Dec 13

Are My Gums Diseased?

Well, if you are over 35 there is a 75% chance they are, according to statistics from the American Dental Association.

Dentists diagnosis periodontal disease primarily by measuring the patient’s gum line.  Where you see your gums start, is not the same spot that it attaches to the tooth.  There normally is a little cuff or what dentists call a sulcus.  It should usually measure between 1 to 3 mm.  When your gum or gingival gets diseased, the attachment of the gum unzips from the tooth.  This deeper area is what dentists call a periodontal pocket.

Periodontal pockets develop because of the build up of plaque and tartar at and below the gum line.  The bacteria and their toxins in these colonies cause inflammation.  The longer the inflammation goes on, the more damage occurs.  The patient’s white blood cells attack the plaque primarily white blood cells are called lymphocytes.  These cells are essentially mediate the disease process.  These white blood cells release enzymes and other blood chemistry products.  These products break down the collegen in the gum and even cause the supporting bone to resorb.

Patients always think they will know this is going on.  They will say to themselves “it will have to hurt before it gets too bad”.  Wrong.  Twice a month I see new patients that need a tooth extracted because it has gotten so diseased and the only symptoms that they have is that the tooth was loose and a little sore.

Signs and symptoms that can indicate periodontal disease:

Swollen and bleeding gums, food impaction in between teeth that have not lost fillings, chronic or continuous bad breath, teeth that have suddenly shifted position,  front teeth spaces that have gotten bigger or front teeth that have splayed out forward.

Treatment for periodontal disease should always include the removal of the tartar and plaque.  The initial therapy for periodontal disease is usually called scaling and root planeing.  This usually consists of the removal of the tartar under local anesthesia with ultrasonic and hand instruments.  This doctor also uses a topical disinfectant as a rinse or (lavage) under the gum. Prior to doing the gum treatment, measurements of the gum are recorded.  This initial therapy is nonsurgical.  After about 2 weeks of healing, measurements are performed again.  Depending upon how much shrinkage or reduction of pocket depths occur, several things may be indicated.  If they improve dramatically, this might complete the therapy, and now the patient is in for what we call maintenance recalls in the months that follow.

For the patient with pocket depths remaining, there are several options.  One nonsurgical option is a product called Arestin.  This is a spherical powdered antibiotic.  The product is puffed into the pocket where it is changed into a gelatenous plug.  Dentists call this a locally delivered chemotherapeutic.  This product will last for upwards of a month and will continue to reduce bacterial numbers, pocket depth, bleeding and inflammation.  Areas that have advanced disease, surgical therapy may be required.  With all periodontal and gum therapy, continuous reevaluation and improved home care is essential.  Not treating this disease could not only cause you to lose your teeth, but multiple medical conditions can worsen with untreated gum disease.   The increase in inflammatory markers or prostaglandins in your blood have definitely been proved to increase plaque and cholosterol formation in your coronary heart arteries.  So leaving your gums diseased can affect your overall health.  All these discussed treatments are available at  our office.  They can also be performed under conscious sedation.  Our sedation patients do not remember a thing!  So, why are you putting this off? You know you need it done.  See our patient testimonials on  Consults are always at no charge.