Your Mouth May Be Killing You
What is periodontal disease?
Periodontal disease or gum disease is an infection caused by bacteria of the tissues that surround and support your teeth. “Peri” means around, and “odontal” refers to teeth. Periodontitis, therefore, means “inflammation around the tooth”. Apart from the gums, the cementum on both the root and crowns of teeth, the periodontal ligament, and the alveolar are also affected.
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Before periodontitis occurs, gingivitis usually takes place; however, not all gingivitis advances to periodontal disease. With gingivitis, the gums become irritated, red, swollen, and easily bleed when teeth brushing or flossing occurs. If gingivitis is left untreated, periodontitis then sets in. With periodontitis, the gums become loose and begin to pull away from the teeth, forming small spaces called “pockets” between the teeth and gum. Food debris and dental plague collects in these small spaces and can cause it to become infected. As the plague grows and spreads bacteria below the gum line and throughout the mouth, the bones and tissue of your jawbone that holds teeth in place starts to break down and is eventually destroyed. When this occurs, teeth become loose and are no longer held in place, causing them to have to be extracted.
Over half of Americans either have or have had bleeding gums at some point in their life, and most think it is normal. This is not the case. Swollen and/or bleeding gums are the earliest sign that gums have been infected with bacteria, and if left untreated, there is a high risk that these bacteria can spread and lead to other health problems.
What causes periodontal disease?
Bacteria in dental plague is what causes periodontal disease. The cells of the body’s immune system fights to get rid of bacteria by releasing substances that irritate and damage the gums, the cementum, the periodontal ligament, and the alveolar. The release of these substances leads to swollen and bleeding gums, and later causes teeth to become loose.
Are there different types of periodontal disease?
There are many different types of periodontal disease, but the most common ones are:
- Aggressive periodontal disease – This type of periodontitis happens to those who are considered clinically healthy. Signs include rapid attachment loss of gums from teeth and rapid bone destruction.
- Chronic periodontal disease – This type of periodontitis causes inflammation within tissue surrounding the teeth, progressive attachment loss of gums from teeth and bone loss. This type of periodontal disease occurs most frequently in adults (but can happen at any age), and signs include the formation of “pockets”.
- Systemic periodontal disease – This type of periodontitis is associated with systemic conditions that often begin at a young age, including heart disease, respiratory disease, and diabetes.
- Necrotizing periodontal disease – This type of periodontitis is characterized by necrosis of gingival tissues, periodontal ligament and alveolar bone, and most often affects those with systemic conditions that include HIV infection, malnutrition and immunosuppression.
What are the risk factors of periodontal disease?
As mentioned above, bacteria in dental plague is the main cause of periodontal disease, but several other factors can also increase the risk of periodontal disease or make it worse once the disease is already in effect. These factors include:
- Genes – Due to genes, certain people are more likely to get periodontal disease than others; however, even those who are more prone to periodontal disease can prevent it by having healthy oral hygiene.
- Smoking – Those who smoke and use tobacco have a higher risk of periodontal disease because smoking causes more calculus to build on teeth. Smokers also develop deeper “pockets” and lose more bone and tissue as the disease gets worse. If periodontal disease is already in effect, smoking and the use of tobacco only makes the disease worse.
- Braces – Dental instruments that are used to straighten misaligned, crooked, or crowded teeth, can make it more difficult to brush or floss. This difficulty is likely to cause more dental plague and calculus to build up which increases the risk of developing periodontal disease. Those with braces can prevent this from happening by visiting their dentist for special tools to clean under and/or around braces.
- Clenching or grinding teeth – If one has periodontal disease, the frequent and constant habit of clenching, grinding, or gritting teeth places excess pressure on gums that are already irritated or swollen. This pressure can cause the bones and tissue of your jawbone to be destroyed faster.
- Stress – When one is under a lot of stress, the body’s immune system is weakened which makes it harder for the body to fight off infection caused by bacteria in dental plague.
- Hormones – When hormone levels change (particularly during puberty, pregnancy, and/or menopause), changes can also occur in the mouth which places the gums at greater risk of periodontal disease.
- Medicine – Certain drugs, prescriptions, and over the counter medications that are used to treat depression, high blood pressure, and other conditions, can dry up or reduce the flow of saliva in the mouth which makes it easier for dental plague to form. When the mouth does not get enough saliva, the gums are more likely to become infected or experience abnormal growth. If you are on medication, check with your dentist and/or doctor to see if it places you at greater risk of periodontal disease.
- Diseases – Those with certain diseases such as diabetes, AIDS, cancer and inflammatory conditions (rheumatoid arthritis, HIV infection) are at greater risk of periodontal disease than those without such diseases.
- Nutrition – Eating right and taking a good dose of vitamins is important to having good health, in general, and healthy gums and mouth, in particular.
What are the signs and symptoms of periodontal disease?
Even though it can occur at any age, periodontal disease usually happens to people who are in their thirties or forties. Men are more likely to develop periodontal disease than women. Children and teenagers almost never develop periodontal disease, but can develop the milder form of it, gingivitis.
If your gums feel irritated or bleed easily, or if you suspect you or someone you know has periodontal disease, look for the symptoms which include:
- Painful chewing
- Constant bad breath
- Red, swollen or tender gums
- Pus between gums and teeth
- Sores or other pain in your mouth
- Sensitive, loose or separating teeth
- Gums that bleed while brushing or flossing
- Receding gums or gums that are pulling away from the teeth, causing the teeth to appear longer
These symptoms are often signs of a more serious problem, and should be checked out by a dentist as soon as possible. If the dentist recognizes that a severe form of periodontal disease has developed, he or she may refer you to a periodontist. A periodontist is a dentist who specializes in the prevention, diagnosis and treatment of periodontal disease, and in the placement of dental implants.
Can periodontal disease cause additional health problems?
Recent research has found that a connection exists between periodontal disease and a number of other serious health problems, which include:
- Atherosclerosis – Periodontal disease may increase the build-up of fats, cholesterol, and other substances inside your arteries.
- Heart disease – Inflammation caused by periodontal disease increases the risk of heart disease and also worsens heart disease conditions that already exist.
- Stroke – Risk of stroke caused by blocked arteries that are due to periodontal disease is increased.
- Premature birth – If a woman suffers periodontal disease while pregnant she is more likely to deliver her baby earlier than usual, and the baby is more likely to suffer low birth weight.
- Diabetes – Those who are diabetic but do not suffer from periodontal disease have an easier time controlling their blood sugar than those who are diabetic but do suffer from periodontal disease.
- Respiratory disease – If periodontal disease is left untreated, bacteria can spread from the gums to the lungs and can cause the lungs to become infected or worsen lung conditions that already exist.
How can periodontal disease be prevented and/or treated?
Periodontal disease can be prevented by having healthy oral hygiene and making regular dentist visits. For most people, a dentist visit should only be made once every six months, but if one suffers from periodontal disease, a dentist visit may need to be made more often. Correctly brushing and flossing teeth daily helps to remove dental plague which cuts down on bacteria. A dentist can give professional cleanings that will remove dental plague in areas that are hard to reach with a toothbrush or floss.
Having unhealthy oral hygiene and skipping dental visits, can cause dental plague to build up on teeth and then spread to the gum line where it is protected because neither a toothbrush nor floss can reach below the gum. If dental plague is not quickly removed, bacteria will continue to spread and gum irritation will get worse. This can result in plague becoming hardened or calcified and turning into calculus, more commonly called tarter. Because calculus has a rougher surface than teeth and cementum, even more plague grows on it and both dental plague and calculus build up on top of each other in layers. Brushing with a tartar-control toothpaste can help prevent calculus from building.