My gums hurt, bleed, and are sensitive? "I think I Have Gum Disease"
What is Periodontal (Gum) Disease?
The term “periodontal” means “around the tooth.” Periodontal disease (also known as periodontitis and gum disease) is a common inflammatory condition which affects the supporting and surrounding soft tissues of the tooth; also the jawbone itself when in its most advanced stages. Periodontal disease is most often preceded by gingivitis which is a bacterial infection of the gum tissue. A bacterial infection affects the gums when the toxins contained in plaque begin to irritate and inflame the gum tissues. Once this bacterial infection colonizes in the gum pockets between the teeth, it becomes much more difficult to remove and treat. Periodontal disease is a progressive condition that eventually leads to the destruction of the connective tissue and jawbone. If left untreated, it can lead to shifting teeth, loose teeth and eventually tooth loss. Periodontal disease is the leading cause of tooth loss among adults in the developed world and should always be promptly treated.What are the common Signs and Symptoms?
It is extremely important to note that periodontal disease can progress without any signs or symptoms such as pain. This is why regular dental checkups are exceptionally important. Described below are some of the most common signs and symptoms of periodontitis. If you have any of these signs or symptoms, the advice of a general dentist or periodontist should be sought as soon as possible:
- Unexplained bleeding while eating or brushing - Bleeding when brushing, flossing or eating food is one of the most common symptoms of a periodontal infection. The toxins in plaque cause a bacterial infection which makes the tissues prone to bleeding.
- Pain, redness or swelling - A periodontal infection may be present if the gums are swollen, red or painful for no apparent reason. It is essential to halt the progression of the infection before the gum tissue and jaw bone have been affected. It is also critical to treat the infection before it is carried into the bloodstream to other areas of the body.
- Longer-looking teeth - Periodontal disease can lead to gum recession. The toxins produced by bacteria can destroy the supporting tissue and bones, thus making the teeth look longer and the smile appear more “toothy.”
- Bad breath/halitosis - Although breath odor can originate from back of the tongue, the lungs and stomach, from the food we consume, or from tobacco use, bad breath may be caused by old food particles which sit between the teeth and underneath the gumline. The deeper gum pockets are able to house more debris and bacteria, causing a foul odor.
- Loose teeth/change in bite pattern - A sign of rapidly progressing periodontitis is the loosening or shifting of the teeth in the affected area. As the bone tissue gets destroyed, teeth that were once firmly attached to the jawbone become loose or may shift in position.
- Gum recession - Longer looking teeth can signal recession of the gums and bone loss due to periodontal disease. As this disease progresses and attacks the jawbone, (the anchor holding the teeth in place) the teeth may become loose or be lost altogether.
- Pus - Pus oozing from between the teeth is a definitive sign that a periodontal infection is in progress. The pus is a result of the body trying to fight the bacterial infection.
- Gangrene in the tissues - Gangrene is hard to self-diagnose but the general dentist and periodontist will check for its presence in the soft tissues, alveolar bone and periodontal ligament.
- Related health conditions Heart disease, diabetes, osteopenia and osteoporosis are highly correlated with periodontitis and periodontal infections. The bacteria infection can spread through the blood stream and affect other parts of the body.
What are the common causes of gum disease?
- There are genetic and environmental factors involved in the onset of gum disease, and in many cases the risk of developing periodontitis can be significantly lowered by taking preventative measures.
- Poor dental hygiene - Preventing dental disease starts at home with good oral hygiene and a balanced diet. Prevention also includes regular dental visits which include exams, cleanings, and x-rays. A combination of excellent home care and professional dental care will ensure and preserve the natural dentition and supporting bony structures. When bacteria and calculus (tartar) are not removed, the gums and bone around the teeth become affected by bacteria toxins and can cause gingivitis or periodontitis, which can lead to tooth loss.
- Tobacco use - Research has indicated that smoking and tobacco use is one of the most significant factors in the development and progression of gum disease. In addition to smokers experiencing a slower recovery and healing rate, smokers are far more likely to suffer from calculus (tartar) build up on teeth, deep pockets in the gingival tissue and significant bone loss.
- Genetic predisposition - Despite practicing rigorous oral hygiene routines, as much as 30% of the population may have a strong genetic predisposition to gum disease. These individuals are six times more likely to develop periodontal disease than individuals with no genetic predisposition. Genetic tests can be used to determine susceptibility and early intervention can be performed to keep the oral cavity healthy.
