Posts for tag: gum disease
Are bleeding gums something you should be concerned about? Dear Doctor magazine recently posed that question to Dr. Travis Stork, an emergency room physician and host of the syndicated TV show The Doctors. He answered with two questions of his own: “If you started bleeding from your eyeball, would you seek medical attention?” Needless to say, most everyone would. “So,” he asked, “why is it that when we bleed all the time when we floss that we think it’s no big deal?” As it turns out, that’s an excellent question — and one that’s often misunderstood.
First of all, let’s clarify what we mean by “bleeding all the time.” As many as 90 percent of people occasionally experience bleeding gums when they clean their teeth — particularly if they don’t do it often, or are just starting a flossing routine. But if your gums bleed regularly when you brush or floss, it almost certainly means there’s a problem. Many think bleeding gums is a sign they are brushing too hard; this is possible, but unlikely. It’s much more probable that irritated and bleeding gums are a sign of periodontal (gum) disease.
How common is this malady? According to the U.S. Centers for Disease Control, nearly half of allÂ Americans over age 30 have mild, moderate or severe gum disease — and that number increases to 70.1 percent for those over 65! Periodontal disease can occur when a bacteria-rich biofilm in the mouth (also called plaque) is allowed to build up on tooth and gum surfaces. Plaque causes the gums to become inflamed, as the immune system responds to the bacteria. Eventually, this can cause gum tissue to pull away from the teeth, forming bacteria-filled “pockets” under the gum surface. If left untreated, it can lead to more serious infection, and even tooth loss.
What should you do if your gums bleed regularly when brushing or flossing? The first step is to come in for a thorough examination. In combination with a regular oral exam (and possibly x-rays or other diagnostic tests), a simple (and painless) instrument called a periodontal probe can be used to determine how far any periodontal disease may have progressed. Armed with this information, we can determine the most effective way to fight the battle against gum disease.
Above all, don’t wait too long to come in for an exam! As Dr. Stork notes, bleeding gums are “a sign that things aren’t quite right.” Â If you would like more information about bleeding gums, please contact us or schedule an appointment. You can read more in the Dear Doctor magazine article “Bleeding Gums.” You can read the entire interview with Dr. Travis Stork in Dear Doctor magazine.
Your gums’ primary role is to protect your teeth and keep them firmly in place. But periodontal (gum) disease can damage your gums to such an extent you could ultimately lose your teeth.
Gum disease is a progressive infection caused by bacterial plaque built up on tooth surfaces from poor oral hygiene. The initial infection triggers inflammation, a defensive response of the body characterized by swelling, redness and bleeding of the gums. An initial form of the disease known as gingivitis occurs in most people after just a few days without brushing or flossing.
Resuming hygienic activities to remove daily plaque, along with regular dental cleanings, may be enough to stop gingivitis and restore healthy gums. If the disease is allowed to advance, however, the infected gum tissues will begin to detach from the teeth, turning the slight normal gaps between teeth and gums into wider voids known as periodontal pockets that fill with bacteria leading to infection. Your hygiene efforts will not be enough to cope with this advanced form of periodontal disease.
At this point professional techniques are required to adequately remove plaque and calculus (hardened plaque deposits), depending on the depth and location of the periodontal pockets. The most basic of these is scaling using specialized hand instruments or ultrasonic equipment to remove plaque and calculus in pockets at or just below the gum line. If plaque and calculus have extended to the roots we may then need to employ root planing, in which we “shave” offending material from root surfaces. In some cases this may require accessing the area surgically beneath the gum tissue.
As plaque removal progresses, inflammation will begin to subside and the gum tissues heal. If, however, swelling, bleeding or pus formation persists, this may indicate bacterial levels remain too high. To decrease these levels we may need to administer antibiotics, or through mouthrinses containing chlorhexidine.
Once under control, it’s crucial from then on for you to maintain a strict daily regimen of brushing and flossing to keep plaque from building up on tooth surfaces. You'll also need to visit us regularly (two or more times a year) for professional cleaning and checkups. Keeping a close eye will help prevent a reoccurrence of this serious disease and prolong the life of your teeth.
If you would like more information on treating periodontal (gum) disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Treating Difficult Areas of Periodontal Disease.”
