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Question: What is Periodontal Disease?

Answer: Periodontal (gum) diseases, including gingivitis and periodontitis, are serious infections that, left untreated, can lead to tooth loss. The word periodontal literally means “around the tooth.” Periodontal disease is a chronic bacterial infection that affects the gums and bone supporting the teeth. Periodontal disease can affect one tooth or many teeth. It begins when the bacteria in plaque (the sticky, colorless film that constantly forms on your teeth) causes the gums to become inflamed.

Question: What is Gingivitis?

Answer: Gingivitis is the mildest form of periodontal disease. It causes the gums to become red, swollen, and bleed easily. There is usually little or no discomfort at this stage. Gingivitis is often caused by inadequate oral hygiene. Gingivitis is reversible with professional treatment and good oral home care.

Question: How do I know if I have early gum disease (gingivitis) or late stage gum disease (Periodontitis)?

Answer: In the early stages of gum disease, the plaque that remains around the teeth harden into calculus (tartar). As plaque and calculus continue to build up, the gums begin to recede (pull away) from the teeth, and pockets form between the teeth and gums. At this stage, with treatment, it is fully reversible. As gum disease progresses, the gums recede farther, destroying more bone and the periodontal ligament that surround the roots. The affected teeth become loose and may need to be extracted. Routine check-ups and periodic measuring of the pockets around the teeth are necessary to monitor and prevent gum disease from progressing.

Question: What is Periodontitis?

Answer: Untreated gingivitis can advance to periodontitis. With time, plaque can spread and grow below the gum line. Toxins produced by the bacteria in plaque can irritate the gums, and stimulate a chronic inflammatory response in which the body in essence turns on itself, and the tissues and bone that support the teeth are broken down and destroyed. Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. Often, this destructive process has very mild symptoms. Eventually, teeth can become loose and may have to be removed.

Question: What are the different forms of Periodontitis?

Answer: There are many forms of periodontitis. The most common ones include the following. Aggressive periodontitis occurs in patients who are otherwise clinically healthy. Common features include rapid attachment loss and bone destruction. Chronic periodontitis results in inflammation within the supporting tissues of the teeth, progressive attachment and bone loss. This is the most frequently occurring form of periodontitis and is characterized by pocket formation and/or recession of the gums. It is prevalent in adults, but can occur at any age. Progression of attachment loss usually occurs slowly, but periods of rapid progression can occur. Periodontitis as a manifestation of systemic diseases often begins at a young age. Systemic conditions such as heart disease, respiratory disease, and diabetes are associated with this form of periodontitis. Necrotizing periodontal disease is an infection characterized by necrosis of gingival tissues, periodontal ligament and alveolar bone. These lesions are most commonly observed in individuals with systemic conditions such as HIV infection, malnutrition and immunosuppression.

Question: How do I know if I have Periodontal Disease?

Answer: Periodontal disease is often painless and develops slowly and progressively. Sometimes it may develop quite rapidly. Unless you see your dentist for regular checkups, you may not realize you have periodontal disease until your gums and bone have been severely damaged to the point of tooth loss. Periodontal disease can occur at any age. In fact, more than half of all people over age 18 show signs of at least the early stages of some type of periodontal disease. Gingivitis is the earliest stage of periodontal disease and affects only the gum tissue. At this stage, it is reversible. If not treated, it could lead to periodontitis, potentially damaging bone and other supporting structures. Such damage can result in loosened teeth.

Question: What can I expect the first time I visit a Periodontist?

Answer: During your first visit, your periodontist will review your complete medical and dental history with you. It’s extremely important for your periodontist to know if you are taking any medications or being treated for any condition that can affect your periodontal care. You will be given a complete oral and periodontal exam. Your periodontist will examine your gums, check to see if there is any gum line recession, assess how your teeth fit together when you bite and check your teeth to see if any are loose. Your periodontist will also take a small measuring instrument and place it between your teeth and gums to determine the depth of those spaces, known as periodontal pockets. This helps your periodontist assess the health of your gums. Radiographs (x-rays) may be used to show the bone levels between your teeth to check for possible bone loss.

Question: Is it true that there is a link between Periodontal (Gum) Disease and Heart Disease?

Answer: Studies show Periodontal Disease can contribute to increased risk of heart attack and stroke. According to some studies, periodontal disease (which affects the bone and tissue surrounding your teeth) has proven to be a stronger risk factor than any of the other conditions usually linked to heart disease (e.g., hypertension, high cholesterol, age and gender). Researchers have concluded that the bacteria found in plaque (the primary etiological factor causing periodontal disease) is clearly linked to coronary disease. People with periodontal disease are up to two times as likely to suffer a fatal heart attack and nearly three times more likely to suffer a stroke as those individuals without this disease.

Question: What can I do to prevent Periodontal Disease?

Answer: Keep your teeth clean by brushing with fluoridated toothpaste at least twice daily. Use dental floss and mouth rinse. Eat a balanced diet for good general health to secure the proper amount of nutrients to build your mouth’s resistance to the infection caused by bacterial plaque. Visit your dentist at least every six months for a checkup, making sure that a thorough periodontal exam is performed. Avoid other risk factors such as smoking and chewing tobacco, both of which have a detrimental effect on the severity of periodontal disease. Systemic diseases such as AIDS or diabetes can lower the oral tissue’s resistance to infection, making periodontal disease more severe. Review your medical history with your dentist. Many of the medications or therapeutic drugs that you may be taking can decrease your salivary flow and adversely affect your teeth and gums.

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