Periodontal Disease FAQ





What is periodontal disease? Is it very common? Why is it called periodontal disease? Does periodontal disease only affect adults? What causes periodontal disease? How can I tell whether I have periodontal disease if it doesn’t hurt? How does my periodontist tell whether I have periodontal disease? How is periodontal disease treated? Can periodontal disease be cured? What is periodontal disease? That is the correct term for a disease of the tissues that surround, support and protect the teeth. You may have heard it referred to as “pink toothbrush”, “pyorrhea,”, or “gum disease.” Is it very common? About 100 million Americans have periodontal disease, and more than 20 million more have lost all other teeth mainly because of it. It is the principal cause of tooth loss among adults over 35 years of age. Why is it called periodontal disease? The word “periodontal” means “around the teeth,” and refers to all the different kinds of tissue that surround, support, and protect the teeth. To be firm, a tooth needs a sound support, just as a house needs a solid foundation. The tooth’s support is a small cup, or socket, of BONE, fitted closely around its roots. The roots are not embedded in the bone, but are suspended within the bony socket by many small, extremely tough bands of tissue call LIGAMENTS. If you accidentally bite down on something hard, this arrangement lets the tooth yield slightly, and thus protects it from breaking. If you look at the tissue around your lower front teeth, you will notice a band of tough, light pink tissue, about a quarter of an inch wide and with a firm texture somewhat resembles and orange peel. This is the GINGIVA (or GUM). The function of the gum is to form a protective covering for the roots, bone, and suspending ligaments. Healthy gums taper to a thin knife-like edge at the point where they touch the teeth. Together, the combination of bone, root, gum and suspending ligaments is called the PERIODONTIUM, and a disease that affects one or more tissues of this complex is called PERIODONTAL DISEASE. Does periodontal disease only affect adults? No, the reason tooth loss usually occurs in adults is that the disease often develops rather slowly, but children may have periodontal disease too. In fact, by the age of 15, four out of five children have GINGIVITIS which is the initial phase of periodontal disease. What causes periodontal disease? The primary cause is an invisible film called PLAQUE. Plaque is a sticky, gelatinous mass that forms from saliva, soluble food, dead cells and BACTERIA. Many harmless bacteria normally live in the mouth, and these invade the plaque because they thrive on the nourishment it provides. Soon billions of bacteria are releasing toxic or poisonous waste products that irritate the gums. This irritation causes the inflammation of the gums called GINGIVITIS. This initial phase is painless and deceptively mild, and patients often ignore it. But if the disease process is not stopped, it progresses slowly along the roots of the teeth, causing the gums to separate from the roots, and produces PERIODONTAL POCKETS and BONE LOSS. How can that happen? Inflammation causes a swelling of the gums. This results in the edges becoming rounded and pulling away from the teeth. At the same time, calcium from the saliva is slowly deposited into the plaque to form a concrete substance called CALCULUS (“tartar”). Calculus is quite rough; therefore it further irritates the gums and provides a hiding place for more bacteria. Soon the gum has pulled away from the root far enough to form a periodontal pocket, which is a septic space between the tooth and the gum tissue that the patient cannot clean effectively. The pocket fills with more bacteria and pus forms. Toxic wastes from bacteria in the pocket invade the tissues and eventually cause loss of the supporting bone. With the loss of bony support the teeth become loose. How can I tell whether I have periodontal disease if it doesn’t hurt? You may notice one or more of these signs: bleeding gums, or “pink toothbrush” red, swollen, or tender gums loose or mobile teeth bad breath or bad taste spaces forming between teeth receding gums pus noted when gums are pressed How does my periodontist tell whether I have periodontal disease? In addition to the signs outlined above, Dr. Lovelace will use a small ruler to measure for periodontal pockets to determine if your gums are pulling away from the roots of your teeth. In addition, x-rays will be taken to find any bone loss around your teeth. How is periodontal disease treated? Various treatments may be indicated depending on the stage to which the disease has progressed. The first stage of the treatment is called initial preparation and generally consists of instructions in proper oral hygiene methods, a thorough cleaning and smoothing of the root surfaces, and bite adjustment. For early stages of the disease, this is usually sufficient. More advanced cases may require laser treatment or periodontal surgery to correct the defects in the supporting bone and eliminate the pockets. Finally, the maintenance stage will provide for periodic recall visits to evaluate your ability to keep the teeth and gums healthy. Can periodontal disease be cured? While an absolute “cure” is not possible, periodontal treatment can restore the tissues to a healthy relationship that can be maintained by you. In this way we can effectively arrest and control the disease, and prevent its progress. It must be emphasized that NO TREATMENT CAN BE SUCCESSFUL WITHOUT YOUR COOPERATION. You must develop efficient oral hygiene techniques that will completely remove bacterial plaque, and practice those techniques daily. Regular periodic visits to Dr. Lovelace will be necessary to help you maintain your smile.