Periodontal (Gum) Disease

It is estimated that more than 60% of people over the age of 25 have some form of periodontal disease. It is very important that "gum disease " not be confused with the more serious form that is really "bone disease". If you have "gum disease", then it is usually not too serious, and can usually be cured with a little effort on your part through better oral hygiene. The trick is to prevent the simple gum disease, which is referred to as "gingivitis" from slowly progressing into the more serious bone disease, referred to as "periodontitis".

In simple terms, it is not your gums that are holding your teeth, but rather the bone which is underneath the gums. You can think of the gums as being like a "leather casing" protecting the bone and acting as a first defense against invading bacteria. Therefore, it should be everyone's goal to protect and preserve the underlying bone by helping the gums stay healthy. This way you can hopefully maintain your teeth for a lifetime. Unfortunately, the only way that you can accomplish this is by a diligent and consistent habit of brushing and flossing on a regular basis, and of course by visiting your dentist. He or she will be able to let you know how you are doing with your cleaning, and can use a simple instrument to measure your bone level and let you know if you have lost any.

Now if your dentist determines that you have begun to lose some bone, the first thing she may recommend is a "deep gum cleaning", sometimes referred to as "root planing". In this proceedure the dentist will anesthetize the areas involved in order to be able to go down to the bone and clean out any infection and tartar buildup. This may take several sessions, depending on how many areas are affected. This treatment is sometimes sufficient to prevent any further deterioration of bone depending on the severity; but success also depends on the patient following up with the proper oral hygiene regimen recommended to you! It would also be extremely important to visit your dentist for cleanings on a more regular basis, about every three months. This is to assure that no further treatment is necessary, or to recommend further treatment if your situation has not stabilized.

If your bone disease has not stopped progressing, your dentist at this time may elect to send you to a periodontist (gum specialist) for further treatment, which may include surgery to remove some of your infected gums, and may at the same time use some advanced grafting techniques to attempt to add bone to the areas of extreme loss. The trick is to floss and brush the gums on a regular basis to prevent any periodontal disease from happening at all in the first place.

Most FAQ

Does gum disease hurt?

Unfortunately periodontal disease is considered a "chronic" one. This means that it takes place over many years at a very slow pace. It may start in your twenties when all you would notice is some bleeding from your gums when you are brushing. If left alone, it will slowly move down into the bone area without your noticing more than the continuous bleeding upon brushing, with maybe a mild amount of tenderness in certain areas. Eventually as more bone is lost, teeth may start to feel loose. Finally, when there is practically no bone left to hold the tooth, the gum seal around the tooth completely breaks down and an abscess forms, which is usually very painful. At this point the tooth can no longer be saved and would most probably need to be extracted. Needless to say, the thing to do is to see your dentist well before it starts hurting.

How does the infection get through the gum to the bone?

If there were no teeth coming out of the bone, there would be no way for the bacteria that cause infection to actually get to the bone. That is why people with dentures don't get periodontal disease! Unfortunately around the neck of each tooth there is an area that is like a "gap" where bacteria can sneak in and attack the bone structure. That gap is what your dentist would refer to as a "pocket". The depth of this pocket is what your dentist will measure with a special instrument called a "periodontal probe" (see illustration). The normal depth of this pocket is usually 2 to 3 mm. before getting to the bone. So when you hear your dentist say you have deep pockets, what he/she is saying is that you've lost some bone in these areas. This gap runs all around the neck of each and every tooth, so you can see that it takes a certain amount of effort to keep it clean and free from bacteria.

When you tell your dentist that you can't understand why you have gum disease because you brush three times a day, he or she will say: "That's great, but you're not flossing". The reason to floss is to get to the section of the pocket that's between your teeth. All that bacteria need is a small entry point to the pocket to get to the bone. Flossing is the biggest problem people have with oral hygiene, so invariably most people end up with periodontal disease starting "between" their teeth.

My gums bleed when I brush. Shouldn't I leave them alone?

Absolutely not. The reason your gums are bleeding is because they are infected. By leaving them alone, you are actually leaving your infection alone, and it will probably go to the bone if it hasn't already. It is natural to think that if you have a bleeding cut, you would be wise to leave it alone for it to heal. However, in your mouth it is quite the opposite. The first thing to do is to make an appointment with your dentist to see the severity of your periodontal disease, and in the meantime, you should continue to brush with a soft brush and ignore the bleeding . In fact, your bleeding should subside dramatically after a few days, especially if you floss also.

Isn't there a pill or mouthwash I can use to cure my periodontal disease?

As of now there is no "magic pill" to heal periodontal disease. Most advances have centered on keeping the "periodontal pocket" as infection-free as possible, especially after treatment is completed. The most effective mouthwash to combat gum disease contains a chemical called "chlorohexidine". It has the ability to get to the infected areas and maintain its effect for a lot longer than other mouth rinses. These mouthwashes need to be used in conjunction with proper hygiene on your part to be most effective. Chlorohexidine mouthwash can be purchased from our web site by clicking here.

Certain antibiotics can be used also in conjunction with treatment and proper hygiene to control the advance of periodontal disease. Recently a pill called "Periostat" has shown to appreciably reduce the disease after a deep gum cleaning. Another medication called "Atridox" is a gel that is being injected into the infected pockets to dissolve on its own while releasing a powerful antibiotic. These rinses and medications show great promise in the fight against periodontal disease, but to date there really isn't a miracle cure. So until that day, the best you can do is to stop it from starting.

Will the lost bone ever come back after it's lost?

Unfortunately, there is no real way yet to bring back your bone, especially if you have an advanced case of periodontal disease with severe bone loss. There has been a tremendous amount of advancement in recent years with various grafting materials to bring back some of your lost bone support. Some of these materials are synthetic and others are ground-down real bone. The success rate varies from person to person, and depends a lot on the kind of bone loss you have. You need to consult with your dentist (who may in turn refer you to a periodontist) to see if you would benefit from any of these grafting procedures.

Are there any special brushes or appliances that are most effective in cleaning?

Usually the proper use of a soft brush and regular or waxed floss is all you need. However, the "Sonicare" not only cleans your teeth and gums very efficiently, but may also have the ability to kill surrounding bacteria without even touching them, due to its unique vibration of water that can "explode" the bacteria nearby. We highly recommend it, and it is available at a great price from our store. Click here. In our view, another superior product is a floss called "Glide". This floss is made out of gortex, and has the ability to slide between your teeth a lot easier than regular floss. A lot of other electric toothbrushes on the market have also been proven to be effective in increasing your hygiene level. See our store for some different types.

As a final note, it should be emphasized that taking care of your general health goes a long way in maintaining your periodontal health. For example, a poor diet, diabetes, and smoking could exacerbate any potential periodontal disease.