Periodontal Problems

Taking good care of your teeth involves more than brushing, flossing and mouthwash. Your gums also need your attention. Periodontal (gum) disease can cause even more problems than dental decay and cavities. According to the California Dental Association's Guide to Periodontal Disease, more than half of the people in the U.S. over the age of 18 have at least early-stage periodontal disease. Of people over age 35, three out of every four people are affected.

Risks

• Periodontal disease is caused by your body's response to a bacterial infection. Periodontal disease, if left untreated, can result not only in the loss of your teeth but can also lead to a variety of health problems including diabetes, cardiovascular disease, stroke, lung infections, and respiratory disease.

Causes

• Certain factors, in addition to lack of proper care, can put you at risk for developing gum disease. These include your family history, medications you are taking, your age, obesity, smoking, osteoporosis, stress, diabetes, hormones, and clenching or grinding your teeth.

Beginnings

• Gingivitis is the first stage of gum disease. It is a bacterial infection of the gums. It starts from a buildup of plaque on your teeth. Regular brushing cleans the surfaces of the teeth, but ordinary toothbrushes can't reach the parts of the teeth where gum disease originates. If it is left untreated, gingivitis will spread from the gums to the bone, leading to moderate or severe periodontal disease and causing permanent damage.

Detection

• Gum disease generally gives no warning signs in its earliest stages. If left untreated, your gums may swell and bleed. Your teeth may even shift in position and become loose.

  During your regular dental checkup, your dentist will examine your mouth for other problems in addition to cavities. Screenings for periodontal disease and oral cancer should be a part of every visit to the dentist. Your dentist view X-rays of your mouth and examine your gums for such telltale signs as bleeding. He will measure the pockets (spaces between the teeth and gums) in millimeters. Pockets deeper than 4 millimeters indicate periodontal disease and require treatment.

  Your dentist should perform a gum-disease screening exam at least once every year.

Treatment

• Periodontal disease requires treatment by a periodontist. The treatment includes scaling--using an instrument to clean and treat the surfaces below the gum line and between the teeth, or root planing, which smooths the roots to prevent bacteria from growing. The periodontist may then apply medication to remove the bacteria that causes the infection.

  The most serious cases of periodontal disease may require that teeth that cannot be saved must be pulled. Surgery may also be necessary to reshape your gums to fit your teeth or to restore lost bone. If the gum disease is caught before it has become too advanced, regular professional scaling and home care may prevent tooth loss and the need for surgery.

  Your dental care professional may recommend various home care treatment options and brushing two times daily with a specific powered toothbrush to remove plaque. You may need three or four professional visits a year, preferably every three months, to maintain your healthy gums.