What Are Periodontal Diseases?

What you need to know

The image of grandparents' "teeth" in a drinking glass is a common memory associated with many people's youth. It was believed that as a person got older, tooth loss was inevitable. With the aid of new research and better oral care, members of today's generation are more likely to keep their teeth in their mouths for life.

Research shows that Periodontal Disease, also known as gum disease affects 80% of the U.S. population at various times in their lifetime.  This high incidence may not only be related to age but also to other risk factors, suggesting that tooth loss is not an inevitable aspect of aging... Read on to discover how you can keep a healthy smile for a lifetime!

What are periodontal diseases?

The word "periodontal" literally means "around the tooth."  Periodontal diseases are bacterial gum infections that destroy the gums and supporting bone that hold your teeth in your mouth. Periodontal diseases can affect one tooth or all your teeth. The main cause of periodontal diseases is bacterial plaque, a sticky, colorless film that constantly forms on your teeth. If the plaque is not removed, it can turn into a hard substance called calculus or tartar in less than two days. Tartar is so hard it can only be removed by an oral health professional, such as a dentist or dental hygienist. The bacteria in plaque infect the gums, and release poisons (toxins) that cause redness and inflammation (irritation). The inflammation and the poisons themselves cause destruction of the tissues that support the teeth, including the bone. When this happens, the gums separate microscopically from the teeth, forming pockets that fill with even more plaque causing even more infection.

Periodontal diseases are multi-factorial. This means that there is not just one cause of periodontal diseases but rather multiple factors that can affect the health of your gums.

• TOBACCO use significantly increases the risk of developing periodontal diseases and can negatively affect treatment.
• HORMONAL CHANGES during pregnancy, puberty and menopause can cause the gums to become red, tender and bleed easily.
• GENETICS and family history of periodontal diseases indicate a greater likelihood of developing these diseases.
• STRESS can make it more difficult for the body to fight off infection, including periodontal diseases.
• MEDICATIONS such as oral contraceptives, antidepressants and certain heart medicine, can affect oral health.
• DESTRUCTIVE HABITS such as improper oral hygiene technique, oral piercing, drug or alcohol abuse can affect periodontal health.
• POOR NUTRITION can make it harder for the body to fight off infection.
• CLENCHING/GRINDING TEETH DURING SLEEP.
• FAILURE TO REPLACE MISSING TEETH.
• LOW QUALITY and POOR FIT of DENTAL FILLINGS and CROWNS.
• SYSTEMIC DISEASES that interfere with the body's immune system may worsen the condition of the gums and supporting bone.

Gingivitis

As the mildest form of the periodontal diseases, gingivitis causes the gums to become red, swollen, and bleed easily.

There is usually no discomfort at this stage.

Chronic Periodontitis

Chronic periodontitis is a condition resulting in inflammation within the soft tissues surrounding the teeth causing progressive attachment and bone loss (see Figures 1.0 and 2.0). It is diagnosed by bone loss on a dental X-ray, the formation of gum pockets and/or receding gums. It is most common in adults, but can occur at any age. See Figure 1.0 and 2.0 below

Aggressive Periodontitis

This form occurs in patients who are otherwise in good health. Common features include rapid attachment loss and bone destruction.

There are two forms of aggressive periodontitis:

LOCALIZED AGGRESSIVE PERIODONTITIS - Most often occurs near puberty and usually involves attachment loss around first molars and/or front teeth but may involve one or two additional teeth.

GENERALIZED AGGRESSIVE PERIODONTITIS - Usually, but not always affects people under 30 years of age. It involves attachment loss on at least three permanent teeth in addition to first molars and incisors.

Periodontitis as a Manifestation of Systemic Disease

As the name indicates, this form is associated with one of several systemic diseases that are related to periodontitis, such as diabetes, lymphoma, HIV, etc.

Necrotizing Periodontal Diseases

These types of periodontal diseases cause ulcers in the gums between the teeth and are most commonly observed in individuals with certain conditions including, but not limited to, HIV infection, malnutrition and immunosuppression. Stress, smoking, and poor oral hygiene sometimes can contribute to this problem.

What are the signs of periodontal diseases?

Periodontal diseases are often silent, meaning that symptoms may not materialize until significant bone loss has occurred.

Some people may have periodontitis and not experience any symptoms and be unaware that they have disease. Common symptoms and signs of periodontal diseases include:

• RED, SWOLLEN OR TENDER GUMS
• BLEEDING WHILE BRUSHING OR FLOSSING
• GUMS PULLING AWAY FROM THE TEETH  MAKING TEETH APPEAR LONGER
• LOOSE OR SEPARATING TEETH
• PUS BETWEEN THE GUM AND TOOTH
• PERSISTENT BAD BREATH
• A CHANGE IN THE WAY YOUR TEETH FIT TOGETHER WHEN YOU BITE
• A CHANGE IN THE FIT OF PARTIAL DENTURES

If you notice any of these symptoms, you should call our office at 408-356-9366 to schedule a complete periodontal examination.

Dr. Poulos and Dr. Gallez are periodontists who specialize in the prevention, diagnosis and treatment of tissues surrounding the teeth. In addition, Dr. Poulos & Dr. Gallez are experts in the placement and maintenance of dental implants.

During a periodontal examination, Dr. Poulos or Dr. Gallez will gently place a small measuring instrument called a periodontal probe in the pocket between the teeth and gums to measure pocket depths and help make a diagnosis. Probing depths measuring 1-3mm are usually considered healthy. Four to 5mm may indicate mild periodontitis, 5-6mm suggest moderate periodontitis, and 7mm or greater may indicate severe periodontitis. In addition to probing depth measurements, X-rays may be taken to evaluate the health of the bone supporting the teeth.

How are periodontal diseases treated?

Once your periodontal health has been evaluated, our doctors will work with you to determine the best treatment options to control your disease and bring you back to health. Treatment can vary depending on how far the disease has progressed. If diagnosed and treated in the early stages, simple non-surgical periodontal therapy may be sufficient. If periodontitis has advanced to the point where the periodontal pockets are deep and significant amounts of bone are lost, surgical therapy may be necessary.

Once periodontitis has been controlled, patients will require ongoing periodontal maintenance procedures to sustain health. This ongoing phase of treatment will allow our doctors to assess your periodontal health and make sure that your infection stays under control or remains eliminated. During these re-evaluation appointments, your mouth will be examined, new calculus and plaque will be removed and, if necessary, your teeth will be polished and your bite will be checked. Periodontal diseases are chronic diseases, just like diabetes. Without careful, ongoing treatment, periodontal diseases can and often do recur.

Periodontics Presentation

To provide you with a better understanding of periodontics, we have provided the following multimedia presentation. Many common questions pertaining to periodontics are discussed.

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