Periodontal Disease

Periodontal Disease

The most common cause of loose and sensitive teeth is periodontal disease. Periodontal disease includes gingivitis (inflammation of the gums) and periodontitis (inflammation of the periodontium). The periodontium is the structure that surrounds the teeth and holds them in their sockets. Periodontal disease is an infection that can cause teeth to become loose and eventually lost.

Periodontal disease is most often caused by bacterial plaque that surrounds teeth. Bacterial plaque is a sticky film that continues to form around teeth. If it isn’t removed constantly, it can continually build up and form calculus (calculus is just a hardened form of bacterial plaque). There are a number of other causes of periodontal disease.

Causes of Periodontal Disease

• Smoking: smoking causes shrinkage of some blood vessels, hence the periodontium is affected by not having enough blood flow and oxygen. Smokers tend to lose teeth more than non-smokers, because of periodontal disease.
• Hormones: gum tissue are sometimes affected by hormonal changes, for example during pregnancy or menopause
• Genetics: some individuals are more prone to periodontal disease, despite proper oral hygiene practices, because of genetic factors. Early diagnosis and treatment may help to save teeth in such individuals.
• Diabetes: diabetics have a higher risk of developing infections, including periodontal disease. Healing is also slower with diabetes, making periodontal disease a greater concern with respect to oral health. Diabetes, though not the only reason, may be a cause of necrosis (tissue death due to lack of blood and oxygen).
• Poor Nutrition: a diet that is low in necessary nutrients affects the body, including the oral cavity. Periodontal disease is a distinct infection that may worsen with poor nutrition.

Treatment of Periodontal Disease

In many cases, an individual may have had long standing or severe periodontal disease, and some teeth (in other cases, all of the teeth) cannot be saved. In these cases, extractions may be the only viable option, with replacement of the missing teeth with implants, bridges or dentures. Other treatment options are available for treating periodontal disease, each option depending on individual cases/.

• Scaling and root planning: this involves professional cleaning of plaque and calculus from root surfaces and periodontal pockets. This is the most common method used to treat periodontal disease.
• Periodontal surgery: if the tissues around the teeth are determined to be unhealthy, periodontal surgery (there are more than one types) may be necessary to treat the periodontal disease. Periodontal surgery can help to improve function.
• Cosmetic methods: this can be done to improve a patient’s appearance, smile and function, if for example a lot of roots are exposed by the periodontal disease.

Each individual’s case of periodontal disease is different, so the necessary treatment may be different for each patient. An individual with a diagnosis of periodontal disease, especially long standing or advanced, can be treated by a periodontist (a dentist with specialized training in diagnosing, preventing and treating periodontal disease). You can be referred to a periodontist by a general dentist, or be treated by a general dentist. Please be pro-active in a consulting with your dentist for a comprehensive evaluation, diagnosis and treatment.

We hope this helps!

Pain and bleeding gums

Question:

I am having pain and bleeding from a tooth.  Also, anything that I eat sticks between by teeth.  Do you have any advice or suggestions for medications?

Answer:

Based off of your description, it looks like you are suffering from pain from your gingiva (gums) and not your actual tooth.  However, please read our article on Toothaches to further assess the situation involving the actual tooth itself.

Inflammation of the Gums = Gingivitis

Usually, when food, bacteria, plaque, calculus, or anything else accumulates around our gums it causes an inflammatory response.  This means that the gums are sensitive, red, puffy, swollen, and bleed very easily.  It sounds like your gums are inflamed, thus causing the bleeding and pain.  This condition is called gingivitis.  A more advanced form of this ailment is called periodontitis if bone loss is involved.

How to Treat Gingivitis

So how can you treat this?  Well, your best bet is to visit your dentist for a thorough cleaning.  If severe, he/she may prescribe you antibiotics to help solve the problem.  However, here are some suggestions to help you with the situation now.

