Gingivitis
If you have, bleeding gums, you may have periodontal (gum) disease (periodontitis). The sooner this is controlled; your mouth and teeth will feel better. If untreated, periodontitis will cause serious loss of bone and eventual tooth loss. Gum disease has also been linked to heart disease, increase risk of stroke, and low birth weight and premature babies. Gum disease is also made worse by chronic diseases such as diabetes. The American Dental Association (ADA) says that over 75 – 80 % of all adults have some degree of gum disease. Gum disease has reached epidemic proportions and we take it very seriously. SO SHOULD YOU!
Periodontal Disease
Gum disease (correct term – periodontal disease) is a bacterial infection of the gums and structures that support the teeth. For communication purposes, periodontal disease is divided into four stages. These stages do not occur separate from each other, but represent a progression of this painless killer of tooth and dental structures from its beginning stages to the final stage of tooth loss. This is similar to progression of cancers through their described stages.
Stage I
Gingivitis affects 9 out of every 10 people in our population, including children. The gums (gingiva) are typically red, puffy and bleed, no matter how little, when brushed and flossed. Bad breath is also common. It is caused by several types of bacteria (sugar bugs) that form slimy colonies called plaque. Plaque is invisible to the eye until it accumulates as a thick yellowish-white coating on the teeth. The harmful bacteria in plaque release toxins that result in inflammation of gum tissues. Brushing you teeth and seeing streaks of red in the toothpaste foam in the sink is a red flag. You should be able to tell us which area of the mouth it came from. If left untreated, gingivitis progresses to the next stages.
Stages II, III, IV
The second third and fourth stages are early, moderate and advanced (severe) periodontitis (pe-rio-don-ti-tis). These are characterized by progressive erosion of the bone supporting the teeth. This occurs in response to the increasing severity of inflammation. As the disease progresses, teeth seem to change position in relation to each other and become loose. It is not uncommon to have a patient complain that “my teeth seem to be shifting” or “I have some loose teeth”. Periodontal disease may progress for years without pain or detection.
Recent research has found a connection between periodontitis and:
- Cardiovascular disease (heart attacks)
- Atherosclerosis (blockage and hardening of arteries)
- Strokes
- Diabetes
- Low birth weight, pre-term births and pre-eclampsia
Exactly how periodontitis contributes to these diseases is not yet known. However, severe periodontitis causes a significant doubling of the risk of death by cardiovascular disease. A recent study in Taiwan showed that having your teeth cleaned decreased the risk of heart attacks and strokes. The medical community is well aware of the effect of diabetes on gum disease (periodontitis) but it has been recently shown that severe periodontitis has a significant association with worsening complications in Type 2 diabetes patients and increase death rates in patients with end-stage renal disease.
The good news is that studies have shown an improvement in HbA1c (an indicator of diabetes) within three months after gum treatment.
Drs. Henry and Carrington must perform a thorough clinical examination of the teeth and structures supporting the teeth and take necessary X-rays to make a diagnosis.
Treatment of earlier stages is often non-surgical in nature and may also involve the use of antibiotics and oral rinses. After treatment, research has shown that a maintenance schedule of every three months is required. Don’t sell yourself short.
Pregnancy Gingivitis
Many mothers-to-be experience swollen, bleeding gums during pregnancy and experience several problems after delivery. This is often blamed on pregnancy. During pregnancy, hormonal changes tend to magnify the gum disease process. Furthermore, pregnant women tend to eat more frequent, smaller meals and may have cravings for “junk foods”. Exposing teeth and gums to more sugars and not improving brushing and flossing to meet these changes, result in increasing susceptibility to gum disease. As we have always heard from our elders, “an ounce of prevention is worth a pound of cure”. Gum disease is preventable if addressed early. Everyone should have his or her teeth cleaned professionally at lease twice each year. Some may need to have their teeth cleaned three or four times per year. Your insurance may only pay for one or two cleanings each year. However, what is best for your oral health may not be what your insurance allows. You are worth the extra dollars invested each year in yourself. It is less expensive to invest some extra dollars each year that to treat periodontal disease later in life.
Diabetes & Gum Disease
Like other complications of diabetes, gum disease is linked to poor control of your diabetes. Persons with poor control of their blood sugar get gum disease more often, more severely, and loose more teeth than persons with good control. People, who have well-controlled diabetes and good oral hygiene, have no more gum disease than people without diabetes. Children with insulin-dependent diabetes mellitus are also at risk for gum problems. Smoking also has a profound effect on gum health. Smokers are 5 times more likely than are non-smokers to have gum disease. If you are a smoker with diabetes and 45 years or older, you are 20 times more likely than a person without these risk factors to get severe gum disease. At Smile Creations, we will work with you to control the effects of this disease on your oral tissues.
Dental Caries
Plaque and the toxins and acids from bacteria also attack our teeth by causing cavities (caries). Fluoride has been beneficial to patients of all ages in preventing caries. Effective brushing, especially at night, lowers the risk of developing caries. The areas of the teeth most prone to developing caries are the grooves and depressions on the chewing surfaces of the back teeth and the surfaces between the teeth. To prevent decay on the chewing surfaces, a plastic-like coating called a dental sealant should be placed on the chewing surface of all back teeth. Studies show that sealants can reduce tooth decay by as much as 90 – 100%. Sealants should be placed on teeth as soon as they are fully erupted. In our office we place sealants typically on the first (six-year) molars, which erupt around 6 years old, and the second (12-year) molars, which erupt around 12 years old. We have had several adults request sealants on non-carious teeth for their own piece of mind and in preparation for long camping trips or vacations. Sealant application is simple, fast and painless.