Gum Disease

Gum disease: Number one reason for adult tooth loss

Gum Disease is also known as periodontal disease. Periodontal disease is a chronic bacterial infection caused by dental plaque (a soft, sticky, colorless bacterial film) that affects the gum tissue and the bone that supports and hold teeth in the jawbone.

There are three stages of periodontal disease

Gingivitis (reversible)
Periodontitis
Advanced periodontitis

Three stages of gum disease illustration

Prevalence of periodontal disease

The prevalence of periodontal disease is staggering. According to recent findings from the Centers for Disease Control and Prevention (CDC)

50% of Americans aged 30 or older have periodontal disease
Over 70% of Americans aged 65 and older have periodontitis
Periodontal disease is the number one reason for tooth loss in adults

Signs & symptoms of periodontal disease

Bleeding gums during brushing
Red, swollen, or tender gums
Receding gum line
Persistent bad breath and/or taste in mouth

Gum disease impacts your health, not just your teeth

Gum disease impacts the entire body, not just the mouth

Perio-systemic connection

Periodontal disease & diabetes

The Surgeon General’s Report on Oral Health highlights the connection between diabetes and periodontal disease. The report discusses how the presence of periodontal disease affects glycemic control and refers to periodontitis as the “sixth complication of diabetes”.

Periodontal disease and Heart disease

“Bacteria originating in tissues such as the oral mucosa (mouth) may directly infect blood vessel walls” (source: Surgeon General’s Report on Oral Health). While researchers agree that an association does exist between periodontal disease and cardiovascular disease (CVD), it remains unclear whether this relationship is causal or coincidental (source: Dentistry IQ).

Additional reading about this topic: American Heart Association and American Dental Association

Periodontal disease and Rheumatoid Arthritis

Several clinical studies have shown that there is a high prevalence of periodontal disease among people who have Rheumatoid arthritis. Research suggests that “tooth loss (a marker for periodontal disease) may predict rheumatoid arthritis (RA) and its severity. The more teeth lost, the greater the risk of RA”. (source: Arthritis Foundation).

Periodontal disease and Pregnancy

Several research studies have suggested that women with periodontal disease may be more likely to deliver babies prematurely or with low-birth weight than mothers with healthy gums (source: American Academy of Periodontology)

Periodontal (Gum) disease risk factors

Genetics

Research has indicated that genetics may increase the incidence of periodontal disease.

Age

According to the CDC, over 50% of Americans over age 30 and over 70% over age 65 have periodontitis.

Stress

Periodontal disease is a chronic inflammatory disease. Inflammation plus stress decreases your body’s ability to fight and reduce inflammation and may increase your risk for periodontal disease.

Poor nutrition

Inadequate and/or poor nutrition often results in nutrient deficiencies which gravely impacts our body’s ability to prevent disease and fight inflammation including gum disease.

Smoking

Smoking reduces the delivery of necessary oxygen and nutrients to the gum tissue and the containing carcinogens increase the inflammatory response and interfere with healing. As a result, smokers are less likely to respond favorably to periodontal disease treatment. According to the CDC, smokers who smoke less than a ½ pack of cigarettes per day are almost three times (3X) more likely than non-smokers to have periodontitis (source: ADHA.org).

Smokeless or chewing tobacco

Several studies show that smokeless tobacco use is destructive for the gum tissue that supports the teeth inside the jawbone. Extreme gum recession is common which may lead to loose and/or loss of teeth. Similar to smoking, smokeless tobacco contains carcinogens that promote inflammation and interferes with healing. As a result, people who use smokeless tobacco are less likely to respond favorably to periodontal disease treatment (source: National Institute of Health)

Gum disease examination

Early detection and screening for periodontal disease is the best way to prevent the onset of periodontal disease. Your dentist or dental hygienist will use an instrument called a dental probe, to measure the depth of the gum tissue pocket that surrounds each tooth. Measurements are recorded in millimeters (mm). Healthy pocket depths are 3mm or less. Pockets that measure 4mm or above are not healthy and will be classified accordingly.

After recording pocket depths, the dental hygienist will check and record:

Amount of dental plaque and calculus (hard tartar)
Color and firmness of your gum tissue
If tongue is coated or not
Any areas with visible bleeding
Areas of gum recession
Teeth that are loose
Teeth that have furcation involvement (central space between multi rooted teeth)
And review your digital x rays

Afterwards, the dentist and dental hygienist will discuss your findings with you to determine what type of teeth cleaning, preventive or therapeutic, that you need to preserve your teeth for a lifetime.

