Periodontal Disease
Periodontal disease affects millions of people and it is the main cause of tooth loss.
In the early stages Periodontal Disease is a ‘silent’ condition and you may not be aware that a problem exists until the disease is quite advanced, which is why it is very important to have regular check ups so that we can detect any problems in the early stages of the disease.
What is Periodontal Disease?
Each tooth consists of two parts namely the crown, which is visible in the mouth and the root, which anchors the tooth into the bone. Each front tooth has one root whilst the back teeth have one, two or three roots.
The gums are a specialised type of skin that surrounds the teeth and covers the bone holding in the teeth. Often the gums will look essentially normal even though a gum condition is present and this is why a thorough examination by a dental professional is required to detect a gum problem.
Gingivitis is a superficial infection that is limited to the gum tissue and does not affect the underlying bone. The gums may look normal but may have some of the following signs – redness and puffiness, bleeding when brushing and bad oral odour (Halitosis).
When the infection advances and affects the supporting ligament and underlying bone, it is termed Periodontitis (once called Pyorrhoea).
Periodontitis ‘eats away’ at the bone that supports the teeth and if untreated can lead to tooth loss. The gums may appear red and swollen, spaces may begin to appear between the teeth, there may be loosening of the teeth, signs of receding gums and vague aching, itching or other discomfort of the gums.
The good news is that most periodontal diseases can be treated.
What causes Periodontal Disease?
Plaque is a primary cause of Periodontal Disease. It is a sticky, almost invisible film that forms daily on our teeth. Plaque is a continually spreading mass of disease-causing bacteria and their waste products, which grow on the teeth and down in the crevice between the gum and tooth. The bacteria produce toxins (poisons) that damage the gums and underlying bone.
What is Periodontal Disease?
Each tooth consists of two parts namely the crown, which is visible in the mouth and the root, which anchors the tooth into the bone. Each front tooth has one root whilst the back teeth have one, two or three roots.
The gums are a specialised type of skin that surrounds the teeth and covers the bone holding in the teeth. Often the gums will look essentially normal even though a gum condition is present and this is why a thorough examination by a dental professional is required to detect a gum problem.
Gingivitis is a superficial infection that is limited to the gum tissue and does not affect the underlying bone. The gums may look normal but may have some of the following signs – redness and puffiness, bleeding when brushing and bad oral odour (Halitosis).
When the infection advances and affects the supporting ligament and underlying bone, it is termed Periodontitis (once called Pyorrhoea).
Periodontitis ‘eats away’ at the bone that supports the teeth and if untreated can lead to tooth loss. The gums may appear red and swollen, spaces may begin to appear between the teeth, there may be loosening of the teeth, signs of receding gums and vague aching, itching or other discomfort of the gums.
The good news is that most periodontal diseases can be treated.
What causes Periodontal Disease?
Plaque is a primary cause of Periodontal Disease. It is a sticky, almost invisible film that forms daily on our teeth. Plaque is a continually spreading mass of disease-causing bacteria and their waste products, which grow on the teeth and down in the crevice between the gum and tooth. The bacteria produce toxins (poisons) that damage the gums and underlying bone.
This diagram shows the stages of gum disease.
Periodontitis: From Plaque to Tooth Loss
Healthy gums and bone hold the tooth firmly in place.
Plaque build-up irritates the gums, and they become inflamed. In time the periodontal fibres that attach the teeth to the bone are destroyed and the underlying bone is lost, the crevice deepens which creates a ‘pocket’ which then fills with more plaque. In large amounts plaque can be seen and can be felt with tongue as a fuzzy, unclean coating on the teeth. If you do not completely remove all the plaque every day by tooth brushing and cleaning in between the teeth, it leads to the formation of calculus (tartar), a stony crust with a pitted, rough surface. You cannot remove calculus yourself- it clings to the teeth with such force that only a dentist or hygienist can remove it.
As the gum disease continues so does the bone destruction. When sufficient bone has been lost the tooth loosens. Finally, deprived of most of the supporting bone, the tooth becomes so loose that is either falls out or must be extracted.
As the gum disease continues so does the bone destruction. When sufficient bone has been lost the tooth loosens. Finally, deprived of most of the supporting bone, the tooth becomes so loose that is either falls out or must be extracted.
In recent studies, health problems have been linked with people who have Periodontal Disease. Studies have shown that bacteria from the mouth can enter the bloodstream which is being increasingly associated with:
• The increased risk of heart disease, fatal heart attacks and strokes
• Make it more difficult for diabetic patients to control their blood sugar
• Lead to reduced birth weight and premature babies for pregnant women
Research has also shown that bacteria associated with Periodontal Disease can be passed through saliva and can be transmitted from one person to another.
Other factors that contribute to an increased risk of developing Periodontal Disease include:
• Smoking
• Systemic diseases e.g. diabetes
• Many medications e.g. steroids, blood pressure medications
• Pregnancy
• Plaque retention factors e.g. crowns and bridges that no longer fit and overcrowding of the teeth
The Treatment of Periodontal Disease
A Dental Hygienist is a skilled clinician in the treatment of Periodontal Disease and with your co-operation can reduce the chance of tooth loss. One of the most important things the dental hygienist will do for you are to take the time to demonstrate correct tooth brushing technique and how to clean in- between the teeth for effective removal of all of the plaque on a daily basis. It is the plaque that causes the periodontal Disease and if the condition is to be stabilised then this is essential.