• Rinse with warm salt water to deal with the pain and sensitivity
• Use a mouthwash with chlorohexidine gluconate.  This is a mild antiseptic that is used to kill harmful bacteria in the mouth thus helping to eliminate plaque, calculus, and gingivitis.
• FLOSS EVERY DAY.  This is key to maintaining the health of your gums/gingiva.  Flossing eliminates the bacteria or food trapped under the gums.  This step is also very important for you being that food packs between your teeth.  In areas such as that, you must be sure to brush thoroughly and floss to remove all irritants.

Hope these tips help out and good luck,

SaveMySmile Team

Is there an alternative to toothpaste?

Question:

I am going on a mission to Malawi, Africa.  We will be handing out toothbrushes to 1000 children.  Do you have any step by step posters to help illustrate how to brush your teeth? Also, what common products could they use when toothpaste is not available? Thank you any help would be appreciated.

Answer:

Feel free to check out our article on Brushing for a step-by-step guide on how to properly brush.  There is a graphic included with the article that illustrates the correct way to effectively brush.

Now, in response to a toothpaste alternative, let’s first discuss the purpose of brushing your teeth and the role of toothpaste (dentifrice).  The ultimate goal of brushing is to remove bacteria and debris (i.e. food debris) from the tooth surfaces.  We want to eliminate food, more specifically sugar, from our tooth surfaces so that bacteria won’t have the opportunity to grow and create harmful substances which could eventually damage our teeth.  This process of removing the above mentioned substances is accomplished with the toothbrush alone!  A toothpaste only adds to the experience of brushing our teeth.

A toothpaste is composed of several parts to enhance the toothbrushing experience and to encourage individuals to brush.  These parts include:

• Abrasive –used to more effectively clean the teeth.  For example an abrasive sponge is used to more effectively remove dirt and grime from a kitchen countertop.
• Detergents
• Flavoring agents – makes the toothpaste “taste good”.  The tolerable taste encourages individuals to brush more.
• Caries (cavity) preventive substance – some toothpastes contain Flouride or Triclosan.  These additional substances are used to strengthen the tooth enamel to aid in preventing cavities or gingivitis.

In a worst case scenario, if no toothpaste is available, baking powder can be used.  If this substance is not available, you can still effectively brush your teeth with just WATER!!  Remember, the goal is to remove bacteria and debris.  Toothpaste just adds to this process.

Hope these tips help out and good luck,

SaveMySmile Team

Signs of Gingivitis

Gum disease, known as gingivitis (or it’s more severe form, periodontitis), refers to the inflammation of the gums (gingiva).  It results from accumulation of bacteria near the gum line, causing bacterial invasion into the tissues of the body.  If not addressed and treated, gingivitis will lead to recession of the gums, bone loss, tooth loss, and systemic disease.

Signs of Gingivitis

• Swollen gums
• Bleeding gums (especially when brushing or flossing)
• Shiny or red gums
• Associated pain
• Bad breath or foul smelling gums
• Gum recession (teeth appear longer)

Causes of Gingivitis

• Most often caused by plaque accumulation and poor oral hygiene habits
• Hormonal changes (i.e. pregnancy)
• Certain medications that may suppress the immune system

Gingivitis is a mild form of inflammation.  Unlike it’s more serious form, periodontitis, gingivitis can be treated quickly and easily if addressed in a timely fashion.

Treatment for Gingivitis

• Improve oral hygiene habits – Brush after each meal and floss every day.  If this regimen is followed precisely, the bleeding will eventually stop.
• Incorporate a mouth rinse, preferably with chlorohexidine, into your daily routine.  This can assist with the removal of unwanted bacteria.
• Visit the dentist and get a cleaning – The dentist will be able to effectively remove plaque and calculus, the main causes of gingivitis.  However, it’s up to you to maintain the plaque free mouth after this point.
• Antibiotics – If serious, the dentist may prescribe antibiotics to control the bacterial invasion.

All in all, gingivitis can easily be managed if addressed early.  Take the right steps in keeping up with your oral hygiene to maintain a healthy smile.

Have more questions?  Feel free to leave a commit or submit a question to be included in our FAQ’s.