What is gum disease, periodontal disease, and gingivitis?
Gum disease is an infection of the tissues that surround and support your teeth. It is a major cause of tooth loss in adults. Because gum disease is usually painless, you may not know you have it. Also referred to as periodontal disease, gum disease is caused by plaque, the sticky film of bacteria that is constantly forming on our teeth.
The early stage of gum disease is called gingivitis. If you have gingivitis, your gums may become red, swollen and bleed easily. At this stage, the disease is still reversible and can usually be eliminated by a professional cleaning at your dental office, followed by daily brushing and flossing.
Advanced gum disease is called periodontitis. Chronic periodontitis can lead to the loss of tissue and bone that support the teeth and it may become more severe over time. If it does, your teeth will feel loose and start moving around in your mouth. This is the most common form of periodontitis in adults but can occur at any age. It usually gets worse slowly, but there can be periods of rapid progression.
Aggressive periodontitis is a highly destructive form of periodontal disease that occurs in patients who are otherwise healthy. Common features include rapid loss of tissue and bone and may occur in some areas of the mouth, or in the entire mouth.
Research between systemic diseases and periodontal diseases is ongoing. While a link is not conclusive, some studies indicate that severe gum disease may be associated with several other health conditions such as diabetes or stroke.
It is possible to have gum disease and have no warning signs. That is one reason why regular dental checkups and periodontal examinations are very important. Treatment methods depend upon the type of disease and how far the condition has progressed. Good dental care at home is essential to help keep periodontal disease from becoming more serious or recurring.
Here are some warning signs that can signal a problem:
- gums that bleed easily
- red, swollen, tender gums
- gums that have pulled away from the teeth
- persistent bad breath or bad taste
- permanent teeth that are loose or separating
- any change in the way your teeth fit together when you bite
- any change in the fit of partial dentures
Some factors increase the risk of developing gum disease. They are:
- poor oral hygiene
- smoking or chewing tobacco
- genetics
- crooked teeth that are hard to keep clean
- pregnancy
- diabetes
- medications, including steroids, certain types of anti-epilepsy drugs, cancer therapy drugs, some calcium channel blockers and oral contraceptive
* Information provided by the American Dental Association.
Why do I need scaling and root planing?
Scaling and root planing is considered the basic treatment of periodontal diseases and may be the only treatment required to treat mild cases of periodontitis; however, it may also be the initial therapy prior to future surgical needs. For the procedure to be considered effective, the patient must be able to be maintained at a level of periodontal health that will prevent reinfection with periodontal pathogens. ** This requires optimal home care and ongoing periodontal maintenance therapy, usually every three – four months to sustain health.
* Giusto, T. Non-surgical vs. surgical periodontal therapy, SUNY Stonybrook, June 1997, page 1
** Robert J. Genco; Henry Maurice Goldman; David Walter Cohen (1990). Contemporary periodontics. Mosby. ISBN 978-0-8016-1935-9. Retrieved 20 September 2011.
My hygienist determined that I have periodontal disease. Why am I on a 2, 3, or 4 month cleaning recall?
* Robert J. Genco; Henry Maurice Goldman; David Walter Cohen (1990). Contemporary periodontics. Mosby. ISBN 978-0-8016-1935-9. Retrieved 20 September 2011.
What happens if I don't treat my gums?
The early stage of gum disease is called gingivitis. Advanced gum disease is called periodontitis. Chronic periodontitis can lead to the loss of tissue and bone that support the teeth and it may become more severe over time. If it does, your teeth will feel loose and start moving around in your mouth. This is the most common form of periodontitis in adults but can occur at any age. It usually gets worse slowly, but there can be periods of rapid progression.
Aggressive periodontitis is a highly destructive form of periodontal disease that occurs in patients who are otherwise healthy. Common features include rapid loss of tissue and bone and may occur in some areas of the mouth, or in the entire mouth.
Research between systemic diseases and periodontal diseases is ongoing. While a link is not conclusive, some studies indicate that severe gum disease may be associated with several other health conditions such as diabetes or stroke.
* Information provided by the American Dental Association.
Why do I need x-rays (radiographs) every 6 months?
What are the benefits of fluoride?
Fluoride is a mineral that occurs naturally in all water sources, including oceans, lakes and rivers. Research shows that fluoride helps prevent cavities in children and adults by making teeth more resistant to the acid attacks that cause cavities. Fluoride is nature’s cavity fighter, helping repair the early stages of tooth decay even before the decay can be seen.
There are two ways that you can benefit from fluoride: topically and systemically.
Topical fluoride is the type of fluoride you receive at the dental office or when you use dental products—such as toothpastes or mouth rinses. Systemic fluoride is ingested, usually through a public water supply, which in the United States applies to nearly 74 percent of the population. While teeth are forming under the gums, the fluoride taken in largely from drinking water and other beverages strengthens tooth enamel making it stronger and more resistant to cavities. This provides what is called a “systemic” benefit. After teeth erupt, fluoride helps rebuild (remineralize) weakened tooth enamel and reverse early signs of tooth decay. When you brush your teeth with fluoride toothpaste, or use other fluoride dental products, you are providing a “topical” benefit because the fluoride is applied to the surface of your teeth.
In addition, drinking fluoridated water and other fluoridated beverages continues to provide a topical benefit because it becomes part of your saliva, constantly bathing the teeth and helping to rebuild weakened tooth enamel. The maximum reduction in tooth decay occurs when fluoride is available systemically and topically. Studies show that community water fluoridation, the addition of fluoride to water to a recommended level for preventing tooth decay, prevents at least 25 percent of tooth decay in children and adults. In fact, community water fluoridation is noted as the single most effective public health measure to prevent tooth decay and the Centers for Disease Control and Prevention has proclaimed community water fluoridation as “one of 10 great public health achievements.”
