PERIODONTAL HEALTH

UNDERSTANDING GUM DISEASE & ITS IMPACT

“Periodontics is the keystone of dental health and serves as the principal foundation for which without it, there would be no support to hold the tooth in place.”
Dr. Juliana Sardenberg-Melcher

Periodontal Health and Disease:

Periodontal disease (aka gum disease) is a preventable chronic inflammatory disease highly prevalent among US adults. According to the National Health and Nutrition Examination Survey of 2009-1014 (NHANES), it is estimated that 42% of dentate US adults 30 years or older have periodontitis.

A periodontist is a dentist who specializes in the prevention, diagnosis, and treatment of periodontal diseases and in the placement of dental implants. Periodontists receive extensive training in both of these areas and more, including three additional years of education beyond dental school. They are trained to perform all procedures dealing with the gingiva (gums) and the bone supporting your teeth and dental implants. 

 

While some general dentists treat less serious periodontal cases, many will refer their patients to periodontists for more challenging periodontal cases. Similarly, while some general dentists perform dental implant procedures, many will refer their patients to periodontists for  more challenging implant cases.

 

In addition to handling challenging periodontal and implant cases, periodontists provide a variety of specialized services. These include scaling and root planning, surgical treatment for periodontitis, frenectomy, functional and esthetic crown lengthening, extractions, bone grafting procedures, bone contouring procedures, exposure of impacted teeth, gum grafts, gingivectomy, sinus lifts,  biopsies,  surgery to facilitate orthodontic movement of teeth,  sedation dentistry,  therapy for ailing implants, bite adjustments,  splinting of teeth, and a variety of treatment aimed at saving the natural dentition. 

Periodontal disease is a broad category that focuses on abnormalities associated with the gingiva and jaw bone. Most common category of periodontal diseases are gingivitis and periodontitis.  Gingivitis – A state of inflammation of the gingival tissues that has not evolved into loss of supporting bone. This stage of gingival disease is most often reversible. It is caused by dental plaque build-up around the gum-line of teeth and is characterized by clinical signs such as swollen, red, and bleeding gums. Treatment for gingivitis includes improving oral hygiene habits and a professional cleaning (prophylaxis or scaling in the presence of inflammation) at your dental office every 6 months. If gingivitis is not treated, most patients will develop periodontitis.  Periodontitis – A chronic state of inflammation initiated by dental plaque that progresses below the gum-line and causes a loss of periodontal structures such as the alveolar bone, periodontal ligament, and gingival tissue. It is typically characterized by receding gums, build-up of calculus (tartar), loose teeth, swollen, red, bleeding gums and deeper probing depths (pocket formation). This stage of periodontal disease requires further treatment than a prophylaxis and patients diagnosed with moderate-severe stages of periodontitis are typically referred to see a periodontist. 
Periodontal health is defined as the absence of clinical inflammation. It is  also the absence of loss of supporting periodontal structures. Gingivitis and periodontitis are preventable. Proper at-home oral care and regular visits to your dental professional will help optimize your oral health and help prevent periodontal disease from initiating. However, once disease has established, it must be addressed and treated.
  • Brush your teeth (and tongue). Brushing your teeth twice daily for two minutes each time, or after meals, helps reduce plaque bacteria (#1 causing agent of periodontal disease). The tongue harbors bacteria that cause bad breath and gum disease. A tongue scrapper can be helpful.
  • Floss. Flossing with dental floss or flossers at least once daily  helps reduce plaque and remove food particles between teeth where your toothbrush doesn’t reach. If you have gaps between your teeth, incorporating inter-dental or inter-proximal brushes to your daily routine is a great way to effectively reduce bacterial load and remove food debris  between your teeth. 
  • Know your risk. Age, smoking, diet, genetics, and systemic diseases such as diabetes and heart disease, can increase your risk for periodontal disease. If you are at increased risk, be sure to  speak with your dental professional.
  • See a periodontist. Get an annual comprehensive periodontal evaluation (CPE). A CPE looks at your teeth, plaque levels, gums, bite, bone structure and other risk factors for periodontal disease. Identifying symptoms of gum disease early is key to protecting your teeth and gums.

Systemic Diseases and Periodontal Disease:

Several studies have shown a link between periodontal disease and other systemic diseases. While a causal relationship may not have been conclusively established, research suggest that periodontal disease may contribute to the progression of other diseases.

People with uncontrolled diabetes are more likely to have periodontal disease than people without diabetes or people with controlled diabetes. Uncontrolled diabetes has a negative effect on your immune system, increasing susceptibility to infections.. In fact, periodontal disease is often considered a complication of diabetes. Those who do not  have their diabetes under control are especially at risk. Research has suggested that the relationship between diabetes and periodontal disease  are a two way street: periodontal disease may also make it more difficult for people who have diabetes to control their blood sugar, increasing the risk for diabetic complications.

Several studies have shown that periodontal disease may increase the risk of heart disease. Scientists believe that inflammation caused by periodontal disease may be responsible for the association. Periodontal disease can also exacerbate existing heart conditions. Patients at risk for infective endocarditis may require antibiotics prior to dental procedures. Your periodontist and cardiologist will be able to determine if your heart condition requires use of antibiotics prior to dental procedures.

Research has found that bacteria associated with periodontal disease can be aspirated into the lungs and contribute to respiratory diseases such as pneumonia.

Researchers found that men with gum disease were 49% more likely to develop kidney cancer, 54% more likely to develop pancreatic cancer, and 30% more likely to develop blood cancers.

Studies have shown a connection between bacteria associated with periodontal disease and the progression of Alzheimer’s disease. Gum disease bacteria may be able to travel to the brain and contribute to the development of Alzheimer’s disease.

Reference:

American Academy of Periodontology

CONTACT KEYSTONE PERIODONTICS

Because Keystone is a traveling periodontal practice, we do not have an office location.

Patients who would like to be seen by Dr. Sardenberg-Melcher must first become a patient of record at one of the practices she collaborates with.
Please inquire by messaging us under ‘Contact Us’. Please include as much information as possible about why you are seeking periodontal care.