Gum Disease (Periodontal Disease)


What is periodontal (gum) disease?

Periodontal (gum) disease is the ‘silent killer’ of teeth. Often, patients don’t know that they have the periodontal disease until it is very advanced and they are going to lose their teeth.

Periodontal disease is the most common disease of humans; it affects more than 80% of the population to some degree and is the main reason for tooth loss.

What causes periodontal disease?

There are multiple factors that cause periodontal disease including:

    1. Genetics

If your parents or ancestors lost their teeth due to gum disease, you are more likely to have periodontal disease, too. However, with modern technology, this does NOT have to be the case.

    1. Poor oral hygiene

Taking good care of your teeth isn’t easy. The sugars and carbohydrates we eat are broken down to be digested by bacteria in our mouths.  This forms what is known as “dental plaque.” If plaque is not brushed away within 24 hours, it hardens into a hard substance called tartar or “calculus.” Calculus can only be removed by a dental professional who uses special instruments.

This picture shows lower front teeth with white dental plaque and yellow tartar. As you can see, the gums are red around this area, because tartar and plaque give off bacteria (germs) which cause the gums to become infected. If this infection continues, the bone around the teeth is lost and eventually, the tooth will be lost too.

    1. Other medical conditions

Other medical conditions can worsen periodontal disease or make someone more prone to it. These conditions include diabetes, arthritis (because it’s harder to brush), poor eyesight (it’s hard to see to brush and floss well) and some medications.

I’ve heard that periodontal disease can make other medical conditions worse.

This is true.  Recent research shows that periodontal disease can particularly make diabetes and heart disease worse. The bacteria (germs) that cause periodontal disease circulate throughout the body, causing infections in other areas.

Here are some examples of oral infection affecting the rest of the body. Before I had my knee replaced a few years ago, I made sure that my teeth were healthy so that bacteria wouldn’t migrate from my teeth to my knee and cause the infection in the knee.  I know cancer victims whose cancer doctors insisted they be free of dental disease before cancer treatment could be done.

When you are treating periodontal disease, you are helping your entire body to be healthier.

Can periodontal disease be cured?

Periodontal disease is a chronic disease.  Just like we can’t ‘cure’ diabetes, some lung disease, and some heart disease and arthritis, we can’t make the periodontal disease go away forever.  However, like these other diseases, we can CONTROL periodontal disease so that teeth aren’t lost, making dentures become necessary.

How is periodontal disease controlled?

The treatment of periodontal disease varies with each patient.  It can include:

  1. Better home care (brushing and flossing) using special tools and techniques to thoroughly remove plaque.
  2. Improving diet to eat fewer sugars and carbohydrates to make plaque less likely to form.
  3. More frequent cleanings. I have found that it’s impossible to get every speck of plaque off my teeth so that tartar doesn’t form where periodontal disease begins, so I get my teeth cleaned every three months.
  4. Deep cleanings, called periodontal therapy, may be done. We numb the patient with a gel so we can clean under the gums painlessly.
  5. Irrigating (washing out) the gum pockets with antimicrobials (germ fighters) after a cleaning or deep cleaning. Sometimes these antimicrobials are also given to the patient to take home and use for a period of time.
  6. Placing tetracycline (an antibiotic) into the gum pocket can help the gums reattach to the teeth.
  7. A low dose of tetracycline (a pill) can be given to help the gums reattach to the teeth for a period of time; this cannot be done indefinitely.
  8. Sometimes gum surgery is needed (done by a specialist called a “periodontist”).
  9. Gum disease can’t always be controlled; despite our best efforts, some teeth are lost even with treatment. This is why treating gum disease early and aggressively is important.


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