Preventive teeth cleanings are for people who are healthy and have no bone loss.
Therapeutic teeth cleanings are for people who have periodontal disease.

Gum disease diagnosis

There are three stages of periodontal disease: gingivitis, periodontitis, and advanced periodontitis.

Healthy

Gum tissue is light pink color
No bleeding while performing home care or when measured at your dental cleaning visit
No receding gums
No bone loss evident on dental x rays
Periodontal disease measurements are 3mm or under

Stage I: Gingivitis

Gingivitis, is the only stage where diligence regarding home care in conjunction with a professional dental cleaning can be reversed to healthy.

Gum tissue is red and inflamed
Gums bleed while performing home care or when measured at your dental cleaning visit
Sensitive or sore gums
Possible bad breath or taste in mouth
No bone loss evident on dental x rays
Periodontal disease measurements are 3-4mm due to gum inflammation
Gingivitis may be localized or generalized
Reversible with improved home care. Exception: receding gums are not reversible

Stage II: Periodontitis

Early Periodontitis

Gum tissue is red and inflamed
Gums bleed while performing home care or when measured at your dental cleaning visit
Presence of receding gums
Sensitive or sore gums
Bad breath or taste in mouth
Bone loss evident on dental x-rays
Periodontal disease measurements are 3-4mm. May be localized or generalized.
Not reversible, but can be stabilized with improved home care and more frequent dental cleaning visits, every 3-4 months instead of every 6 months.

Moderate Periodontitis

Gum tissue is red and inflamed
Gums bleed while performing home care or when measured at your dental cleaning visit
Presence of receding gums and potentially exposed root furcations
Sensitive or sore gums
Bad breath or taste in mouth
Bone loss evident on dental x rays
Periodontal disease measurements are 4-6mm. May be localized or generalized.
Possible presence of gum abscess
Possible tooth mobility of 1 or more teeth
Possible undesirable movement or drifting of teeth
Not reversible. Requires periodontal therapy followed by frequent dental cleaning visits every 3-4 months to prevent additional bone loss.
May include referral to periodontist (dentist who specializes in treatment of periodontal disease) for evaluation and/or surgical intervention.

Stage III: Advanced periodontitis

Gum tissue is red and inflamed
Gums bleed while performing home care or when measured at your dental cleaning visit
Presence of receding gums and exposed root furcations
Sensitive or sore gums
Bad breath or taste in mouth
Bone loss evident on dental x rays
Periodontal disease measurements exceed 6mm. May be localized or generalized.
Possible presence of gum abscess (fluid filled bump on gum)
Possible loss of teeth
Undesirable movement or drifting of teeth and change in bite
Referral to periodontist (dentist who specializes in treatment of periodontal disease) for evaluation and/or surgical intervention
Requires surgical periodontal therapy by periodontist followed by frequent dental cleaning visits every 3 months to prevent additional loss of teeth.

Gum disease treatment

There is no known cure for periodontitis.

Effective daily oral home care practices (brushing and flossing) in addition to having your teeth examined and professionally cleaned at least every six months is the best way to prevent the onset of periodontal disease. Left untreated, periodontal disease will lead to eventual tooth loss.

Periodontal treatment options

Periodontal therapy (non surgical)
Periodontal surgery (surgical)
Periodontal maintenance (post therapy/surgery)

Periodontal therapy (also known as root planing & scaling)

Periodontal therapy is a specialized teeth cleaning performed to resolve gum tissue inflammation and preserve the bone that supports the teeth. Dental plaque and calculus are removed from tooth surfaces above and below the gum line using ultrasonic and hand instruments.

Periodontal maintenance appointments (every 3-4 months) are necessary to preserve bone support long term after completing periodontal therapy.

Periodontal surgery

For those with moderate to advanced stages of periodontal disease, periodontal surgery may be necessary by a periodontist (a specialist dentist who specializes in the treatment of periodontal disease).

Periodontal maintenance appointments are necessary to preserve bone support after completing periodontal surgery. Oftentimes, patients will alternate their every three months maintenance appointments with their dental hygienist and their periodontist.

Gum disease treatment costs

Comprehensive periodontal exam is often a covered service under most dental insurance plans.
Periodontal therapy and surgery are therapeutic, not preventive procedures. Comprehensive dental insurance plans typically provide coverage for these services. Coverage varies depending upon individual dental insurance plan.
Periodontal maintenance is often a covered service under most dental insurance plans; however, many dental insurance companies cap how many maintenance visits they will provide coverage for in a coverage year.

Call (763) 586-9988 to schedule an examination appointment today or click the button below to request an appointment. We look forward to helping you preserve your smile for a lifetime.