Periodontal disease is also known as gum disease or periodontitis. All three terms refer to the same condition: deterioration of the gum tissues (gingiva) and bone around the teeth.
Gum disease starts out as gingivitis — which is a simple inflammation and redness along the gums — but if it goes untreated, those tissues begin to physically detach from the tooth they support.
Gum Pockets vs. Sulcus
In order to understand what gum disease is and how severe periodontitis can become, it’s important to have a general awareness of the “sulcus” around the teeth. The sulcus is the level of attachment where the gums meet the tooth, up to the loose edges of the gum tissues. It’s like a shallow trench that encircles the tooth.
When the sulcus around the teeth isn’t cleaned regularly, it becomes infected. Gradually the tissues detach, and the sulcus becomes deeper. We call these infected areas “periodontal pockets”. Any time there is a deep pocket around a tooth, it means the tissues have detached in that area.
A healthy gingival sulcus is anywhere from 1-3mm deep. Periodontal pockets are 4mm or deeper.
Symptoms of Periodontal Disease
Common symptoms of gum disease include:
- Bleeding when you brush or floss
- Swollen, tender gums
- Bad breath
- Gum recession / “long teeth”
- Gaps between teeth
- Food getting caught when you eat
- Tooth mobility
- Tartar buildup
What Causes Gum Disease?
Periodontal disease is caused by plaque biofilm, which contains numerous infectious bacteria and bacterial byproducts. When flossing isn’t part of your daily routine, it allows plaque accumulation to build up along and underneath your gum tissues. Left alone, they calcify into tartar or “calculus”. At that point, the hard buildup can’t be cleaned away with a toothbrush or floss. The continual exposure to bacteria results in a cyclic infection that causes gum tenderness, bleeding, swelling, and detachment of the supporting structures.
Oral-Systemic Health Risks
Your mouth is the gateway to the rest of your body. Any time there are issues such as bleeding gums, oral swelling, or visible discharge, it’s important to realize that the dental infection is straining your immune system. Numerous health studies have shown that active oral diseases like periodontitis can complicate underlying health issues, making certain medical conditions worse (and less responsive to treatment.)
Those same researchers also show us that treating periodontal disease can have a positive impact on your health. In some cases, gum treatments improved things like blood glucose levels and infertility challenges within three months post-therapy.
Which health conditions do we know hold a direct correlation to gum disease? Issues like:
- Erectile dysfunction
- Pneumonia and respiratory diseases
- Cardiovascular disease (heart attack, stroke, high blood pressure)
- Preeclampsia, pre-term labor, low birth weight
It’s also likely that gum disease is somehow associated with Alzheimer’s disease and other forms of dementia.
“Gum Disease Runs in My Family”
Is periodontal disease genetic? Can gum disease be passed from parents to their children? Science shows us that the bacteria responsible for periodontitis can be passed through saliva. Sharing food, kissing, or using the same glass/eating utensils could potentially allow bacterial spread from one person to another.
However, health habits such as oral hygiene routines are also something that’s passed down from parents to their children. As such, a combination of bacterial exposure and lifestyle choices (such as the importance of flossing), along with a potential genetic predisposition, can all compound into a situation where gum disease is worse among family members.
Why Does Gum Disease Make Teeth Fall Out?
Any time a tooth is affected by gum disease, it means the supporting tissues — gingiva and bone — are deteriorating. As they shrink and detach, it lessens the support around the tooth. In time, the tooth will become mobile, causing it to move when pressure is applied. Left untreated, the detachment will continue until the tooth can no longer support pressure and ultimately falls out or needs to be extracted.
Is Periodontal Disease Reversible?
Gingivitis is reversible. Gum disease is not. Since periodontitis destroys the tissues surrounding and supporting your tooth, it’s crucial to intercept it as early as possible. Bone simply does not grow back. Gum tissues do not either. However, it’s possible to encourage an environment where detached gingiva (gums) can reattach to the surface of your tooth root. When this process takes place, it reduces the depth of your gum pocket and prevents additional bone deterioration.
Best Treatments for Gum Disease
The best treatment for gum disease is prevention. Active periodontal disease is typically treated with a series of deep cleanings (periodontal scaling and root planing) to remove the calcified, infectious bacteria from below your gums. If there’s too much buildup to perform an exam, a debridement is sometimes added into the process.
Preventative cleanings (prophylaxis visits) are used to maintain and prevent gum disease. These are the cleanings you usually schedule every six months. However, if you have active periodontitis, a preventive cleaning will not be adequate for the situation.
Following your deep cleanings, periodontal maintenance cleanings will be scheduled every 3-4 months until symptoms are controlled. In some cases, these maintenance visits are alternated with your traditional preventative cleanings.
Aggressive periodontal disease may need additional adjunctive therapies, such as: antibiotics, prescription mouthwash, locally placed medication (antibiotic capsules), laser therapy, bone grafts, or tissue grafting.
Periodontal Screenings and Evaluations
How often should someone get screened for gum disease? At least 1-2 times per year. In most cases, periodontal evaluations are performed during your routine six-month checkup and cleaning. The exam includes measuring specific points around each tooth in your mouth. Typically, you’ll hear a series of numbers called out, such as “4 – 2 – 3 – 4 – 3 – 5 …”
If you haven’t had a periodontal exam in the last year and you’re experiencing symptoms of gum disease, we encourage you to visit with our multi-specialty general dentistry team. Sachem Dental Group provides comprehensive preventative and periodontal care in Long Island. Our providers have over 35 years of experience caring for Suffolk County smiles. Call us today!