Hygiene and Preventive Services

A mouth full of bacteria, which along with mucous and other particles constantly forms a sticky, colorless “plaque” on teeth. This is what causes gum disease. Brushing and flossing daily helps control this infection-causing plaque.

Bad Breathe (Halitosis) that won’t go away is one early sign of gum disease.

Bleeding and red swollen gums (gingivitis) is a sign of inflammation and infection. Bleeding is bad because it allows bacteria in mouth to get into the blood stream and infect other parts of our body. This is especially bad for diabetics and others with heart and stroke conditions. Studies show that periodontal disease in patients with uncontrolled diabetes increases the incidence of heart attacks or strokes by up to 80%.

Periodontitis (deeper inflammation around the tooth) develops when gingivitis is not treated. Receding gums and mobility begin to appear as plaque spreads and grows below the gum line. The infected gums pull away from the teeth and form spaces (pockets) between the tooth and gum. Bacterial toxins and the body’s natural response to infection now begin to break down the bone and connective tissue that holds teeth in place. If not diagnosed and treated, teeth eventually become loose, fall out or have to be removed.

Other signs and symptoms are:
• Tender gums
• Sensitive teeth
• Pus between gums and teeth
• Widening spaces between teeth
• Changes in the bite
• Longer-looking teeth

Risk Factors

• Smoking: Smoking is one of the most significant risk factors associated with the development of gum disease. Additionally, smoking can lower the chances for successful treatment of gum and bone infections.
• Diabetes: Diabetics are at higher risk for developing infections, including gum and bone disease.
• Other illnesses: Diseases like Parkinson’s, Alzheimer’s, heart conditions, strokes, cancer and their treatments can also negatively affect the health of gums.
• Medications: There are hundreds of prescription and over the counter medications that can reduce the flow of saliva. Without enough saliva (dry mouth), the mouth is more vulnerable to infections such as gum disease.
• Genetic susceptibility: Some people are more susceptible to severe gum disease than others and we now have laboratory tests to identify these individuals.
• Poor nutrition
• Stress

• We will first review your medical history to identify underlying conditions or risk factors that may exist.

• We will examine your mouth and gums for signs of inflammation and infection.

• We will use a tiny ruler called a “probe” to check for and measure any pockets. In a healthy mouth, the depth of theses pockets is between 1 and 3 millimeters. This test for pocket depths is usually painless.

• We will take x-rays to see assess the degree of infection and bone loss.

The main goal of treatment is to control the infection. For some, daily brushing and flossing, along with 2 cleanings per year will control periodontal disease and prevent tooth loss. For others, the number and types of treatment will vary depending on the extent of the gum disease.

Deep Cleaning (Scaling and Root Planing): The hygienist cleans the plaque and tartar from below the gum line. This treatment removes the germs and bacteria that cause gum disease.

Periodontal maintenance: After a deep cleaning, follow up care is every 3 months for the first year. Thereafter, a follow up plan customized to your specific condition will be developed and implemented.

Medications: In addition to scaling and root planing, medications may be used, depending on where the disease has progressed.

• Peridex: A prescription mouth rinse used to control overall bacterial levels in the mouth.

• Site-specific Antibiotics: Powdered medication placed directly at the site to control bacteria and reduce the size and depth of the pocket.

• Oral antibiotics: Antibiotic tablets or capsules taken by mouth for short-term treatment of an acute infection.

Surgical Treatments: In cases where inflammation and deep pockets remain following treatment, the dentist or a gum specialist may suggest lifting back the gums (flap surgery) to completely eliminate the infection. The goal is to have gums heal and fit more tightly around the teeth.

In other cases, bone and tissue grafts may be needed to help promote healthy gum and bone growth.

Treatment results will depend on many things, including how far the disease has progressed, how well the patient complies with home care and on other risk factors.

Current research shows that people with gum disease (when compared to those without gum disease) are more likely to develop heart disease, strokes and diabetes. Studies also show that women with gum disease are more likely to deliver pre-term, low birth babies. In addition, other studies have identified a variety of health conditions that may arise from harmful oral bacteria entering the blood stream.