- Pregnancy and menopause - During pregnancy, regular brushing and flossing is critical. Hormonal changes experienced by the body can cause the gum tissue to become more sensitive, rendering them more susceptible to gum disease.
- Chronic stress and poor diet - Stress lowers the ability of the immune system to fight off disease, which means bacterial infections may possibly beat the body’s defense system. Poor diet or malnutrition can also lower the body’s ability to fight periodontal infections, as well as negatively affecting the health of the gums.
- Diabetes and underlying medical issues - Many medical conditions can intensify or accelerate the onset and progression of gum disease including respiratory disease, heart disease, arthritis and osteoporosis. Diabetes hinders the body’s ability to utilize insulin which makes the bacterial infection in the gums more difficult to control and cure.
- Grinding teeth - The clenching or grinding of the teeth can significantly damage the supporting tissue surrounding the teeth. Grinding one’s teeth is usually associated with a “bad bite” or the misalignment of the teeth. When an individual is suffering from gum disease, the additional destruction of gingival tissue due to grinding can accelerate the progression of the disease.
- Medication - Many drugs including oral contraceptive pills, heart medicines, anti-depressants and steroids affect the overall condition of teeth and gums; making them more susceptible to gum disease. Steroid use promotes gingival overgrowth, which makes swelling more commonplace and allows bacteria to colonize more readily in the gum tissue.
The Periodontal Assessment?
After diagnosing that you have some level of disease, your dentist may refer you to a specialist called a periodontist who will evaluate your gums to determine your level of periodontal disease. The periodontist will measure the space between your tooth and gum, which is called a periodontal pocket. If those spaces are deeper than normal and show signs of redness, inflammation, bleeding, or tenderness, the periodontist will diagnose your level of gum disease and discuss ways to treat it.Why is Periodontal Treatment Important? (Mouth – Body Connection)
Obviously, the mouth is not separate from the rest of the body. So, if your mouth is not healthy, it can affect your overall health. Many links exist between periodontal disease and other systemic diseases such as diabetes, heart disease, stroke, Alzheimer’s Disease, pneumonia, and even some forms of cancer. In addition, periodontal inflammation is linked to body inflammation, which is your body’s way of trying to fight the infection. Many medical conditions are linked to inflammation, of which periodontal disease can be part of the cause. Most recently, the main comorbidities that are associated with Covid-19 complications are heart disease and diabetes, both of which are linked to periodontal disease. This new connection highlights yet another reason why maintaining health gums is vital to overall health.How Can Periodontal Disease Be Treated?
The periodontist will initially assess the whole mouth in order to ascertain the progress of the disease. After diagnosing the periodontist may treat the bacterial infection with antibiotics in conjunction with nonsurgical or surgical treatment or both. The choice of procedure depends upon the exact condition of the teeth, gums and jawbone. Here are some of the more common treatments for periodontal disease:- Scaling and root planing periodontal-scaling-root-planing– In order to preserve the health of the gum tissue, the bacteria and calculus (tartar) which initially caused the infection, must be removed. The gum pockets will be cleaned and treated with antibiotics as necessary to help alleviate the infection. A prescription mouthwash may be incorporated into daily cleaning routines.
- Deep pocket cleanings periodontal-scaling-root-planing – As gingivitis and periodontitis progress, it becomes more difficult to cleanse the pockets between the soft tissues and the teeth (deep cleaning). The periodontist can scale and root plane the teeth (sometimes under local anesthetic) to remove debris and infection-causing bacteria.
- Pocket elimination surgery pocket-reduction– Pocket elimination surgery (also known as flap surgery) is a surgical treatment which can be performed to reduce the pocket size between the teeth and gums. Surgery on the jawbone is another option which serves to eliminate indentations in the bone which foster the colonization of bacteria.
- Laser treatment (LANAP) – This can be used to reduce the size of the pockets between the teeth and the gums.
Home Care: How You Become Part of the Team
Keep in mind that the bacteria that causes periodontal disease form daily within your mouth and have the potential to cause damage. Your involvement as a part of the team is critical because your daily oral hygiene will determine how much bacteria is within your mouth daily. It is very important to follow the home oral care routine tailored to your specific needs that will remove the greatest number of bacteria in the most efficient and safe way for you. Recommendations may include new tools like power toothbrushes, floss, special tools that clean in-between teeth, and special toothpastes that can all help to reduce the harmful bacteria every day. Working together, we can help you achieve better oral health, which is vital to overall well-being.Ask your periodontist or visit our website if you have questions or concerns about periodontal disease, periodontal treatment, or dental implants.
