Periodontal disease, or periodontitis (formerly known as "pyorrhea"), is one of the most prevalent diseases known to medicine. It is responsible for 80 percent of tooth extractions performed on adults over 30. Often characterized by a slow, insidious and often pain-free onset, periodontitis may progress undiagnosed and untreated until extensive damage has occurred in the bony apparatus of the jawbones that support the teeth.
Ironically, like other dental disease, periodontitis is both preventable and treatable. With contemporary life expectancies extending well into the 80's and beyond, there should be substantial motivation to invest in one's teeth -- a lifetime of dental health is certainly an attainable goal!
Dr. Keith Robinson recently published the first volume in an "anthology on aging." Using tongue-in-cheek humor, "Growing Older With Your Teeth ... or Something Like Them," depicts the image of a beautiful, healthy smile opposing dentures in a glass. The message is clear: The choice is yours!
In its early stages, periodontal disease is known as gingivitis, or inflammation of the gums. Gingivitis occurs in 98 percent of the population, even children. The primary cause of gingivitis is the accumulation of plaque around the teeth. Plaque is a sticky film composed of food debris, minerals from saliva and bacteria indigenous to the mouth. The bacteria produce acidic toxins that cause tooth decay and irritation of the gum tissue. Left unattended, calcium deposits form tartar (calculus) that attracts a further buildup of plaque.
As tartar accumulates beneath the gum tissue (subgingival calculus), the inflammatory process slowly causes destruction of the periodontal attachment -- the fibrous connection that secures the tooth to the bone. Over time, the supporting bone resorbs (shrinks), teeth loosen, drift, become infected and even fall out in advanced cases of periodontitis (as depicted in this clinical photo).
Unquestionably, the primary cause of periodontitis is inadequate oral hygiene. Familial histories of poor dental health are commonly found; however, it is more often explained by the incidence of poor oral hygiene practices within families than a discernible hereditary pattern. Other factors that may influence the progress or extent of periodontal disease include:
Scrupulous oral hygiene practices and frequent dental exams offer the best defense against periodontitis and other dental disease. Plaque may easily be removed by judiciously brushing your teeth and flossing. As it takes approximately 24 hours for bacteria to colonize within plaque, dental hygiene practices should be done at a minimum of once a day -- preferably twice -- ideally after every meal.
Regular dental checkups include a prophylaxis (dental cleaning) and a periodontal exam to identify potential problems in early stages. Personal oral hygiene must include the regular use of dental floss since most tooth decay and periodontal disease occur between the teeth. Hard tooth brushing does not compensate for lack of flossing. Many dental hygienists have advised patients: "It's not necessary to floss all your teeth -- only the ones you wish to save."
The early warning signs of moderate to advanced periodontal disease include:
Periodontal treatment may necessitate scaling and root planing -- removing plaque and calculus and smoothing the root surfaces below the gum level. Prescription mouth rinses may be used as an adjunct to improved hygiene techniques. In many cases of early gum disease, scaling, root planing and proper daily cleaning achieve a satisfactory result. More advanced cases may require surgical intervention, which may involve recontouring of the gums, and removing crusty, tenacious calculus. The supporting tissues are often repositioned to facilitate good oral hygiene.
Periodontal detection and treatment begins with the general dentist, who may choose to refer the patient to a periodontist (specialist in periodontics). Patients should bear in mind that there is no absolute cure for periodontal disease -- the maintenance of periodontal health depends on a team approach -- the most important being the patient. Dentists and dental hygienists cannot do for the patient what he must manage by himself -- the daily routine.
A regular oral hygiene regimen is critical for patients who want to maintain positive results of periodontal therapy. Patients should visit the dentist every 2-4 months (depending on the patient) for scaling, root planing and periodic evaluations. Customarily accepted hygiene practices include brushing teeth at least twice a day and daily flossing.
Manual soft nylon bristle brushes are the most dependable and least expensive. Electric brushes are also an acceptable option, but don't reach any further into the pocket than manual brushes. Water irrigating devices (such as WaterpikTM) may be helpful, especially in patients with fixed bridgework. Proxy brushes (small, narrow brushes) are an effective means to clean between recesses in the teeth. Wooden toothpicks and rubber tips should only be used if recommended by your dentist.
Remember, only a dentist can diagnose your dental problems and offer the right dental treatment planning for you. If you need a dentist, call us at 1-866-970-0441 to be connected with one today.