Posts for tag: periodontal disease
That bit of gum bleeding after you brush, along with redness and swelling, are strong signs you have gingivitis, a form of periodontal (gum) disease. Without treatment, though, your gingivitis could turn into something much more painful and unsightly — a condition commonly known as “trench mouth.”
Properly known as Acute Necrotizing Ulcerative Gingivitis (ANUG), the more colorful name arose from its frequent occurrence among soldiers during World War I. Although not contagious, many soldiers contracted it due to a lack of means to properly clean their teeth and gums and the anxiety associated with war. Inadequate hygiene and high stress still contribute to its occurrence today, along with smoking, medications that dry the mouth and reduced disease resistance — all of which create a perfect environment for bacterial growth.
ANUG can arise suddenly and be very painful. The cells in the gum tissue begin to die (“necrotizing”) and become swollen (“ulcerative”), especially the small triangle of gum tissue between the teeth called the papillae, which can appear yellowish. Patients also encounter a characteristic foul breath and taste. Untreated, ANUG can damage tissue and contribute to future tooth loss.
Fortunately, antibiotics and other treatments are quite effective in eradicating bacteria that cause the disease, so if caught early it’s completely reversible. We start with a complete examination to confirm the diagnosis and rule out other possible causes.Â We then attempt to relieve the pain and inflammation with non-steroidal, anti-inflammatory drugs like aspirin or ibuprofen and begin antibiotic treatment, most notably Metronidazole or amoxicillin. We may also prescribe a mouthrinse containing chlorhexidine and mild salt water rinses to further reduce the symptoms.
We must also treat any underlying gingivitis that gave rise to the more acute disease. Our goal here is remove any bacterial plaque and calculus (hardened plaque deposits) that have built up on tooth surfaces, particularly below the gums. Only then can we fully bring the disease under control.
It’s also important you become more consistent and effective with daily brushing and flossing, quit smoking, reduce undue stress, and get better rest and nutrition. Establishing these new habits and lifestyle changes will help ensure you’ll never have to experience trench mouth again.
If you would like more information on ANUG and other periodontal gum conditions, 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 “Painful Gums in Teens & Adults.”
After several treatment sessions your periodontal (gum) disease is under control. But, while we may have won this battle, the war rages on. To keep an infection from re-occurring we'll have to remain on guard.
Gum disease begins and thrives on a thin film of bacteria and food particles on tooth surfaces called plaque. The infection usually begins as gingivitis, which causes the gums to become red and swollen (inflamed). Untreated it can develop into periodontitis, a more advanced form that progresses deeper into the gum tissues resulting in bone loss.
To treat the disease, we must remove all the plaque and calculus (hardened plaque deposits) we can find no matter how deeply they've penetrated below the gum line. Since the deeper it extends the more likely surgical techniques may be necessary to consider, it's better to catch the disease in its earliest stages when plaque can be removed with hand instruments or ultrasonic equipment.
The appropriate treatment technique can effectively stop and even reverse gum disease's effects — but it won't change your susceptibility. Constant vigilance is the best way to significantly reduce your risk of another episode. In this case, our prevention goal is the same as in treatment: remove plaque.
It begins with you learning and applying effective brushing and flossing techniques, and being consistent with these habits every day. As your dentist, we play a role too: we may need to see you as often as every few weeks or quarter to perform meticulous cleaning above and below the gum line. We may also perform procedures on your gums to make it easier to maintain them and your teeth, including correcting root surface irregularities that can accumulate plaque.
Our aim is to reduce the chances of another infection as much as possible. "Fighting the good fight" calls for attention, diligence and effort — but the reward is continuing good health for your teeth and gums.
If you would like more information on continuing dental care after 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 “Periodontal Cleanings.”
Your body’s organ systems are interlinked — what happens in one system may affect another. An example of this is the interrelationship between periodontal (gum) disease and cardiovascular disease (CVD).
Medicine has discovered a common link between these two different conditions — inflammation. A result of the body’s defense mechanisms, chronic inflammation is damaging to both your mouth and your heart. Inflammation can destroy the gum’s soft tissue and underlying bone and lead to tooth loss. In the cardiovascular system, inflammation can begin and accelerate the buildup of plaque within arterial blood vessels (atherosclerosis). This inhibits the flow of oxygenated blood to both the heart and brain, which sets the stage for a heart attack or stroke.
Gum disease begins with poor oral hygiene. When brushing and flossing aren’t performed on a regular basis, or not performed adequately, it allows a thin layer of bacterial plaque called biofilm to build up on the teeth. The bacteria cause infection in the soft tissues of the gum that triggers the chronic inflammation. Because it’s often unaccompanied by other signs of infection like fever, a patient may not even be aware of it. There’s evidence now that inflammation caused by moderate to severe gum disease can contribute to a similar response in blood vessels.
