Periodontal Gum Eng

8/6/2019 Periodontal Gum Eng

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Periodontal (Gum) Disease

If you have been told you have periodontal (gum) disease,

youre not alone. An estimated 80 percent of American

adults currently have some form of the disease.

Periodontal 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.

Gum disease is a threat to your oral health. Research is

also pointing to possible health effects of periodontal

diseases that go well beyond your mouth (more about

this later). Whether it is stopped, slowed, or gets worsedepends a great deal on how well you care for your teeth

and gums every day, from this point forward.

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What causes periodontal disease?

Our mouths are full of bacteria. These bacteria, along withmucus and other particles, constantly form a sticky, colorless plaque on teeth. Brushing and flossing help get ridof plaque. Plaque that is not removed can harden and formbacteria-harboring tartar that brushing doesnt clean.

Only a professional cleaning by a dentist or dental hygienist can remove tartar.

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GingivitisThe longer plaque and tartarare on teeth, the more harmful they become. The bacteriacause inflammation of thegums that is called gingivitis. In gingivitis, the gums

become red, swollen and canbleed easily. Gingivitis is amild form of gum disease thatcan usually be reversed withdaily brushing and flossing,and regular cleaning by a dentist or dental hygienist. This

form of gum disease does notinclude any loss of bone andtissue that hold teeth in place.

PeriodontitisWhen gingivitis is not treated,it can advance to periodontitis (which means inflammation around the tooth.)In periodontitis, gums pullaway from the teeth and form

pockets that are infected.The bodys immune systemfights the bacteria as theplaque spreads and growsbelow the gum line. Bacterialtoxins and the bodys enzymesfighting the infection actu

ally start to break down thebone and connective tissuethat hold teeth in place. If nottreated, the bones, gums, andconnective tissue that supportthe teeth are destroyed. Theteeth may eventually becomeloose and have to be removed.

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Risk Factors Smoking. Need another reason to quit smoking?

Smoking is one of the most significant risk factorsassociated with the development of periodontitis.Additionally, smoking can lower the chances of success of some treatments.

Hormonal changes in girls/women. These changescan make gums more sensitive and make it easierfor gingivitis to develop.

Diabetes. People with diabetes are at higher risk fordeveloping infections, including periodontal disease.

Stress. Research shows that stress can make it more

difficult for our bodies to fight infection, includingperiodontal disease. Medications. Some drugs, such as antidepressants

and some heart medicines, can affect oral healthbecause they lessen the flow of saliva. (Saliva has aprotective effect on teeth and gums.)

Illnesses. Diseases like cancer or AIDS and theirtreatments can also affect the health of gums.

Genetic susceptibility. Some people are more proneto severe periodontal disease than others.

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Who gets periodontaldisease?

People usually dont showsigns of gum disease until theyare in their 30s or 40s. Men aremore likely to have periodontal

disease than women. Althoughteenagers rarely develop periodontitis, they can developgingivitis, the milder form of gum disease. Most commonly,gum disease develops whenplaque is allowed to build up

along and under the gum line.

What can I do to preventgum disease?

Brush your teeth twice a day(with a fluoride toothpaste)

Floss every day Visit the dentist routinely

for a check-up and professional cleaning

Dont use tobacco products

How do I know if I haveperiodontal disease?

Symptoms are often notnoticeable until the diseaseis advanced. They include: Bad breath that wont

go away Red or swollen gums Tender or bleeding gums Painful chewing Loose teeth Sensitive teeth

Any of these symptoms maysignal a serious problem,which should be checked bya dentist. At your dental visit:

The dentist will ask aboutyour medical history toidentify underlying conditions or risk factors (suchas smoking) that may contribute to periodontaldisease.

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The dentist or hygienist willexamine your gums and noteany signs of inflammation.

The dentist or hygienistwill use a tiny ruler calleda probe to check for periodontal pockets and tomeasure any pockets. In ahealthy mouth, the depthof these pockets is usuallybetween 1 and 3 millimeters.

The dentist or hygienist maytake an x-ray to see whetherthere is any bone loss.

The dentist may refer youto a periodontist, a specialistwho treats gum diseases.

How is periodontal diseasetreated?

The main goal of treatment isto control the infection. Thenumber and types of treatmentwill vary, depending on theextent of the gum disease. Anytype of treatment requires that

the patient keep up good dailycare at home. Additionally,modifying certain behaviors,such as quitting tobacco use,might also be suggested asa way to improve treatmentoutcome.

