Periodontal (Gum) Disease

Periodontal or gum disease is an infection of the tissue that surrounds and supports your teeth. It is a leading cause of tooth loss and is most often caused by a build-up of plaque on the teeth. Plaque is the sticky film of bacteria that is brushed and flossed away with proper oral care. When left on the teeth, plaque produces toxins that attack below the gum line in the sulcus, a shallow v-shaped crevice between the tooth and gums. This causes the bond between teeth and gums to break down.

In the early stage of gum disease, a condition known as gingivitis, where gums may become red, swollen and bleed easily. In the more advanced stage (periodontal disease), teeth can loosen and even fall out. Good oral hygiene and regular dental examinations are essential in the prevention and early detection of gum disease.

Symptoms of Periodontal Disease

In early cases of periodontal disease there are often no noticeable symptoms, although damage to the gums is still occurring. As the disease progresses, patients may experience:

• Gums that are red, swollen, tender, bleed easily or have pulled away from the teeth
• Persistent bad breath or bad taste
• Loose or separating teeth
• Pus coming from the gums
• A change in the way your teeth fit together
• A change in the fit of partial dentures

Once symptoms are detected, your periodontist may perform a series of tests in order to determine the severity of the condition and extent of the damage. This may include X-ray exams, full evaluation of your medical history and underlying conditions, and examination with a dental probe to detect any periodontal pockets.

Causes of Periodontal Disease

Most cases of periodontal disease develop because of bacterial plaque that builds up on teeth over time. Plaque is a sticky, colorless film that stimulates an inflammatory response and causes the body to attack itself. If it is not removed, it hardens and causes tartar to develop on the teeth, which cannot be removed through brushing at home. The tissue and bone that supports the teeth is gradually destroyed by this process.
While plaque is the most common cause of periodontal disease, lifestyle or hereditary factors play a significant role in the health of your gums. Some patients may be at a higher risk for developing periodontal disease because of their habits. Some of the risk factors for these dental conditions include:

• Tobacco smoking or chewing
• Systemic diseases such as diabetes
• Medications such as steroids, anti-epilepsy drugs, cancer therapy drugs and calcium channel blockers
• Pregnancy or use of oral contraceptives
• Crooked teeth
• Worn bridges or fillings

Preventing Gum Disease

You can reduce your risk of developing gum disease by practicing proper oral hygiene. This includes thoroughly brushing your teeth at least twice a day and flossing at least once a day. It is important for patients to practice proper brushing and flossing techniques to ensure that teeth are adequately cleaned.

The products you choose for your dental hygiene can also play a role in keeping teeth happy and healthy. Electronic toothbrushes are among one of the safest and most effective types of toothbrush for most patients. Fluoride products can significantly reduce the risk of tooth decay, but should not be used by children under the age of six.

Seeing your dentist for a professional cleaning on a regular basis is also essential to maintaining dental health. Your dentist will also recommend other prevention techniques you can use to maintain your health and prevent gum disease. Eating a balanced diet and avoiding smoking can also help maintain dental and overall health.

Oral Pathology

In addition to screening for and treating periodontal disease, your dentist also evaluates your teeth and mouth for any indications of a pathological process.
Normally, the inside of the mouth appears pink and smooth because of a special lining called mucosa. Certain changes within the mouth may indicate a growth or abnormality that should be treated quickly and efficiently. Some of these changes may include:

• Red or white patches in the mouth (sign of oral cancer)
• Sores that do not heal and/or bleed easily
• Thickening of the skin inside the mouth
• Difficulty swallowing or chewing
• Chronic sore throat or hoarseness

These changes can occur anywhere in or around the mouth, including the lips, cheeks, gum tissue, tongue, face or neck. If you detect any of these or other abnormalities, you should seek medical attention so that the condition can be properly diagnosed.

It is recommended that patients perform monthly oral cancer screenings at home in order to detect any changes as soon as they occur.