We can treat the gum disease and reduce or eliminate the inflammation. This first requires the removal of all plaque and calculus (harder deposits) on the teeth, down to the root level. It may require surgery to access these areas and to help regenerate some of the lost tissue and bone that support the teeth. It’s also important to institute proper oral hygiene — effective daily brushing and flossing, semi-annual office cleanings and checkups.
In a similar way, you should address signs of inflammation in your cardiovascular system, including blood pressure management and the control of LDL (bad) cholesterol. Because both gum disease and CVD share many of the same risk factors, you can positively impact both your oral and general health by eating more nutritional foods, engaging in regular exercise and quitting tobacco products.
Treating any symptom of inflammation is important to improving your total health. By bringing gum disease and its accompanying inflammation under control, you may in turn help your heart and blood vessels.
If you would like more information on the relationship between heart and gum diseases, 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 “The Link Between Heart & Gum Diseases.”
While hygiene and regular dental care go a long way to reduce your risk of oral disease and disorders, you’re still subject to your heredity. Everything from tooth alignment to the shape of your jaws is determined by your genes.
So is the biological structure of your gum tissue. Aside from minute variations, gum tissue structure falls into two broad categories — “thin” or “thick,” which refer to the actual thickness of the tissue and the underlying bone. The tooth’s appearance is the best indicator of which type you may have: those with more triangular-shaped tooth (often called scalloped) have thin gum tissue; a person with a squarer appearance (flat) has thick gum tissue. People of Asian descent tend to have thin/scalloped tissue while those with European or African heritage tend to have thick/flat tissues.
Thick gum tissue isn’t superior to thin, or vice-versa. In fact, each type is susceptible to certain types of diseases or adverse conditions.
Thin tissues are more susceptible to the occurrence of receding gums. Caused mainly by periodontal disease and toothbrush abrasion, the gum tissue recedes and exposes more of the unprotected tooth surface that should be below the gum line. This increases the risk of decay and tooth loss. Patients with thick tissue, on the other hand, have a higher risk of developing a condition known as “pocketing.” As the thicker gum tissue becomes inflamed from dental plaque, it loses its attachment to the teeth and forms a small pocket. The end result is possible bone and tooth loss.
There’s not much you can do about which type of gum tissue you have, for which you can thank (or blame!) your ancestors. But there’s something you can do to reduce your risk of periodontal disease. First and foremost, you should practice good daily hygiene, brushing with a soft-bristled tooth brush and gentle flossing. It’s also important to maintain regular cleanings and checkups in our office; not only will this ensure complete plaque and tartar removal, but gives us a better chance to detect either receding gums or pocketing early. Earlier detection can mean better treatment outcomes — and a saved smile.
If you would like more information on genetic types of periodontal tissues, 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 “Genetics & Gum Tissue Types.”
Your gums are red around the margins and bleed whenever you brush or floss but there's minimal to no pain... You: (select the most appropriate answer[s])
- are brushing or flossing too vigorously
- have an accumulation of dental plaque where the teeth meet the gums
- are using a toothbrush that's too firm
- are experiencing early signs of gum disease
- should see your dentist if this persists for more than 6 months
Kudos if you picked b) and d). The most common cause of bleeding gums is the accumulation of dental plaque (bacterial deposits) at the gum line, which is an early sign of periodontal (from the Latin “peri” – around, and the Greek “odont” – tooth) disease. It is usually painless so people tend to underestimate the risk of allowing gum disease to progress and become a more significant problem.
It's a common misconception that bleeding gums are caused by brushing or flossing too vigorously or using a toothbrush that's too firm. This is sometimes the case, but the abrasion would probably cause noticeable pain. Instead, it's likely that you're not brushing and flossing effectively enough, allowing bacterial deposits to accumulate at the gum line and feed on food particles that haven't been adequately flushed from your mouth.
The bacterial deposits form a whitish film that is hard to detect when you look in the mirror. But you will notice bleeding and redness and eventually inflammation of the gums — an immune response to disease-causing bacteria that flourish in the plaque. As the biofilm grows, with time it also hardens (calcifies), making it increasingly difficult to dislodge. Eventually, only professional cleaning can remove it and sometimes antibiotics are needed. If no action is taken, gum disease will progress, and eventually cause loss of the underlying bone that anchors the teeth.
There are other reasons that gums may bleed, such as elevated hormone levels in women, a side effect of certain medications, or a systemic (bodily) disease. Whatever the cause, it's important to get a professional diagnosis promptly and take appropriate therapeutic action as needed. Optimally, with good oral hygiene and regular checkups, you can avoid this problem entirely!
If you would like more information about preventing or treating bleeding gums, 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 “Bleeding Gums.”