Periodontal (Gum) Disease..
What is it?
Periodontal disease affects the gums and bone supporting your teeth. It is caused by sticky plaque and hard deposits of tartar. It usually happens when the teeth and gums are not kept clean enough. If you have very bad gum disease, you may have inherited it or you may have a probelm with your general health which needs to be investigated.
Thorough brushing can remove sticky plaque. Scaling and polishing can remove hard tartar. Without regular cleaning, the gum will come away from the tooth, making pockets around the teeth where food and plaque can collect. Pockets are more difficult to keep clean so gum disease will usually get worse if nothing is done.
Gum disease has two stages:
- It starts with inflammation - redness and swelling. Dentists call this gingivitis. It can be cured with good oral hygiene.
- The next stage is called chronic periodontitis. Some of the bone that supports the teeth is lost and the teeth become loose until they eventually have to be taken out. Periodontitis cannot be reversed once it starts, but it doesn't have to get worse if you clean your teeth properly and have regular root planing from your dentist or hygienist.
Who gets gum disease?
Gum disease can start when you are a child. Chronic periodontitis is normally only a problem for adults. You might be worried about bad breath or your teeth looking longer as the gum covers less of them.
Some people are more likely to have periodontal disease than others:
- Crooked teeth are more difficult to keep clean, so you might have gum disease in just one part of your mouth;
- People have different bacteria in their mouths. This may explain why gum disease can get worse very quickly for some people but not for others;
- Smoking and drinking a lot of alcohol can make gum disease worse. Both are also linked to mouth cancer;
- Drugs and medicines can affect your gums, so your dentist will ask you about your general health;
- Diabetes and some other diseases can reduce how resistant gums and bones are to damage;
- Hormonal changes also affect gum health. It could make a difference if you are pregnant or using an oral contraceptive.
Why should I try to avoid periodontal problems?
- However healthy and strong your teeth are, they need to be supported by healthy gums and bone. Periodontal disease can lead to you losing teeth and all the difficulties that this can cause for eating and speaking;
- Scientists are now discovering that periodontal disease is linked to coronary heart disease and stroke, especially for people who are already at risk in other ways (through poor diet, smoking or high blood pressure).
What can my dentist do?
Treatment will depend upon how far the inflammation has reached. Teeth which are affected only by gingivitis can be treated relatively easily with good results. Your dentist or hygienist will make sure that your teeth are free from calculus and that you know how to clean them properly. After that, thorough cleaning every day will make the gums pink, firm and healthy again.
Periodontitis can be cured except when it has become very advanced. This is why treatment must begin as soon as possible. You must first be shown how to brush your teeth properly and how to clean between your teeth. It is your responsibilty to clean your teeth in this way every day. The dentist or hygienist will then remove the calculus from the pockets. This is done by scaling and root planing, which may require several visits.
As the crowns and roots become clean, the inflammation will disappear, and the gums will tighten up around the root surfaces. Any redness or swelling in the gums should disappear and loose teeth may become firmer.
Sometimes, if the pocket is deep, some of the bacteria will get left behind. In this case, the dentist will need to use a dental antibiotic, such as Colgate Elyzol Dental Gel.
Your dentist will place the gel into the pocket around your tooth. The gel melts to fill the entire pocket and starts killing bacteria straight away. The saliva in your mouth turns the gel solid and it will not be removed if you eat, drink or brush your teeth, but you should not floss for 24 hours after the application.
Dentists and hygienists use two types of tool for root planing:
- Hand scalers come in different sizes and shapes, to reach different parts of the teeth. This is why you will see the dentist or hygienist changing instruments quite often;
- Electric scalers use very fast vibration with water. The water is removed from your mouth using suction. A hand scaler is used to check whether the roots are completely cleaned of deposits.
After a root has been planed, the pocket should shrink, making the gum sit closer to the tooth. You then need to be especially careful about cleaning the teeth above the gum-line. Root planing will probably need to be repeated at intervals.