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This week, I thought I would have my hygienist write this column. Rita explained that several patients seem to be confused about whether or not they have gum disease, known as periodontal disease, as opposed to gingivitis, or swelling of the gums. She thought it would be a good idea to try and explain the difference. I agreed.
Many patients have been told that they have gum disease but are confused as to what this actually means. Although gum disease is a general term, it usually refers to either gingivitis or periodontitis. However, there are many differences between the two.
Gingivitis is gum inflammation. When the bacteria in plaque builds up, it causes the gums to become inflamed and irritated, which can lead to bleeding when flossing or brushing. When a patient has gingivitis, there is no bone loss, therefore, the teeth are firmly planted and no movement is evident.
However, the gums can appear red and swollen. If left untreated, gingivitis can advance to periodontitis, or inflammation of the periodontium — the surrounding supportive structures of the teeth. When a patient has periodontitis, the inner layer of the gum and bone can pull away from the teeth, forming a space between the tooth and the gums.
This space is called a pocket and food, plaque and debris can collect in these pockets and become infected as bacteria builds. The toxins in plaque bacteria start to break down the bone and other supportive tissues that hold teeth in place.
If the disease is allowed to progress, the pockets deepen, making it difficult for the patient to effectively remove the plaque that collects there, thus leading to more destruction of the surrounding bone and tissue. Eventually, when enough surrounding bone is destroyed, the teeth will become loose and the patient may eventually lose those teeth that are affected.
During an initial exam, your dentist will be looking for signs of either gingivitis or periodontitis. You may recall having measurements taken where the doctor calls out numbers to his assistant. This is a procedure where the dentist is using an instrument to determine the presence of pockets. The lower the numbers, the less likely that you have periodontitis.
However, he or she may detect the signs of gingivitis during that exam and will recommend treatment to prevent the advancement of the gingivitis to periodontitis. If the dentist detects deeper pockets, or other signs of periodontitis, such as red, swollen, bleeding gums, bad breath, receding gums or loose teeth, he or she will recommend treatment to address the disease process.
The goal of the treatment of periodontitis is to reduce the pockets and promote reattachment of the gums to the teeth. There are different treatment options, depending on the stage of the disease, ranging from non-surgical therapies that focus on plaque control, to surgery to restore the supportive structures.
Since plaque is the primary factor that is responsible for gum disease, plaque control is of utmost importance. Plaque control is accomplished through professional cleanings, at least twice a year, and flossing and brushing daily. While brushing eliminates plaque from reachable tooth surfaces, flossing removes plaque from between teeth and under the gumline where your brush cannot reach.
It is not uncommon for patients to not notice signs of gum disease, so it is important to have regular dental exams and to see your hygienist in order to prevent any serious disease to develop. I hope this has helped to clarify this important topic.
Dr. Frank Vascimini is a dentist practicing in Homosassa. Send your questions to 4805 S. Suncoast Blvd., Homosassa, FL 34446 or email them to him at info@MasterpieceDentalStudio.com.