Gum and Bone
Online Dental Education Library
Our team of dental specialists and staff strive to improve the overall health of our patients by focusing on preventing, diagnosing and treating conditions associated with your teeth and gums. Please use our dental library to learn more about dental problems and treatments available. If you have questions or need to schedule an appointment, contact us.
Periodontics is that specialty of dentistry that encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth. This includes crowns, implants, or other substitutes and the maintenance of the health, function and aesthetics of all of the structures and tissues.
Professional dental cleanings are necessary at least twice each year to maintain good oral health. Many people require a routine cleaning three or four times a year due to buildup of plaque and tartar.
If you have been told you have periodontal (gum) disease, you're not alone. An estimated 80 percent of American adults currently have some form of the disease.
Periodontal diseases range from simple gum inflammation to serious diseases that result in major damage to the soft tissue and bone that support the teeth. In the worst cases, teeth are lost.
Gum disease is a threat to your oral health. Research also points to possible health effects of periodontal diseases that go well beyond your mouth (more about this later).
Whether it is stopped, slowed, or gets worse depends on how well you care for your teeth and gums every day.
- We are on the same team!
- Why do I need a prophylaxis (professional cleaning)?
- What is plaque?
- What is calculus (tartar)?
- What does a professional cleaning do that I can't do for myself?
- What causes periodontal disease?
- How can I tell if I have gum disease?
- What can I do to prevent gum disease?
- Who gets periodontal disease?
- How is periodontal disease treated?
- What are the risk factors?
Dental health begins with good oral hygiene. This requires professional care and guidance provided by us, combined with proper care at home by you. When you follow our recommended home care routine and have regular professional care, you will be able to maintain healthier teeth and gums. When you do your part at home every day, it makes the visits to our office much more enjoyable. Please see How to Brush and How to Floss for more information.
Professional cleaning removes plaque, calculus (tartar), and stains from your teeth. Cleaning is done by a dental professional in the dental office and we provide education in proper care of the teeth and gums.
Plaque is a soft, sticky, colorless film of bacteria that is constantly forming on your teeth. It combines with sugar and other carbohydrates to form acids, which attack tooth enamel and can cause cavities.
Plaque can also cause inflammation of the gums (gingivitis), which can result in swollen and bleeding gums. If not treated early, gingivitis can lead to periodontitis, a more serious condition that causes gums to recede and bone to deteriorate. As a result, the supporting structures are weakened and teeth become loose. It's easy to see why brushing and flossing to remove plaque is essential to keep your teeth and gums healthy.
Minerals in saliva combine with plaque at the tooth surface and harden into a rough, unsightly deposit called calculus (tartar). Calculus, which is mostly mineral, provides a rough surface to which more plaque can attach, and makes thorough plaque removal more difficult. Your toothbrush and floss can't remove calculus once it has formed. It can only be removed during regular dental prophylaxis.
A prophylaxis is a professional cleaning procedure that can be done only by a dentist or hygienist. The prophylaxis not only helps prevent gum disease, but also improves the appearance of your teeth by making them look clean and bright. A prophylaxis is usually performed in two steps. Instruments called scalers are used to remove calculus from teeth above and below the gumline. Then, polishing with a special paste by means of a motorized instrument removes the remaining plaque and surface stains caused by various foods, beverages, tobacco, etc. A polished tooth surface makes it more difficult for plaque and debris to accumulate.
You can help improve your oral hygiene by making plaque control part of your daily routine. Proper brushing helps remove plaque from the outer, inner and chewing surfaces of your teeth. Flossing thoroughly helps remove plaque and debris from between the teeth, especially in hard-to-reach areas at and slightly below the gumline.
Our mouths are full of bacteria. These bacteria, along with mucus and other particles, constantly form a sticky, colorless "plaque" on teeth. Brushing and flossing help get rid of plaque. Plaque that is not removed can harden and form bacteria-harboring "tartar" that brushing doesn't clean. Only a professional cleaning by a dentist or dental hygienist can remove tartar.
The longer plaque and tartar are on teeth, the more harmful they become. The bacteria cause inflammation of the gums that is called "gingivitis." In gingivitis, the gums become red, swollen, and can bleed easily. Gingivitis is a mild form of gum disease that can usually be reversed with daily brushing, flossing, and regular cleaning by a dentist or dental hygienist. This form of gum disease does not include any loss of bone or tissue that hold teeth in place.
When gingivitis is not treated, it can advance to "periodontitis" (which means "inflammation around the tooth.") In periodontitis, gums pull away from the teeth and form "pockets" that are infected. The body's immune system fights the bacteria as the plaque spreads and grows below the gum line. Bacterial toxins and the body's enzymes that are fighting the infection actually start to break down the bone and connective tissue that hold teeth in place. If not treated, the bones, gums, and connective tissue that support the teeth are destroyed. The teeth may eventually become loose and have to be removed.
Symptoms are often not noticed until the disease is advanced. They include:
- Bad breath that won't go away
- Red or swollen gums
- Tender or bleeding gums
- Painful chewing
- Loose teeth
- Sensitive teeth
Any of these symptoms may signal a serious problem, which should be checked by a dentist. At your dental visit:
- We will ask about your medical history to identify underlying conditions or risk factors (such as smoking) that may contribute to periodontal disease.
- We will examine your gums and note any signs of inflammation.
- We will use a tiny ruler called a 'probe' to check for periodontal pockets and to measure any pockets. In a healthy mouth, the depth of these pockets is usually between 1 and 3 millimeters.
- We may take an x-ray to see whether there is any bone loss.
- We may refer you to a periodontist, a specialist who treats gum diseases.
Here are some things you can do to prevent periodontal diseases:
- Brush your teeth twice a day (with a fluoride toothpaste)
- Floss every day
- Visit the dentist routinely for a check-up and professional cleaning
- Eat a well balanced diet
- Don't use tobacco products
People usually don't show signs of gum disease until they are in their 30s or 40s. Men are more likely to have periodontal disease than women. Although teenagers rarely develop periodontitis, they can develop gingivitis, the milder form of gum disease. Most commonly, gum disease develops when plaque is allowed to build up along and under the gum line.
The main goal of treatment is to control the infection. The number and types of treatment will vary, depending on the extent of the gum disease. Any type of treatment requires that the patient keep up good daily care at home. Additionally, modifying certain behaviors, such as quitting tobacco use, might also be suggested as a way to improve treatment outcome.
- Smoking. Need another reason to quit smoking? Smoking is one of the most significant risk factors associated with the development of periodontitis. Additionally, smoking can lower the chances of success of some treatments.
- Hormonal changes in girls/women. These changes can make gums more sensitive and make it easier for gingivitis to develop.
- Diabetes. People with diabetes are at higher risk for developing infections, including periodontal disease.
- Stress. Research shows that stress can make it more difficult for our bodies to fight infection, including periodontal disease.
- Medications. Some drugs, such as antidepressants and some heart medicines, can affect oral health because they lessen the flow of saliva. (Saliva has a protective effect on teeth and gums.)
- Illnesses. Diseases like cancer or AIDS and their treatments can also affect the health of gums.
- Genetic susceptibility. Some people are more prone to severe periodontal disease than others.