When told about their oral health, most people would think only about their teeth. After all, the teeth are the most conspicuous feature of the mouth. But there are other tissues in the mouth that constitute a fully functioning oral cavity, each of which requires just as much care as the teeth receive on a daily basis. One of these “often neglected” tissues is the “gingiva” or “gum”.
As unassuming as it may seem, the gum plays a critical role in the overall performance of the teeth. Apart from serving as an indicator of potential dental issues, it also holds the teeth together, providing the teeth the strength they need to handle hard foods. Without the gum, the teeth could easily fall out of the mandible or maxilla.
What happens when the gum gets infected?
We all know that the teeth usually are the first structures in the mouth to suffer from bacterial damage because they are exposed to food substances. This is dental caries or tooth decay. However, just like teeth, the gum is also susceptible to infection. This occurs when the teeth develop what is known as deep subgingival (= under the gum) ‘tartar’ or plaque. This plaque is essentially a biofilm of bacterial colonies and can lead to the deeper gum infection known as “Periodontitis”, “Periodontal Disease”, “Pyorrhoea” or “gum disease”.
When the bacteria existing in the plaque spread through the gum, that’s when infection takes place. It starts out as gingivitis (= inflamed bleeding gums) and then may progress to deeper periodontal disease – a much more serious condition that usually results in permanent advancing damage to the gums andalso to the tooth roots and supporting jaw bone.
What is periodontal disease?
Periodontal disease or periodontitis is an inflammatory condition that affects the gums and other tissues that support the teeth. It is considered as one of the leading causes of tooth loss among adults. It begins when the bacteria from the plaque colonise in the gum pockets surrounding the tooth crown. Often preceded by gingivitis, which is known for its painless symptoms, this disease is often detected only in its advanced stage.
If neglected, periodontal disease may slowly destroy the connective tissues that provide the teeth with the support needed to resist chewing forces. As a result, the teeth can begin to drift, loosen up, or fall off. Depending on severity, periodontal disease can also destroy a lot of the underlying jawbone, leading to chewing issues that may require expensive complex dentistry to repair.
What are the different types of periodontitis?
Periodontal disease is categorised according to the type of damage it creates and its severity. Proper diagnosis is needed to ensure that correct treatment will be implemented. Here are the major types of periodontal disease on which a periodontist in Brisbane bases their recommendations.
● Chronic. Considered as the most common type of periodontitis, chronic periodontitis is characterised by the progressive recession of the gum. The most apparent sign of this condition developing is the exposure of the tooth root, which consequently makes the teeth look longer than usual. The common saying is that someone is becoming “long in the tooth”. This is not due to old age – it is due to untreated gum issues.
● Aggressive. In some people the destruction from Periodontal Disease can be very rapid or occur at a relatively young age. Very quickly their teeth can loosen and be lost. Swollen gums, loose teeth and bad breath are often features of this type of gum infection.
● Necrotizing. Systemic health conditions, such as HIV, cancer,and malnutrition, can lead to the death of certain tissues in the body. Tissues in the oral cavity, particularly the periodontal ligament, alveolar bone and gingival tissues, are also susceptible to this process. As a result, painful ulceration can develop with rapid loss of teeth and portions of the supporting jaw bone.
Natural Occurrences and Practices that Could Lead to Periodontitis
The first step to treating periodontitis is to determine its origin. There are a variety of factors that influence a person’s susceptibility to the condition, each of which must be addressed in the right order to treat the disease and get a person’s oral health back to a point of stability. Incorrect management and treatment may only result in either temporary relief or may create further dental complications.
One of the most influential factors in the cause of periodontitis is poor oral hygiene. As a matter of fact, around 95 per cent of all dental conditions originate from inadequate cleaning skills. Keeping a balanced diet (which also means avoiding foods that have a detrimental effect on the teeth and gums – such as sugars and acidic foods) and regular brushing and cleaning between the teeth is essential to minimise any bacterial infection in the mouth. The main aim is to reduce the population of potentially harmful bacteria in the mouth.
If you are a smoker you are at an even greater risk of periodontitis. Research shows that tobacco use can trigger the progression of the disease and slow down the healing rate. Your periodontist can help you formulate a plan to “quit” this habit.
Some people also have a “family susceptibility” to developing gum issues. It has been shown that in some families the risk for gum problems can be up to six times the average. This is why your clinician will ask about tooth loss in your wider family and recommend you advise siblings and children to also have themselves checked for the problem.
Some research suggests that hormonal changes such as pregnancy and menopause can leave a person more vulnerable to Periodontitis.
Chronic stress also plays a role – leaving a person more vulnerable to disease and slowing healing.
Dealing with the Disease
Depending on the extent and severity of the periodontitis problem, the treatment may range from deeper cleaning through to corrective steps to eliminate food traps.
If a significant portion of the bone and gum has been destroyed, then your clinician may recommend“tissue regeneration” procedures.
The inevitable outcome of not treating Periodontitis is tooth loss. It is not a question of “if” they will be lost – just “when”.
You may then have to pay for dental implants to replace these missing teeth.
However, these implants are still susceptible to the same bacteria – so you will still need a periodontist to help you maintain them.
Considering all the above points – the best way to address a Periodontitis risk is to PREVENT it in the first place. You need to ask your dentist to check your gums – as well as your teeth. If you believe you already have problems (such as gum recession, bleeding, bad breath or drifting loose teeth) then get yourself to a periodontist as soon as possible. Remember that periodontitis is known as the “silent” disease in dentistry – so don’t wait too long!
You can be referred to a periodontist by your general dentist – or you can make an appointment directly (i.e. you don’t need a separate referral).At Foundation Dental Services – our specialists are registered with the Australian Dental Board for periodontics and are supported by a team of highly motivated and caring clinicians and support staff.
Foundation Dental Services (FDS) has state of the art ‘accredited’ facilities in Brisbane and also on the Sunshine Coast.With over 20 years of experience – you can rest assured that at FDS you are in good hands.
Anatomy of a Mouth, yourdentistryguide.com