It's one of the hardest things I have to tell patients. Many patients have gone to the same provider for years who have never mentioned periodontal (gum) disease to the patient and continued to do a prophylaxis (healthy gum cleaning), when in reality the patient's gums are inflamed, have pockets (space between the gum and tooth), even mobility (loose) due to loss of bone. There are many reasons why a provider may not diagnose a patient with periodontal disease, non of them ethical. It is my main priority to be truthful with patients about the current state of their oral condition no matter how unfavorable it may be. My goal is to save them time and money, while reducing the chance of pain and tooth loss.
Worse yet, some patient's are aware of their gum disease, have had periodontal therapy (scaling and root planing) performed yet never kept up on their periodontal maintenance's (more frequent "cleanings" below the gum line) for one reason or another. Whether it was loss of insurance, out of pocket expense or lack of concern, one thing is certain, tooth loss is almost inevitable.
I see it more often than I should. Patients invest a large sum of time and money to treat periodontal
disease through a process called scaling and root planing. However, without the more frequent maintenance program (every 3-4 months following the therapy), all the efforts, time and investment will have been in vain.
Is gum disease a hopeless cause? Absolutely not, but you have to own the disease because in reality you'll never be free from it. Much like Diabetes, you're never cured, but it can definitely be managed.
A recent CDC (Center for Disease Control) study provides the following data related to prevalence of periodontitis (a more advanced form of periodontal disease) in the U.S.:
- 47.2% of of adults age 30 years and older have some sort of periodontal disease.
- Periodontal Disease increases with age, 70.1% of adults aged 65 and older have periodontal disease. (Center for Disease Control)
How do you get periodontal disease? It's caused by plaque, a sticky film that is always forming on your teeth. Plaque contains bacteria that produce harmful toxins. If teeth are not cleaned well, the toxins can irritate and inflame the gums. Most of know that some inflammation in the body can be good, signaling the bodies response to try and repair itself. Excessive inflammation is bad and can cause major damage. I often tell patients that the bacteria poop acid on your teeth, simply put. The acid produced by bacteria eat away at the enamel on your teeth, inflames the gums causing pockets, and eventually eats away at the bone structure that houses your teeth.
Symptoms. Some people with periodontal disease have few or no warning signs. Here are few:
- gums that bleed when you brush or floss
- red, swollen or tender gums
- gums that have pulled away from your teeth
- bad breath that doesn't go away
- pus between your teeth and gums
- loose or separating teeth
- a change in the way your teeth fit together when you bit
- a change in the fit of partial dentures
Treatment. Gingivitis is the mildest form of gum disease. The gum tissue is read and swollen and may bleed when brushing or flossing. The good news is it can be reversed! Better home care and getting regular professional cleanings will reduce the inflammation and could eliminate it.
The more advanced form is called periodontitis. Increased swelling and redness of the tissue around the teeth that causes the tissue and bone to break down creating pockets between the gum and teeth. The recommended treatment is called scaling and root planing. This is a treatment that gets below the surface of the gums to remove plaque and tarter that bacteria feed on. By cleaning out the pockets, the gum tissue has a better chance to reattach to the tooth structure.
Once scaling and root planing is completed, patients need to be seen for a periodontal maintenance every 3 to 4 months depending on the severity of the periodontal disease. Without these maintenance, the infection will continue and scaling a root planing may be needed more often.
Periodontal disease will not go away on its own. Catch it early to keep a healthy smile and avoid tooth loss.
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