What are some of the risk factors for developing periodontal disease, also known as gum disease?
The biggest factor is having poor home care, meaning you're not brushing your teeth regularly, flossing your teeth regularly, or coming in for your cleaning appointments. Smoking and having uncontrolled diabetes are also factors. You'll also see patients with untreated heart disease who have an increased risk for gum disease, as well as those taking certain medications.
What is the progression of gum disease?
Gum disease typically starts as gingivitis, which we often see in younger patients. This typically means we have bleeding gums, not just in one spot but throughout the entire mouth. If we let that inflammation continue, it progresses to full-on periodontal disease, known as periodontitis.
The difference between gingivitis and periodontitis is when we start to see the loss of bone, which provides our teeth with support. It's what allows us to bite without feeling our teeth move. Once we start to lose that bone, we cannot get it back.
What is the role of inflammation and genetics within gum disease?
You will see many patients with gum disease who might say that a parent or grandparent had gum disease. There are genetic factors that increase your risk. As far as inflammation, if you have uncontrolled inflammation in your body, like autoimmune diseases, you can see an increase in bone loss and bleeding within the mouth. This affects how the gum attaches to the roots of our teeth and the ability to keep bacteria out, preventing further bleeding and maintaining oral cleanliness.
How does gum disease affect your heart health?
Studies have shown that bacteria from the mouth can be found in cultures from plaque in the arteries. We want to make sure that our heart patients keep their mouths clean to protect against bacterial infections around the heart, and to increase the longevity of their teeth and oral health.
What steps will a dentist take to treat gum disease?
The first thing we'll do is discuss your home care habits. I always say that I can clean your teeth here, but if you're not doing the heavy lifting at home, it won't make much difference. We focus heavily on teaching patients how to properly brush and floss, and adding other methods like water flossing to improve oral health.
We typically perform a deeper cleaning, also known as scaling and root planing, to remove bacteria and buildup below the gums to help them heal and tighten around the tooth. We will want to see you more frequently, every 3 to 4 months, rather than every six months. This is because bacteria can grow and reactivate the disease over time. We're trying to keep bacteria levels low to control the disease. If we don't see good results from the initial treatment, we typically refer you to a periodontist, a specialist who deals with gum disease. They may perform laser-targeted therapy or even surgery to help save your teeth.
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