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Deep Cleaning (Scaling and Root Planing)The dentist, periodontist, or dental hygienist removes the plaquethrough a deep-cleaning method called scaling and root planing.Scaling means scraping off the tartar from above and below thegum line. Root planing gets rid of rough spots on the tooth rootwhere the germs gather, and helps remove bacteria that contribute to the disease.

MedicationsMedications may be used with treatment that includes scalingand root planning, but they cannot always take the place of surgery. Depending on the severity of gum disease, the dentist or

periodontist may still suggest surgical treatment. Long-termstudies will be needed to determine whether using medicationsreduces the need for surgery and whether they are effective overa long period of time. Listed on the next page are some medications that are currently used.

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M e d i c a t i o n s

Prescription antimicrobialmouthrinse

Antiseptic chip

Antibiotic gel

Antibiotic micro-spheres

Enzyme suppressant

What is it?

A prescription mouthrinse con-taining an antimicrobial calledchlorhexidine

A tiny piece of gelatin filled withthe medicine chlorhexidine

A gel that contains the antibiotic

doxycycline

Tiny, round particles that con

tain the antibiotic minocycline

A low dose of the medicationdoxycycline that keeps destructive enzymes in check


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Why is it used?

To control bacteria when treat-ing gingivitis and after gumsurgery

To control bacteria and reducethe size of periodontal pockets

To control bacteria and reduce

the size of periodontal pockets

To control bacteria and reduce

the size of periodontal pockets

To hold back the bodys enzymeresponse If not controlled,certain enzymes can break downgum tissue

How is it used?

Its used like a regular mouthwash

After root planing, its placed inthe pockets where the medicineis slowly released over time.

The periodontist puts it in

the pockets after scaling androot planing. The antibiotic isreleased slowly over a period of about seven days.

The periodontist puts the micro-

spheres into the pockets afterscaling and root planing. Theparticles release minocyclineslowly over time.

This medication is in pill form.It is used in combination withscaling and root planing.


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Surgical TreatmentsFlap Surgery. Surgery might be necessary if inflammation anddeep pockets remain following treatment with deep cleaning andmedications. A periodontist may perform flap surgery to removetartar deposits in deep pockets or to reduce the periodontalpocket and make it easier for the patient, dentist, and hygienistto keep the area clean. This common surgery involves lifting backthe gums and removing the tartar. The gums are then suturedback in place so that the tissue fits snugly around the tooth again.

Bone and Tissue Grafts. In addition to flap surgery, your periodontist may suggest bone or tissue grafts. Grafting is a way toreplace or encourage new growth of bone or gum tissue destroyedby periodontitis. A technique that can be used with bone graftingis called guided regeneration, in which a small piece of mesh-likefabric is inserted between the bone and gum tissue. This keepsthe gum tissue from growing into the area where the bone shouldbe, allowing the bone and connective tissue to regrow.

Since each case is different, it is not possible to predict withcertainty which grafts will be successful over the long-term.

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Treatment results depend on many things, including severity of the disease, ability to maintain oral hygiene at home, and certainrisk factors, such as smoking, which may lower the chances of success. Ask your periodontist what the level of success might bein your particular case.

Second Opinion

When considering any extensive dental ormedical treatment options, you should thinkabout getting a second opinion. To find adentist or periodontist for a second opinion,call your local dental society. They can provide

you with names of practitioners in your area.Additionally, dental schools may sometimes beable to offer a second opinion. Call the dentalschool in your area to find out whether it offersthis service.

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Can periodontal diseasecause health problemsbeyond the mouth?

Maybe. But so far the researchis inconclusive. Studies areongoing to try to determine

whether there is a cause-andeffect relationship betweenperiodontal disease and: an increased risk of heart

attack or stroke,

an increased risk of delivering preterm, low birthweight babies,

difficulty controlling bloodsugar levels in people withdiabetes.

In the meantime, its a factthat controlling periodontaldisease can save your teeth a very good reason to takecare of your teeth and gums.

Clinical Trials

Clinical trials are research studies of new andpromising ways to prevent, diagnose, or treatdisease. If you want to take part in a clinicaltrial about periodontal disease, visitwww.clinicaltrials.gov. In the box under SearchClinical Trials, type in: periodontal diseases.This will give you a list of clinical trials on gumdisease for which you might be eligible.

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Periodontal Gum Eng

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