A loose permanent tooth isn’t normal — it represents a serious threat to the tooth’s survival. There may be a chance to save the tooth, however, if we can determine the cause of the looseness and treat it appropriately.
Teeth are normally held securely in place by the periodontal ligament, an elastic tissue that attaches to both the teeth and the bone. Certain conditions, however, can disrupt this attachment. The most common is advanced periodontal (gum) disease, an infectious condition caused by bacterial plaque. It can severely inflame and damage the surrounding gum tissues resulting in bone loss. As the bone is lost, the periodontal ligament is lost as they detach from the teeth. In fact, tooth looseness may be a fairly late sign of the disease.
Another major cause is teeth grinding (bruxism) and clenching habits that result in excessive biting forces. Usually stress-related, teeth grinding and clenching generate forces on the teeth outside of their normal range. As a result the periodontal ligament can become stretched, inducing tooth looseness.
Our treatment approach depends on which condition is causing the looseness, best assessed with a thorough dental examination. If gum disease is the culprit, the main treatment is to remove as much bacterial plaque and calculus (tartar) as possible using various techniques such as scaling or root planing (accessing and cleaning root surfaces). It’s also imperative for you the patient to start and maintain an effective hygiene regimen of daily brushing and flossing, along with professional cleanings every three to six months depending on your degree of vulnerability to gum disease. Subsequent healing will stimulate tissue reattachment to the teeth.
In the case of excessive biting forces, we primarily want to reduce their effect on the teeth. Treatment can include muscle relaxants or anti-inflammatory drugs, or a custom-fitted bite guard to minimize biting forces from teeth grinding during sleep. In some cases we may opt to reshape the biting surfaces of teeth through removal of small amounts of surface enamel: this will reduce the biting force by altering how the upper and lower teeth contact. It’s also possible to splint loose teeth to more stable teeth, joining them like pickets in a fence. This helps relieve the biting force on teeth with significant loss of bone support.
If you notice a loose tooth, you should make an exam appointment with us as soon as possible. The sooner we can diagnose the cause and begin treatment, the less chance you’ll lose your tooth.
If you would like more information on loose teeth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Loose Teeth.”
The increasing rates of obesity and diabetes in Americans have been getting a lot of attention lately. Most people know that the two are clearly linked. But did you know there's also strong evidence of a link between diabetes and gum disease?
Both diabetes and periodontal (gum) disease are chronic inflammatory conditions. That means they are disorders that develop over time (chronic), and are characterized by problems with a function of the immune system (inflammation). In diabetes, problems with the hormone insulin lead to abnormal levels of sugar in the blood. This can bring about a number of complications which, if not treated, may result in kidney failure, coma and even death. In many people, however, it's a condition that can be managed with drugs and lifestyle changes.
You may not think of gum disease (periodontitis) as a serious illness. But here's something you should know: If you have diabetes, having gum disease is a risk factor for worsening control of blood glucose levels, and may also increase the risk of complications. Likewise, having diabetes puts you at greater risk for developing more severe forms of periodontal disease.
What is gum disease? It's actually a group of diseases caused by many types of bacteria in the mouth, which affect the tissues around the teeth. Initially, it often causes swelling and redness of the gum tissue. Left untreated, it may result in bone loss, abscess formation, and ultimately the loss of teeth. But its ill effects aren't limited to your mouth.
Periodontal inflammation is associated with a higher systemic (whole-body) inflammatory state. That means it may increase your risk for cardiovascular diseases like heart attack and stroke, and adverse pregnancy outcomes — as well as complicating the management of blood-sugar levels in diabetics.
Now, here's the good news: Treatment of periodontal disease which reduces inflammation has a beneficial impact on the inflammatory status of the whole body. For people who have both diabetes and periodontal disease, that means that periodontal therapy can lead to improved blood sugar control.
How do you know if you have periodontal disease? Bleeding gums and bad breath are both possible symptoms, as are redness and soreness of the gum tissues. But these warning signs may be masked by any number of other factors — or may not be noticed at all.
The sure-fire way to diagnose and treat periodontal disease is by getting regular dental checkups, followed by specialized periodontal treatment when necessary. If you presently have diabetes, or may be at risk for developing the disease, those check-ups and treatments are even more important.
If you have concerns about diabetes and gum disease, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Diabetes & Periodontal Disease” and “Understanding Gum (Periodontal) Disease.”