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Periodontal
Care
Knowing the state of your periodontal
health is important. So, if you don't know, ask your dental
professional. It is a good idea to know if you are in good periodontal
health because periodontal disease and decay are the primary causes of
adult tooth loss. But even more importantly, recent research has found a
relationship between periodontal infection and more serious health
problems such as cardiovascular disease, diabetes, respiratory disease,
and preterm low birth weight babies.
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What
is Periodontal Disease?
The word "periodontal" literally means around the tooth.
Periodontal disease, also known as gum disease, is a chronic bacterial
infection that affects the gums and bone supporting the teeth.
Periodontal disease can affect one tooth or many teeth. It begins when
the bacteria in plaque (the sticky, colorless film that constantly forms
on your teeth) causes the gums to become inflamed.
In the mildest forms of the disease, gingivitis, the gums redden,
swell, and bleed easily. There is usually little or no discomfort.
Gingivitis is often caused by inadequate oral hygiene. Gingivitis is
reversible with professional treatment and good oral home care.
Untreated gingivitis can advance to periodontitis. With time, plaque
can spread and grow below the gum line. Toxins produced by the bacteria
in plaque irritate the gums. The toxins stimulate a chronic inflammatory
response in which the body in essence turns on itself, and the tissues
and bone that support the teeth are broken down and destroyed. Gums
separate from the teeth, forming pockets (spaces between the teeth and
gums) that become infected. As the disease progresses, the pockets
deepen and more gum tissue and bone are destroyed. Often, this
destructive process has very mild symptoms. Eventually, teeth can become
loose and may have to be removed.
The American Dental Association
(ADA) web site has some excellent information on Periodontal Disease as
well. Click
here to visit their site and learn more.
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What Causes
Periodontal Disease?
Plaque
is the culprit, which means that without proper at home oral hygiene and
regular dental visits, your risk clearly increases.
However, even perfect oral hygiene isn’t enough to ward off
periodontal disease in everyone. Other risk factors that are thought to increase the risk,
severity and speed of development of periodontal disease include tobacco
use, general health conditions, medications, stress, genetics, hormonal
changes and poor nutrition.
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Who Is A
Periodontist?
A periodontist is a dentist who
specializes in the prevention, diagnosis and treatment of periodontal
disease and in the placement of dental implants.
Periodontists receive extensive training in these areas,
including two to three additional years of education beyond dental
school. Periodontists are
familiar with the latest techniques for diagnosing and treating
periodontal disease. In
addition, they can perform cosmetic periodontal procedures to help you
achieve the smile you desire.
Often, dentists refer their
patients to a periodontist when periodontal disease is present.
However, you don’t need a referral to see a periodontist.
In fact, there are occasions when you may choose to go directly
to a periodontist or to refer a family member of friend to your own
periodontist.
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When
Should I See A Periodontist?
A periodontal evaluation may
be especially important if you:
1. Notice
any symptoms of periodontal disease, including:
-
gums
that bleed easily, such as during brushing or flossing
-
red,
swollen or tender gums
-
gums
that have pulled away from the teeth
-
persistent
bad breath
-
pus
between the teeth and gums
-
loose
or separating teeth
-
a
change in the way your teeth fit together when you bite
2. Are
thinking or becoming pregnant. Pregnant
women who have periodontal disease
may be seven times more likely to
have a baby born too early and too small.
In addition, about half of women experience “pregnancy
gingivitis.” However, women who have good oral hygiene and have no
gingivitis before pregnancy are very unlikely to experience this
condition.
3.
Have
a family member with periodontal disease.
Research suggests that the bacteria
that cause periodontal disease can
pass through saliva. This
means the common contact of saliva in families puts children and couples
at risk for contracting the periodontal disease of another family
member.
4.
Have heart disease, diabetes, respiratory disease, or
osteoporosis. Ongoing
research is showing
that periodontal disease may be linked to these conditions.
The bacteria
associated with periodontal disease can
travel into the blood stream and pose a threat to other parts of the body.
Healthy gums may lead to a healthier body.
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Gingivitis:
Prevalence and Distribution
Gingivitis is closely
correlated with plaque deposits, a relationship long considered one of
cause-and-effect. It is generally believed that gingivitis has declined over
recent years in the United States because of greater attention to oral
hygiene as a part of personal grooming.
The main interest in gingivitis today is whether it is a
precursor to periodontitis, since research suggests that only some sites
or patients with gingivitis go on to develop periodontitis.
When assessed in populations,
gingivitis is found in early childhood, and is more prevalent and severe
in adolescence, after which prevalence tends to level off.
The prevalence of gingivitis among school children in the United
States has ranged from 40% to 60% in national surveys.
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Teeth
Grinding or Clenching
Research has found that about
50% of the population has excessive wear patterns on their teeth that
may be seen even in the teenage patients.
The biting force when chewing food is about 25 pounds per square
inch. Clenching and
grinding contacts may be ten times that much or more.
Often these grinding contacts occur during sleep, two or three
times an hour, and for perhaps ten to fifteen seconds each episode.
Only 15% are heard to make grinding noises.
Night grinding of teeth is called “bruxism” and can severely
damage the teeth. A night guard appliance can be made to protect teeth from
loss of length and protect crowns from breakage of porcelain.
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Gum
Recession
Gum recession is usually not
caused by disease but is a special category of gum problems.
Exposed roots are subject to sensitivity, tooth decay, and
abrasive action from tooth brushing.
There are several reasons a person may have gum recession:
-
The jaw bone may be narrow from front to back meaning bone next
to the lip may not extend all the way up near
the crowns of teeth.
-
Crowded teeth may leave certain teeth too far out with less bone
and gum available for that tooth.
-
The gums may be thin and
fragile and easily damaged by the toothbrush.
-
A person could be brushing too hard, too long, and or with a too
hard toothbrush.
-
Muscle attachments may cause movement of the gum in some sites.
Click here to
see examples of gum recession and the treatment that can repair it.
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References
“Spread the
Word, Periodontal Care is for Everyone.”
The American Academy of Periodontology.
Pamphlet 2000
“AAP
News”. The American Academy of Periodontology.
Volume 32, Number 10, October 1997 -
The AAP is a 7,000 member
organization of dentists specializing in the prevention, diagnosis,
treatment of tissues surrounding the teeth, and in the placement of
dental implants.
“Periodontal
Management of Patients with Cardiovascular Diseases.” The
Research, Science, and Therapy Committee of the American Academy
of Periodontology. Informational Paper. Volume 67, Number 6, June 1996
“Epidemiology
of Periodontal Diseases.” The Research, Science, and Therapy Committee
of The American Academy of Periodontology. Volume 67, Number
9, September 1996.
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