The American Dental Association and more than 100 other national and international organizations recognize the public health benefits of fluoridated water in preventing tooth decay.
* Information provided by the American Dental Association.
What are sealants?
Thorough brushing and flossing help remove food particles and plaque from smooth surfaces of teeth. But toothbrush bristles cannot reach all the way into the depressions and grooves to extract food and plaque. Sealants protect these vulnerable areas by “sealing out” plaque and food.
Sealants are easy for your dentist to apply. The sealant is painted onto the tooth enamel, where it bonds directly to the tooth and hardens. This plastic resin bonds into the depressions and grooves (pits and fissures) of the chewing surfaces of back teeth. The sealant acts as a barrier, protecting enamel from plaque and acids. As long as the sealant remains intact, the tooth surface will be protected from decay. Sealants hold up well under the force of normal chewing and may last several years before a reapplication is needed. During your regular dental visits, your dentist will check the condition of the sealants and reapply them when necessary.
The likelihood of developing pit and fissure decay begins early in life, so children and teenagers are obvious candidates. But adults can benefit from sealants as well.
* Information provided by the American Dental Association.
Why do I need a crown?
A crown can help strengthen a tooth with a large filling when there isn’t enough tooth remaining to hold the filling. Crowns can also be used to attach bridges, protect a weak tooth from breaking or restore one that’s already broken. A crown is a good way to cover teeth that are discolored or badly shaped. It’s also used to cover a dental implant.
If your dentist recommends a crown, it is probably to correct one of these conditions. Your dentist’s primary concern, like yours, is helping you keep your teeth healthy and your smile bright.
* Information provided by the American Dental Association.
What is a root canal?
Root canal treatment is necessary when the pulp (soft tissue inside your teeth containing blood vessels, nerves and connective tissue) becomes inflamed or diseased. During root canal treatment, your dentist or endodontist removes the diseased pulp. The pulp chamber and root canal(s) of the tooth are then cleaned and sealed. If the infected pulp is not removed, pain and swelling can result, and your tooth may have to be removed.
Causes of an infected pulp could include:
- a deep cavity
- repeated dental procedures
- a cracked or broken tooth
- injury to the tooth (even if there’s not a visible crack or chip)
If you continue to care for your teeth and gums your restored tooth could last a lifetime. However, regular checkups are necessary; a tooth without its nerve can still develop cavities or gum disease. Most of the time, a root canal is a relatively simple procedure with little or no discomfort involving one to three visits. Best of all, it can save your tooth and your smile.
* Information provided by the American Dental Association.
What is TMJ?
The temporomandibular joints, called TMJ, are the joints and jaw muscles that make it possible to open and close your mouth. Located on each side of the head, your TMJ work together when you chew, speak or swallow and include muscles and ligaments as well as the jaw bone. They also control the lower jaw (mandible) as it moves forward, backward and side to side.
Each TMJ has a disc between the ball and socket. The disc cushions the load while enabling the jaw to open widely and rotate or glide. Any problem that prevents this complex system of muscles, ligaments, discs and bones from working properly may result in a painful TMJ disorder.
Possible causes of TMJ disorders include:
- arthritis
- dislocation
- injury
- tooth and jaw alignment
- stress and teeth grinding
Diagnosis is an important step before treatment. Part of the dental examination includes checking the joints and muscles for tenderness, clicking, popping or difficulty moving. Depending on the diagnosis, the dentist may refer you to a physician or another dentist.
There are several treatments for TMJ disorders. This step-by-step plan from the National Institute of Dental and Craniofacial Research allows you to try simple treatment before moving on to more involved treatment. The NIDCR also recommends a “less is often best” approach in treating TMJ disorders, which includes:
- eating softer foods
- avoiding chewing gum and biting your nails
- modifying the pain with heat packs
- practicing relaxation techniques to control jaw tension, such as meditation or biofeedback.
If necessary for your symptoms, the following treatments may be advised:
- exercises to strengthen your jaw muscles
- medications prescribed by your dentist; for example, muscle relaxants, analgesics, anti-anxiety drugs or anti-inflammatory medications
- a night guard or bite plate to decrease clenching or grinding of teeth.
In some cases, your dentist may recommend fixing an uneven bite by adjusting or reshaping some teeth. Orthodontic treatment may also be recommended. Your dentist can suggest the most appropriate therapy based on the suspected cause.
* Information provided by the American Dental Association.
I'm grinding my teeth, what should I do?
Teeth grinding can be caused not just by stress and anxiety but by sleep disorders, an abnormal bite or teeth that are missing or crooked. The symptoms of teeth grinding include:
- dull headaches
- jaw soreness
- teeth that are painful or loose
- fractured teeth
Your dentist can fit you with a mouth guard to protect your teeth during sleep. In some cases, your dentist or physician may recommend taking a muscle relaxant before bedtime. If stress is the cause you need to find a way to relax. Meditation, counseling and exercise can all help reduce stress and anxiety.
Teeth grinding is also common in children. However, because their teeth and jaws change and grow so quickly it is not usually a damaging habit that requires treatment and most outgrow it by adolescence.
Although in adults teeth grinding is often the result of stress, the same is not always true with children. Other possible causes of teeth grinding in children include:
- irritation in the mouth
- allergies
- misaligned teeth
If you’re concerned about your child’s teeth grinding, ask your child’s dentist about the potential causes and, if necessary, the possible solutions.
* Information provided by the American Dental Association.