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Periodontics
About Periodontal Disease
About Periodontal Disease

Periodontal disease can affect one to several teeth. Periodontal disease an infection of the gums, which gradually lead to the destruction of the support of your natural teeth. These diseases effect more than 80% of Americans by the age of 45.

Dental plaque is the primary cause of gum disease. Bacteria found in plaque produce enzymes and toxins which injure the gums. Injured gums turn red, swell and bleed easily.

If this injury is prolonged, the gums separate from the teeth, causing pockets (spaces) to form.

Plaque can also harden into a rough, porous substance known as calculus (tartar).

This can occur both above and below the gum line. As periodontal diseases progress, the supporting gum tissue and bone that holds teeth in place deteriorate.

If left untreated, this leads to tooth loss. Pain is usually not present until damage from this disease is very advanced.

Periodontal Health Effects

Studies have shown links between periodontal (gum) disease, heart disease and other health conditions.

Research further suggests that gum disease may be a more serious risk factor for heart disease than hypertension, smoking, cholesterol, gender and possibly ages.

Researchers conclusions suggest that bacteria present in infected gums can become loose and move throughout the body through the bloodstream. Once bacteria reach the arteries, they can irritate them in the same way that they irritate gum tissue causing arterial plaque, which can cause hardening and affect blood-flow.

Plaque
Plaque

Plaque is essentially the start of gum disease problems. Plaque is a build-up from bacteria in the mouth and particles from the foods you eat every day.

Once sugars are introduced to plaque, it turns into a tooth eating acid that sits just above the gum line. If regular oral care isn't standard, the acid will start eating at the teeth producing cavities and the plaque will cause gum disease.

Plaque that is allowed to sit for a prolonged period of time can cause cavities, gingivitis, and other problems in your mouth. If it's left longer than that, serious dental procedures may be required to restore your decaying smile.

Gingivitis

Gingivitis is an early stage of gum disease. Gingivitis develops as toxins, enzymes and other plaque byproducts by irritating the gums, making them tender, swollen and likely to bleed easily. Gingivitis generally can be stopped with proper oral hygiene and minor treatment from your dentist. If this is achieved, your gums can return to a healthy state.

Periodontitis

Periodontal disease is when the tooth's bone tissue starts to deteriorate. Periodontitis occurs when plaque byproducts destroy the tissues that anchor your teeth in the bone. The gums deteriorate and begin detaching themselves from the teeth forming gum pockets, which allows more plaque to collect below the gum line. This causes the roots of the teeth to become susceptible to decay. Sometimes the patient notices an increase in sensitivity to hot and cold and to touch.

Advanced Periodontitis

With severe periodontitis, a radical amount of gum tissue and bone tissue is lost. Usually, teeth lose more support as the disease continues to destroy the periodontal ligament and bone. Teeth become loose and may even need to be extracted. This causes difficulties in normal everyday chewing and biting habits. If advanced periodontal disease is left untreated, patients run the risk of other serious health problems.

Diabetes and Periodontal Disease
Diabetes and Periodontal Disease

Individuals suffering from diabetes have defects in small blood vessels, not only in the extremities (toes and fingers) and the retina of the eye but also in the gums.

The immune system of diabetics is also compromised. Diabetics are at higher risk of developing bacterial infections, especially in the mouth.

These infections may result in greater difficulty with controlling your diabetes. This unique "vicious cycle" makes periodontal diseases in the diabetic more severe, more difficult to treat and more likely to recur.

Steps to prevent periodontal disease include daily brushing and flossing to remove plaque from your teeth and gums, regular dental visits for professional cleaning and regular periodontal evaluation.

For the diabetic, this may not be enough. Your health professional must also be told of your history and the current status of your condition. And finally, you can help resist periodontal infection by carefully controlling your blood sugar levels.

Women and Periodontal Health
Women and Periodontal Health

Throughout a woman's life, hormonal changes affect tissues throughout the body. Fluctuations in hormone levels occur during puberty, pregnancy and menopause. At these times, the chance of periodontal disease may increase, requiring special care of your oral health.

