Signs, Causes & Treatments of Gum or Periodontal Disease

 

Four out of five people have periodontal disease and don’t know it! Most people are not aware of it because the disease is usually painless in the early stages.

Not only is it the number one reason for tooth loss, research suggests that there may be a link between periodontal disease and other diseases such as, stroke, bacterial pneumonia, diabetes, cardiovascular disease, and increased risk during pregnancy. Researchers are determining if inflammation and bacteria associated with periodontal disease affects these systemic diseases and conditions. Smoking also increases the risk of periodontal disease.
San Ramon CA Dentist Dr. Mohammad Khandaqji, DDS provides Periodontal (gum) disease, gum disease treatment, periodontal disease, treatment for gum disease, gingivitis to patients suffering from gum disease, receding gums, tooth loss, bleeding gums, sore gums, sensitive gums in Blackhawk, Pleasanton, Dublin, Alamo, Walnut Creek, and Livermore, CA Dentist providing Periodontal (gum) disease in San Ramon CA.
The Journal of the American Dental Association features new ADA clinical practice guidelines and a supporting systematic review regarding the nonsurgical treatment of chronic periodontitis by scaling and root planing (SRP) with or without adjuncts. The ADA Council on Scientific Affairs convened a panel of experts to conduct a systemic review of evidence, resulting in the guidelines. “The treatment of chronic periodontal disease is challenging for both the patient and the dental team,” said Dr. Smiley. “It is hoped that this systematic review will aid in the decision-making process on the broad range of available treatment options.” To view this and other features in July 2015 JADA, visit jada.ada.org/current.
From Journal of the American Dental Association website.

 

Some of the most common causes of gum disease

There are genetic and environmental factors involved in the onset of gum disease, and in many cases, the risk of developing periodontitis can be significantly lowered by taking preventative measures.

Poor dental hygiene – Preventing dental disease starts at home with good oral hygiene and a balanced diet. Prevention also includes regular dental visits which include exams, cleanings, and x-rays. A combination of excellent home care and professional dental care will preserve the natural dentition and support of bony structures. When bacteria and calculus (tartar) are not removed, the gums and bone around the teeth become affected by bacterial toxins and can cause gingivitis or periodontitis, which ultimately lead to tooth loss.
Tobacco use – Research has indicated that smoking and tobacco use are some of the most significant factors in the development and progression of gum disease. In addition to smokers experiencing a slower recovery and healing rate, smokers are far more likely to suffer from calculus (tartar) build-up on teeth, deep pockets in the gingival tissue, and significant bone loss.
Genetic predisposition – Despite practicing rigorous oral hygiene routines, as much as 30% of the population may have a strong genetic predisposition to gum disease. These individuals are six times more likely to develop periodontal disease than individuals with no genetic predisposition. Genetic tests can be used to determine susceptibility and early intervention can be performed to keep the oral cavity healthy.
Pregnancy and menopause – During pregnancy, regular brushing and flossing is critical. Hormonal changes experienced by the body can cause the gum tissue to become more sensitive, rendering them more susceptible to gum disease.
Chronic stress and poor diet – Stress lowers the ability of the immune system to fight off disease which means bacterial infection can beat the body’s defense system. Poor diet or malnutrition can also lower the body’s ability to fight periodontal infections, as well as negatively affecting the health of the gums.
Diabetes and underlying medical issues – Many medical conditions can intensify or accelerate the onset and progression of gum disease including respiratory disease, heart disease, arthritis and osteoporosis. Diabetes hinders the body’s ability to utilize insulin which makes the bacterial infection in the gums more difficult to control and cure.
Grinding teeth – The clenching or grinding of teeth can significantly damage the supporting tissue surrounding the teeth. Grinding one’s teeth is usually associated with a “bad bite” or the misalignment of the teeth. When an individual is suffering from gum disease, the additional destruction of gingival tissue due to grinding can accelerate the progression of the disease.
Medication – Many drugs including oral contraceptive pills, heart medicines, anti-depressants, and steroids affect the overall condition of teeth and gums, making them more susceptible to gum disease. Steroid use promotes gingival overgrowth, which makes swelling more commonplace and allows bacteria to colonize more readily in the gum tissue.

