Gum disease begins with bacterial growth in the mouth and, if left untreated, can escalate to tooth loss. In the early stages of gum disease (gingivitis), patients experience red and swollen gums and occasional bleeding. In advanced stages of gum disease (periodontitis), the gums pull away from the tooth, there may be bone loss, and teeth may loosen or fall out.
If gingivitis is left untreated, it can lead to periodontitis, where irreversible bone or other tissue damage may occur. When this happens, the inner layer of the gum and bone pulls away from the teeth and forms pockets that collect debris that can later become infected. As plaque spreads and grows below the gum line, the pockets deepen, and more gum tissue and bone are destroyed. As a result, teeth are no longer anchored in place, and they become loose and may eventually fall out.
Prevalence of Gum Disease in the US
According to the Centers for Disease Control and Prevention (CDC), 47.2 percent of adults aged 30 years and older have some form of periodontal disease.
The CDC further reports that periodontitis is more common in:
- Men versus women (56.4% vs 38.4%)
- People living below the federal poverty level (65.4%)
- People with less than a high school education (66.9%)
- Smokers (64.2%)
Causes of Gum Disease
The primary cause of gum disease is plaque build-up due to poor oral hygiene (irregular brushing and flossing).
After eating, if you don’t rinse your mouth or follow a brushing and flossing routine, you will develop gum disease. When residual carbohydrates, sugars, and starches from food are left on the teeth, they cause plaque build-up on your teeth. The bacteria in your mouth feed off these foods and produce acids that break down and destroy tooth enamel. Over time, this can lead to severe tooth decay.
Plaque can also develop under the gums, in the roots of your teeth, and build-up can cause a breakdown of the bone supporting the tooth and lead to tooth loss.
Risks Factors for Gum Disease
Risk factors for gum disease include:
- Alcohol consumption in excess
- Poor oral hygiene
- High sugar intake
- Illnesses and diseases such as cancer or HIV that interfere with the immune system
- Women's hormone changes make gums more sensitive, making it easier to develop gingivitis.
- Drugs and medications that cause dry mouth
- Old age (the CDC states that 70.1 percent of adults 65 years and older have periodontal disease)
- Family history of gum disease
Two-Way Relationship Between Diabetes and Periodontitis
Epidemiological data shows that diabetes and periodontitis are closely connected. The presence of diabetes increases the risk for periodontitis, and periodontal inflammation negatively affects glycemic control in diabetic patients. It is, therefore, essential that diabetic patients take extra care of their oral health. The good news is that proper treatment for gum disease can help patients control their diabetes.
Symptoms of Gum Disease
Symptoms of gum disease may not always be obvious and may be an indicator of another ailment. However, if you have the following symptoms, you should consult with your dentist:
- Bleeding gums during and after brushing
- Red, swollen, or tender gums
- Receding gums
- Persistent bad breath or a bad taste in the mouth
- Painful chewing
- Loose or shifting teeth
- Sensitive teeth
- Gums that have pulled away from your teeth
- Formation of deep pockets between teeth and gums
- Any change in the way your teeth fit together when you bite
- Any change in the fit of partial dentures
Diagnosing Gum Disease
During your consultation, Dr. Weishoff will examine
- Your gums for bleeding, swelling, firmness, and pocket depth (the space between the gum and the tooth–the more extensive and deeper the pocket, the more severe the disease)
- Your teeth to see the movement and sensitivity of teeth
- Your jawbone to detect the breakdown of bone surrounding the teeth
If you are diagnosed with gum disease, Dr. Weishoff will develop a treatment plan for you that is based on your stage of disease, how you have responded to earlier treatments, and your overall health.
Treatment for Gum Disease
Treatment options can range from nonsurgical to control bacterial growth to surgery to restore supportive tissues.
Periodontal treatments aim to:
- Promote reattachment of healthy gums to teeth
- Reduce swelling, depth of pockets, and risk of infection
- Stop disease progression
Nonsurgical Treatment for Gum Disease
For active gum disease, Dr. Weishoff may recommend scaling and root planing, a deep cleaning procedure performed under a local anesthetic.
During the procedure, plaque and tartar (hardened plaque or calculus) are scraped away (scaling) from both above and below the gum line, and rough spots on the tooth are made smooth (planing). This process helps remove bacteria from the surface of the teeth and helps your gums reattach to the clean surface.
Surgical Treatment for Gum Disease
Surgical options for gum disease are for patients who need more than scaling and root planing to treat their stage of disease. Some of these surgical options can be combined.
Flap surgery (pocket reduction) involves lifting back the gums to remove tartar build-up. In more severe cases, bone is smoothed to limit the areas where bacteria can grow.
Bone grafts aid in the regrowth of bone to restore the stability of teeth. Fragments of your bone, synthetic bone, or donated bone can be used to replace any bone destroyed by gum disease.
Soft tissue grafts are done to reinforce thin gums or fill in places where gums have receded. The tissue is grafted from the roof of the mouth and stitched in place to the affected area.
Guided tissue regeneration is performed to stimulate bone and gum tissue growth. A small piece of mesh-like fabric is inserted between the bone and gum tissue to keep the gum tissue from growing into the area where the bone should be. This procedure is often done in combination with flap surgery, and both are done to allow the bone and connective tissue to regrow to better support the teeth.
Bone surgery is performed to smooth shallow craters in the bone. The bone around the tooth is reshaped to decrease the craters, thus making it harder for bacteria to collect and grow. This procedure is often done following flap surgery.
Gum Disease Prevention
Gum disease is completely preventable. The condition can be controlled and even reversed with daily brushing and flossing and regular professional cleanings twice a year.
For severe cases of periodontal disease, your doctor may advise you to have dental cleanings more than twice a year to remove the plaque and tartar build-up on the teeth. Dental cleanings are a preventive measure to prevent disease progression and are not a treatment for active gum disease.
Gum Disease Treatment in Mt. Angel, Oregon
We understand that some patients haven’t seen a dentist in a while and may be wary about scheduling an appointment. We want to reassure you that at Mt. Angel Dental, we do not judge or admonish. We are here to help restore your oral health by offering you the best dental care services in Oregon.
If you think you have symptoms associated with gum disease, please call Mt. Angel Dental at (503) 845-2273 to schedule an appointment or you may request an appointment online.