Posts for: May, 2019
If you’re over age 30 there’s a fifty percent chance you have periodontal (gum) disease—and you may not even know it. Without treatment this often “silent” bacterial infection could cause you to lose gum coverage, supporting bone volume or eventually your teeth.
That’s not to say there can’t be noticeable symptoms like swollen, red, bleeding or painful gums. But the surest way to know if you have gum disease, as well as how advanced it is, is to have us examine your gums with manual probing below the gum line.
Using a long metal device called a periodontal probe, we can detect if you’ve developed periodontal pockets. These are gaps created when the diseased gum’s attachment to teeth has weakened and begun to pull away. The increased void may become inflamed (swollen) and filled with infection.
During an exam we insert the probe, which has markings indicating depths in millimeters, into the naturally occurring space between tooth and gums called the sulcus. Normally, the sulcus extends only about 1-3 mm deep, so being able to probe deeper is a sign of a periodontal pocket. How deep we can probe can also tell us about the extent of the infection: if we can probe to 5 mm, you may have early to mild gum disease; 5-7 mm indicates moderate gum disease; and anything deeper is a sign of advanced disease.
Knowing periodontal pocket depth helps guide our treatment strategy. Our main goal is to remove bacterial plaque, a thin film of food particles that collects on teeth and is the main cause and continuing fuel for the infection. In mild to moderate cases this may only require the use of hand instruments called scalers to manually remove plaque from tooth surfaces.
If, however, our periodontal probing indicates deeper, advanced gum disease, we may need to include surgical procedures to access these infected areas through the gum tissue. By knowing the depth and extent of any periodontal pockets, we can determine whether or not to use these more invasive techniques.
Like many other health conditions, discovering gum disease early could help you avoid these more advanced procedures and limit the damage caused by the infection. Besides daily brushing and flossing to remove plaque and regular dental checkups, keep watch for signs of swollen or bleeding gums and contact us for an appointment as soon as possible. And be aware that if you smoke, your gums will not likely bleed or swell—that could make diagnosis more difficult.
If you would like more information on treating gum disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Understanding Periodontal Pockets.”
If you're over 30 your chances for developing periodontal (gum) disease are better than half. And it's not a minor matter—untreated gum disease can lead not only to tooth loss, but to an increased risk of cardiovascular disease and other inflammatory conditions.
Fortunately, we have effective ways to treat gum disease, even in advanced stages. But the best approach by far in avoiding a devastating outcome for your teeth is to prevent gum disease from developing in the first place.
It helps first to know how gum disease begins. The most common cause is dental plaque, a thin biofilm of food particles on tooth surfaces that harbors the bacteria that triggers the disease. If you keep your teeth clean of built-up plaque and tartar (calcified plaque) with daily brushing and flossing and regular dental cleanings, you'll minimize the growth of disease-causing bacteria.
If you don't practice effective oral hygiene, however, within a few days you could develop an initial infection called gingivitis. This form affects the outermost layers of the gums and triggers a defensive response from the body known as inflammation. Ordinarily, inflammation helps protect surrounding tissues from infection spread, but it can damage your gums if it becomes chronic. Your weakened gums may begin to detach from the teeth, forming voids filled with inflammation known as periodontal pockets. Eventually, the infection can spread to the supporting bone and lead to tooth loss.
In addition to a dedicated oral hygiene and dental care program, you should also be on the lookout for early signs of gingivitis. Infected gums can become red, swollen and tender to the touch. You may notice they bleed easily while brushing and flossing, or a foul taste or breath that won't go away even after brushing. And if some of your teeth feel loose or don't seem to bite together as they used to, this is a sign of advanced gum disease that deserves your dentist's immediate attention.
Practicing preventive hygiene is the best way to stop gum disease before it starts. But if gum disease does happen, catching it early can be a game-changer, both for your teeth and your smile.
If you would like more information on preventing and treating gum disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “How Gum Disease Gets Started.”
It takes only a few days of inadequate oral hygiene for bacterial plaque to trigger the periodontal (gum) disease gingivitis. Though sometimes subtle, there are signs to watch for like inflamed, reddened or bleeding gums.
Untreated gingivitis can develop into more advanced forms of gum disease that infect deeper levels of the gums and supporting bone and ultimately cause bone and tooth loss. Fortunately, though, prompt treatment by a dentist removing plaque from teeth and gums, along with you reinstituting daily brushing and flossing, can stop gingivitis and help restore health to your gums.
If you’re under acute stress or anxiety, however, basic gingivitis can develop into something much more serious and painful, a condition called Acute Necrotizing Ulcerative Gingivitis (ANUG). It’s also known as “trench mouth” from its common occurrence among World War I soldiers experiencing stressful periods in front line trenches without the means for proper oral hygiene.
ANUG develops from a “perfect storm” of conditions: besides anxiety and deficient hygiene practices, ANUG has a high occurrence risk in people who smoke (which dries the mouth and changes the normal populations of oral bacteria) or have issues with general health or nutrition.
In contrast to many cases of basic gingivitis, ANUG can produce highly noticeable symptoms. The gum tissues begin to die and become ulcerative and yellowish in appearance. This can create very bad breath and taste along with extreme gum pain.
The good news is ANUG can be treated and completely reversed if caught early. In addition to plaque removal, the dentist or periodontist (a specialist in the treatment of gum disease) may prescribe antibiotics along with an antibacterial mouthrinse to reduce bacteria levels in the mouth. A person with ANUG may also need pain relief, usually with over-the-counter drugs like aspirin or ibuprofen.
It’s important that you seek treatment as soon as possible if you suspect you have ANUG or any gum disease. It’s possible to lose tissue, particularly the papillae (the small triangle of tissue between teeth), which can have an adverse effect on your appearance. You can also reduce your risk by quitting smoking, addressing any stress issues, and practicing diligent, daily oral hygiene and visiting your dentist for cleanings and checkups twice a year or more if needed.
If you would like more information on the signs and treatments for gum disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Painful Gums in Teens & Adults.”