Common Signs & Symptoms of Gum Disease

It is extremely important to note that periodontal disease can progress without any signs or symptoms such as pain. This is why regular dental checkups are exceptionally important. Described below are some of the most common signs and symptoms of periodontitis.If you have any of these signs or symptoms, the advice of Dr. Khandaqji or a periodontist should be sought as soon as possible:

Unexplained bleeding – Bleeding when brushing, flossing or eating food is one of the most common symptoms of a periodontal infection. The toxins in plaque cause a bacterial infection which makes the tissues prone to bleeding.

Pain, redness or swelling – A periodontal infection may be present if the gums are swollen, red or painful for no apparent reason. It is essential to halt the progression of the infection before the gum tissue and jaw bone have been affected. It is also critical to treat the infection before it is carried into the bloodstream to other areas of the body.

Longer-looking teeth – Periodontal disease can lead to gum recession. The toxins produced by bacteria can destroy the supporting tissue and bones, thus making the teeth look longer and the smile appear more “toothy.”

Bad breath/halitosis – Although breath odor can originate from the back of the tongue, the lungs and stomach, the food we consume, or from tobacco use, bad breath can also be caused by old food particles that sit between the teeth and underneath the gumline. The deeper gum pockets are able to house more debris and bacteria, causing a foul odor.

Loose teeth/change in bite pattern – A sign of rapidly progressing periodontitis is the loosening or shifting of the teeth in the affected area. As the bone tissue gets destroyed, teeth that were once firmly attached to the jawbone become loose or may shift in position.

Pus – Pus oozing from between the teeth is a definitive sign that a periodontal infection is in progress. The pus is a result of the body trying to fight the bacterial infection.

Periodontal treatment methods depend upon the type and severity of the disease

Periodontal treatment methods depend upon the type and severity of the disease. Dr. Khandaqji and the Mona Lisa Smile Dental hygienist will evaluate for periodontal disease and recommend the appropriate treatment. Periodontal disease progresses as the sulcus (pocket or space) between the tooth and gums gets filled with bacteria, plaque, and tartar, causing irritation to the surrounding tissues. When these irritants remain in the pocket space, they can cause damage to the gums and eventually, the bone that supports the teeth!
If the disease is caught in the early stages of gingivitis, and no damage has been done, one to two regular cleanings will be recommended. You will also be given instructions on improving your daily oral hygiene habits and having regular dental cleanings.
If the disease has progressed to more advanced stages, a special periodontal cleaning called scaling and root planing (deep cleaning) will be recommended. It is usually done one quadrant of the mouth at a time while the area is numb. In this procedure, tartar, plaque, and toxins are removed from above and below the gum line (scaling) and rough spots on root surfaces are made smooth (planing). This procedure helps gum tissue to heal and pockets to shrink. Medications, special medicated mouth rinses, and an electric tooth brush may be recommended to help control infection and healing.
If the pockets do not heal after scaling and root planing, periodontal surgery may be needed to reduce pocket depths, making teeth easier to clean. It only takes twenty four hours for plaque that is not removed from your teeth to turn into calculus (tartar)! Daily home cleaning helps control plaque and tartar formation, but those hard to reach areas will always need special attention.
These and similar procedures are usually performed with local anesthesia, sometimes supplemented with other sedation methods. Special cleaning instructions will be given to protect the site from further infection, and any minor discomfort after the procedure can usually be managed with anti-inflammatory medication (like ibuprofen) for a few days.

