptible to gum disease.
Brushing Your Teeth:
This may sound easy but most people do a horrible job brushing their
teeth. It takes a full 2 minutes to brush all of your tooth surfaces,
however, most people spend 30 seconds or less when brushing!
As a result, they miss the same spots in their mouth day after day.
Here, bacteria build-up to dangerous levels, creating a great risk
for gum disease. The next time you brush, take along a timer to make
sure you brush for 2 minutes. You will be surprised at how long it
seems. Make a conscious effort to brush ever single tooth.
Unfortunately, manual toothbrushes cannot reach bacteria in one of
their favorite hiding places - right below the gumline. Electric toothbrushes
(plaque removers) like the Braun OralB 3D electric toothbrush remove
bacteria below the gumline where manual toothbrushes cannot reach.
As a result, they represent a great advance in gum disease
protection. Although these electric toothbrushes cost more, the extra
protection and peace of mind are well worth the price.
Summary : While gum disease is a very serious
dental condition, it can be prevented. Regular dental check ups are
a key factor in early detection of gum disease as well as detecting
oral cancer
, another serious dental condition that can also be fatal. Don't put
off your dental check ups! Protecting your periodontal health brings
many benefits. You can chew with more comfort. You can smile and speak
with greater confidence. You can keep dental costs down by preventing
further problems. A commitment to maintenance therapy is a commitment
to better health.
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