What is going on in the body? Gingivitis and periodontitis can be considered one disease complex, with gingivitis leading to periodontitis in most cases. Gingivitis often goes unnoticed in the early stages and may cause no symptoms even when it has progressed to peridonitis.
When gingivitis is advanced, it spreads to the bony tissues, which lie under the gums and support the teeth. This is called periodontitis which is much more serious than gingivitis.
In later stages of periodontitis, the teeth can become loose and severely infected with pus oozing from around the sockets. In very advanced periodontitis, the teeth can actually fall out or may have to be removed because of infection. Gum disease is the major cause of premature tooth loss in adults.
Gingivitis and periodontitis are caused by bacteria, which are incorporated into a substance called dental plaque. Plaque begins as a soft and sticky substance, which forms constantly on all areas of the teeth. It is especially harmful in areas where it is hard to see and hard to remove, such as between the teeth, and in the crevices between the gum and the tooth surface.
The longer this material is allowed to set, the more difficult it is to remove. At some point, this plaque hardens and has to be scraped off the teeth. In the early stages, it can be brushed and flossed off the teeth but once it has set and formed tartar or calculus, it must be removed by a dentist or dental hygienist.
The bacteria in this plaque material is the primary cause of the problem. The bacteria in plaque or tartar produces irritating substances that cause gingivitis and periodontitis.
What are the signs and symptoms of the disease? There may be no symptoms in the early stages of gingivitis and periodontitis. Symptoms of gingivitis and periodontitis include:
blood on the tooth brush when brushing the teeth
swelling of the gums
redness of the gums
tenderness when the gums are touched
tenderness when chewing
pus around the teeth
bad taste in the mouth
change in the bite
visible deposits of tartar or calculus on the teeth
What are the causes and risks of the disease? If untreated, periodontitis can lead to the loss of teeth. It is the biggest single factor in tooth loss in adults. If treated early, loss of teeth is usually preventable.
What can be done to prevent the disease? Gingivitis and periodontitis are preventable diseases. Simple attention to everyday oral hygiene and regular visits to the dentist may be all that is necessary to prevent this disease process. Smoking increases the risk of tooth loss via periodontitis three fold. Diabetes also increases the risk approximately two fold.
Specific oral hygiene measures are:
Brush with a soft toothbrush at least once a day.
Change toothbrushes whenever the bristles begin to wear out.
Use floss once a day to clean between the teeth.
Use special tips or devices to clean between the teeth or around bridges as suggested by a dentist or hygienist.
Keep dentures just as clean as the teeth.
Clean around orthodontic appliances or retainers.
Have teeth cleaned and examined every six months unless instructed otherwise by a healthcare professional.
limit the use of tobacco
keep diabetes well controlled
How is the disease diagnosed? A dentist will make the diagnosis of gingivitis or periodontitis by examination, gum probing, and dental X-rays.
What are the long-term effects of the disease? If untreated, gingivitis and periodontitis can lead to the loss of the teeth. With preventive care, there is no reason that the teeth should not last a lifetime. This disease process is almost always preventable or controllable if simple oral hygiene and regular dental checkups are followed.
What are the risks to others? The infection of advanced periodontal disease can spread to other parts of the body, including the heart and other organs. This can happen without warning and can be avoided by simple prevention or early treatment.
What are the treatments for the disease? A dentist is responsible for recommending appropriate treatment, which may vary considerably from person to person. Full patient cooperation is essential and will be stressed by the dentist or hygienist. Treatment without good oral hygiene practices at home will not be as successful. Referral to a periodontist may be necessary with aggressive or advanced form of perodontitis.
Depending on the stage of the disease, treatment can range anywhere from simple cleaning, called prophylaxis, and home care to complex periodontal surgery. In advanced cases, some or all the teeth may have to be extracted.
What happens after treatment for the disease? Since dental plaque will continue to form after treatment, good home care is needed to prevent relapse of this disease.
How is the disease monitored? Regular dental checkups must continue to detect relapse or resumption of this disease, which can happen at any time.
Author: Marvin Goldfogel, DDS Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
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