Puberty:
During puberty, there is increased production of sex hormones. These higher levels increase gum sensitivity to plaque. The gums can become red, swollen and tender.
Similar symptoms occasionally appear several days before menstruation. The gums can become red, swollen and tender; bleeding may occur when brushing or flossing.
The symptoms will clear up once the period of menstruation has started. Over the years, the amount of sex hormones decrease, so do these problems.

Oral contraceptives:
Swelling, bleeding and tenderness of the gums may also occur when you are taking oral contraceptives, which are synthetic hormones.
You must mention any prescriptions you are taking, including oral contraceptives, prior to periodontal treatment. This will help eliminate risk of drug interactions, such as antibiotics with oral contraceptives where the effectiveness of the contraceptive can be lessened.

Pregnancy:
Many women are aware that their gums are affected during pregnancy. There is an 'old wives tale' that goes, 'For every child a tooth is lost'.
Not only do hormonal changes directly effect the gums, but (especially with morning sickness) oral hygiene can suffer. Between the second and eighth month, your gums may also become red or tender and swell. Sometimes an area of swelling may resemble a tumor, which may have to be removed. While the swellings usually disappear after delivery, periodontal pockets may persist, creating chronic problems. Periodontal disease during pregnancy can place a baby's health at risk. Periodontal health should be part of your prenatal care.
Pay particular attention to performing good oral hygiene and have professional tooth cleaning at three-month intervals until sometime after delivery.

Menopause:
Changes in the look and feel of your mouth may occur around the menopause. These include feeling pain and burning in your tongue or gum tissue.
Even careful oral hygiene practices and professional cleaning may not relieve these symptoms.

Medication Side Effects
Medication Side Effects
While antibiotics are used in the treatment of periodontal diseases, other medicines can complicate treatment by causing gum tissue overgrowth:

- Certain blood pressure medicines (Calcium-channel blockers)
- Certain anti-seizure medicines (Dilantin)
- Certain immune suppressant medicines (Cyclosporin)
Stress and Illness
Stress and Illness

Stress triggers the 'fight or flight' response in our bodies. It is mediated by the hormone adrenalin which has many effects. One effect is to allow the mobilization of glycogen from our fat stores to produce energy. This is secondarily mediated by Cortisol. Insulin also becomes involved.

Unfortunately, in the modern world chronic stress results in heightened levels of Cortisol long-term which suppresses our immune system. This leaves us susceptible to all sorts of chronic diseases, including Periodontal Disease.

Tobacco

You are probably familiar with the links between tobacco use and lung disease, cancer and cardiovascular disease.

Current studies have also established that tobacco smoking not only causes direct damage to your mouth but also makes periodontal diseases more damaging and harder to treat. There is a greater incidence of calculus formation on teeth, deeper pockets between gums and teeth, more gum recession and more loss of the bone that hold teeth in your mouth. In addition, smokeless tobacco greatly increases your chance of developing oral cancer. Any tobacco usage can complicate the placement of dental implants.

Chemicals in tobacco such as nicotine, which constricts blood vessels, slow down wound healing.

Other chemicals impair the function of your white blood cells which are your first line of defence against infection. The tars contain carcinogens which over time induce cell mutations and cancers.

Quitting tobacco use will lower the risk of your developing cancer and improve the health of your teeth and gums, as well as your heart and lungs.

Smokeless tobacco poses very serious problems including:

  • Causes tooth decay
  • Eats away your gums
  • Leads to tooth loss
  • Bad Breath
  • Stains your teeth
  • Causes oral sensitivity to hot and cold
  • Decreases sense of taste and smell
If oral cancer are left untreated long enough, it may even cause death.
Bruxism

Bruxism, commonly known as "tooth grinding," is the process of clenching together and the grinding of the upper and lower teeth. During sleep, the biting force of clenched jaws can be up to six times greater than during waking hours.

Bruxism can cause complications over the years. It can wear down tooth enamel and break fillings or other dental work. Bruxism can worsen TMJ dysfunction, cause Jaw pain, toothaches, headaches, or earaches. It can also cause tooth sensitivity, tooth mobility, chipped teeth and erodes gums and supporting bones contributing to gum disease.

There is no cure for bruxism; however, the condition can be managed. The most common procedure to help to alleviate pain and discomfort is a Nightguard.

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