 

Cosmetic Periodontal Surgery at Mona Lisa Smile Dental to enhance your smile

Cosmetic periodontal procedures are a predictable way to cover unsightly, sensitive, or exposed root surfaces and to prevent future gum recession. Dr. Khandaqji utilize minimally invasive surgically procedures and microsurgery to treat recession. Changing the appearance of your gums can cosmetically enhance your smile. Your gums define your teeth…we can adjust this relationship making teeth look longer, shorter, even better shaped to provide a more attractive smile.
These procedures are a predictable way to cover unsightly, sensitive, or exposed root surfaces and to prevent future gum recession. If you are unhappy with the appearance of short unsightly teeth this can be greatly improved by a combination of periodontal procedures by Dr. Khandaqji and cosmetic dentistry at Mona Lisa Smile Dental.
Crown lengthening, excess gum and bone tissue are reshaped to expose more of the natural tooth. This can be done to more than one tooth, to even your gum line, and to create a beautiful smile.
Another cosmetic procedure is the soft tissue graft. It is used to cover unattractive tooth roots, reduce gum recession, and protect the roots from decay and eventual loss. Tooth loss causes the jawbone to recede and can lead to an unnatural looking indentation in your gums and jaw, an appearance of a general aging. The original look of your mouth may not be recaptured because of spaces remaining under and between replacement teeth. They may appear too long compared to nearby teeth.
Bone grafting following tooth loss can preserve the socket/ridge and minimize gum and bone collapse. There is less shrinkage and a more aesthetic tooth replacement for either an dental implant crown or fixed bridge around the replacement teeth.
Gum Grafting is when recession of the gingiva occurs, the body loses a natural defense against both bacterial penetration and trauma. When gum recession is a problem, gum reconstruction using grafting techniques is an option. When there is only minor recession, some healthy gingiva often remains and protects the tooth, so that no treatment other than modifying home care practices is necessary. However, when recession reaches the mucosa, the first line of defense against bacterial penetration is lost. In addition, gum recession often results in root sensitivity to hot and cold foods as well as an unsightly appearance of the gum and tooth. When significant, gym recession can predispose to worsening recession and expose the root surface, which is softer than enamel, leading to root caries and root gouging.
A gingival graft is designed to solve these problems. A thin piece of tissue is taken from the roof of the mouth or gently moved over from adjacent areas to provide a stable band of attached gingiva around the tooth. The gingival graft may be placed in such a way as to cover the exposed portion of the root. The gingival graft procedure is highly predictable and results in a stable healthy band of attached tissue around the tooth.

After periodontal treatment cleaning and evaluation

Once your periodontal treatment has been completed, Dr. Khandaqji and the Mona Lisa Smile Dental hygienist will recommend that you have regular maintenance cleanings (periodontal cleanings), usually four times a year. At these cleaning appointments, the pocket depths will be carefully checked to ensure that they are healthy. Plaque and calculus that is difficult for you to remove on a daily basis will be removed from above and below the gum line. In addition to your periodontal cleaning and evaluation, your appointment will usually include:

Examination of diagnostic x-rays (radiographs): Essential for detection of decay, tumors, cysts, and bone loss.X-rays also help determine tooth and root positions.
Examination of existing restorations: Check current fillings, crowns, etc.
Examination of tooth decay: Check all tooth surfaces for decay.
Oral cancer screening: Check the face, neck, lips, tongue, throat, cheek tissues, and gums for any signs of oral cancer.
Oral hygiene recommendations: Review and recommend oral hygiene aids as needed. (Electric toothbrushes, special periodontal brushes, fluorides, rinses, etc.)
Teeth polishing: Remove stain and plaque that is not otherwise removed during tooth brushing and scaling.
Good oral hygiene practices and periodontal cleanings are essential in maintaining dental health and keeping periodontal disease under control!

Good oral hygiene, a balanced diet, and regular dental visits can help reduce your risk of developing periodontal disease.

 

Gum disease treatment, including surgery, isn’t a cure—the prospect for reoccurrence is always there. Proper hygiene and maintenance by both you and Dr. Khandaqji are essential for preventing this. Gum surgery is performed to regenerate lost bone and to help create an environment around the teeth and gums that makes it easier to clean and maintain them. Gum surgery, then, should be considered as part of an overall strategy to stop periodontal (gum) disease’s unchecked advance so that healing can take place. This will allow you to keep your natural teeth for as long as possible—maybe even for life.
If you have been told or think that you have a gummy smile or other periodontal problem that makes you embarrassed about your smile, please contact Dr. Khandaqji’s office at 925-543-0000 for a consultation, or ask your general dentist for a referral.