Our Dental Hygienist will gently remove the calculus from above and below the gum margin. It is important that all the calculus is removed and this takes time and skill. Measurement of the pockets is recorded around each tooth and this is called a Pocket Chart. These measurements are required in order to accurately monitor the progression of the disease. Your dentist or hygienist can show you this chart and discuss any areas of the mouth that requires special attention. To enable the hygienist to care expertly for your periodontal needs this initial cause of Periodontal Therapy may take a number of visits and it may be necessary for your dentist to prescribe a particular mouthwash or medication, which will assist in controlling the disease.
Once this course of treatment has been completed you will be required to visit your hygienist to enable her/him to provide regular maintenance care for your periodontal condition. This will also ensure the condition can be monitored with a view of stabilising the condition, to provide the best chance against tooth loss.
In some cases where the periodontal problem has not responded to the initial course of treatment or the problem is advanced you will need to see a Periodontist. A Periodontist is a specialist in the care of gums and supporting bone, He/she has years of extra schooling and experience that permits them to use special techniques to treat more difficult and more advanced periodontal problems. Our resident Periodontist is Dr Denise Mcpartlin.
Conclusion
The prevention and treatment of Periodontal Disease involves the combine efforts of yourself and your dental hygienist. The professional care is only half the battle – the essential other half is dependent on your daily personal oral hygiene. Loss of your teeth from periodontal disease is not inevitable. You and your hygienist, working together, can see to that.
As the gum disease continues so does the bone destruction. When sufficient bone has been lost the tooth loosens. Finally, deprived of most of the supporting bone, the tooth becomes so loose that is either falls out or must be extracted.
As the pockets get deeper, and the plaque hardens into tartar more plaque accumulates on top.
Tartar moves down to the root of the tooth It is possible to see the calculus that forms above the gum margin however it is the hidden calculus under the gums that does the harm. Calculus greatly complicates the problem of preventing the progression of Periodontal Disease. The toxins produced by the bacteria in plaque not only affect the gum but also destroy the periodontal fibres and will eventually destroy the bone supporting the tooth.
As the gum disease continues so does the bone destruction. When sufficient bone has been lost the tooth loosens. Finally, deprived of most of the supporting bone, the tooth becomes so loose that is either falls out or must be extracted.
In recent studies, health problems have been linked with people who have Periodontal Disease. Studies have shown that bacteria from the mouth can enter the bloodstream which is being increasingly associated with:
• The increased risk of heart disease, fatal heart attacks and strokes
• Make it more difficult for diabetic patients to control their blood sugar
• Lead to reduced birth weight and premature babies for pregnant women
Research has also shown that bacteria associated with Periodontal Disease can be passed through saliva and can be transmitted from one person to another.
Other factors that contribute to an increased risk of developing Periodontal Disease include:
• Smoking
• Systemic diseases e.g. diabetes
• Many medications e.g. steroids, blood pressure medications
• Pregnancy
• Plaque retention factors e.g. crowns and bridges that no longer fit and overcrowding of the teeth
The Treatment of Periodontal Disease
A Dental Hygienist is a skilled clinician in the treatment of Periodontal Disease and with your co-operation can reduce the chance of tooth loss. One of the most important things the dental hygienist will do for you are to take the time to demonstrate correct tooth brushing technique and how to clean in- between the teeth for effective removal of all of the plaque on a daily basis. It is the plaque that causes the periodontal Disease and if the condition is to be stabilised then this is essential.
Our Dental Hygienist will gently remove the calculus from above and below the gum margin. It is important that all the calculus is removed and this takes time and skill. Measurement of the pockets is recorded around each tooth and this is called a Pocket Chart. These measurements are required in order to accurately monitor the progression of the disease. Your dentist or hygienist can show you this chart and discuss any areas of the mouth that requires special attention. To enable the hygienist to care expertly for your periodontal needs this initial cause of Periodontal Therapy may take a number of visits and it may be necessary for your dentist to prescribe a particular mouthwash or medication, which will assist in controlling the disease.
Once this course of treatment has been completed you will be required to visit your hygienist to enable her/him to provide regular maintenance care for your periodontal condition. This will also ensure the condition can be monitored with a view of stabilising the condition, to provide the best chance against tooth loss.
In some cases where the periodontal problem has not responded to the initial course of treatment or the problem is advanced you will need to see a Periodontist. A Periodontist is a specialist in the care of gums and supporting bone, He/she has years of extra schooling and experience that permits them to use special techniques to treat more difficult and more advanced periodontal problems. Our resident Periodontist is Dr Denise Mcpartlin.
Conclusion
The prevention and treatment of Periodontal Disease involves the combine efforts of yourself and your dental hygienist. The professional care is only half the battle – the essential other half is dependent on your daily personal oral hygiene. Loss of your teeth from periodontal disease is not inevitable. You and your hygienist, working together, can see to that.
We have a resident Specialist in Periodontics, Dr Denise McPartlin, who sees patients on referral from other practices, as well as treating our own patients.
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