Periodontal Disease
Clackamas, OR

Taking care of your mouth is essential for the prevention of serious oral health conditions, including periodontal, or gum, disease. Periodontal disease is a bacterial infection that causes chronic inflammation in the gums and surrounding tissues, including the periodontal ligaments and your jawbone. It is the leading cause of tooth loss in adults, and approximately 80% of individuals have been affected by the condition at least once in their life. Without treatment, periodontal disease only continues to get worse. At Sunnyside Dentistry, we can diagnose periodontal disease and then provide you with the treatment you need to restore your oral health and the appearance of your smile.

How Does Periodontal Disease Develop?

Periodontal disease develops as a result of a bacterial infection. It begins when plaque, a sticky substance that forms on the surfaces of your teeth, and bacteria begin to accumulate. They cause sensitive gum tissue to become irritated and then inflamed. The swollen gum tissue begins to pull away from the surfaces of your teeth, which leads to the formation of periodontal pockets. Bacteria fall into these pockets and plaque begins to form on the now exposed surfaces. Inside the pockets, bacteria continue attacking the gum tissue, and the pockets continue to grow deeper, and your gum line begins to recede. Eventually, the bacteria begin to attack the periodontal ligaments, the structures that help hold your teeth securely in place, and your jawbone. Both of these structures gradually weaken. The teeth start to become loose and wobbly, which can lead to significant complications. Gum disease can even lead to tooth loss or the need for tooth extractions.

What Causes Periodontal Disease?

There are numerous risk factors that can lead to the development of periodontal disease. Risk factors for periodontal disease include :

•	Poor oral hygiene practices. Brushing and flossing, along with regular dental cleanings and exams, are essential habits for preventing the buildup of plaque and bacteria on your teeth, thereby preventing the formation of periodontal disease. Skipping any of these practices, even if you only do so occasionally, can lead to a buildup on your teeth that can significantly increase your risk for periodontal disease.
•	Misaligned teeth. When your teeth are aligned poorly your teeth become more difficult to brush and floss. There may be areas of overlapping or gaps between your teeth that can easily trap plaque and bacteria. If these spaces are not cleaned properly, your risk for developing periodontal disease increases.
•	The use of tobacco products. Cigarettes, as well as other types of tobacco products, all contain numerous harmful chemicals that can significantly impact your health. In addition to increasing your risk for developing certain health issues, tobacco products can also significantly increase your risk of developing periodontal disease. Tobacco products limit the amount of oxygen in your blood, and they slow your blood flow. This slows the delivery of essential nutrients to your gums. Tobacco products also interfere with your immune response, preventing your body from being able to effectively fight off infections.
•	Excessive alcohol consumption. While the occasional drink may not impact your oral health very much, excessive alcohol consumption can. Alcohol causes a condition known as dry mouth. This is a condition in which there is not enough saliva in your mouth. Without enough saliva, your mouth cannot effectively wash away food particles and oral bacteria. Your mouth becomes an ideal breeding ground for bacteria, greatly increasing your risk for periodontal disease. Additionally, those who consume large amounts of alcohol tend to ignore their oral hygiene, which is also a major contributing factor for periodontal disease.
•	Certain types of drugs. Certain types of drugs, both prescription as well as illegal, can lead to dry mouth.
•	Nutritional deficiencies. Your body requires a variety of different nutrients that allow it to function properly, fight off infections, and remain healthy. Certain types of nutrients, particularly vitamins C and B12, are essential for the health of your gum tissue, enabling the soft tissue to effectively fight off bacterial infections. Maintaining a healthy, well-balanced diet, is crucial for ensuring that your gum tissue, and the rest of your body, get the nutrients it needs to prevent complications.
•	Hormonal changes. Fluctuations in hormones can leave your body more vulnerable to the development of infections because it cannot effectively fight off bacteria. Common hormonal changes that increase your risk for periodontal disease include pregnancy and menopause.
•	Stress. When your body is under a great deal of stress, its ability to effectively fight off infections becomes compromised. This can lead to an increased incidence of periodontal disease.
•	Genetics. Some individuals are genetically predisposed to the development of periodontal disease.

Symptoms of Periodontal Disease

There are multiple signs and symptoms that can point toward the presence of periodontal disease. The exact symptoms that you experience depend upon how advanced your periodontal disease is.

•	Red, swollen gum tissue. Red, swollen gums, often occurring with bleeding when you brush and floss your teeth, are the earliest warning signs of periodontal disease. However, these symptoms are often missed or overlooked. Many mistakenly believe that these symptoms are the effect of aggressive brushing or flossing too hard. As a result, the symptoms go untreated, leaving periodontal disease to continue to worsen.
•	Gum recession. When periodontal pockets form, bacteria begins to collect in these pockets and plaque begins to accumulate on the now exposed surfaces. The bacteria continue to attack the gums from the inside and swelling continues. The pockets grow deeper and deeper. The infected gum tissue begins to die off, which leads to a receding gum line. When this happens, your teeth begin to appear longer. You may start to notice small gaps between your teeth that were not there before. You may even start to experience tooth sensitivity as the roots of your teeth become exposed.
•	Bad breath. While most normal bad breath can be eliminated with brushing and flossing, chewing gum or mints, bad breath associated with periodontal disease cannot. Bacteria and food particles below your gum line cannot easily be removed, leaving you with chronic bad breath that does not go away no matter what you try to do about it.
•	Your teeth become loose and unstable. Bacteria under the gum line begin to attack the periodontal ligaments and the jawbone. These structures provide support for your teeth, holding them securely in place. However, when bacteria attack them, they become weak. This causes your teeth to become loose and wobbly. Your bite may be altered, which can lead to issues such as difficulty chewing, uneven tooth wear, an increased risk for tooth damage, and bruxism.
•	Tooth loss. If the structures that provide support for your teeth become too weak, they can no longer hold your teeth in place. This can ultimately lead to tooth loss. If the teeth do not fall out on their own, they may need to be extracted.

Types of Periodontal Disease

There are several different types of periodontal disease. These include:

•	Gingivitis. Gingivitis is the earliest, and most common, stage of periodontal disease. It occurs when the plaque and bacterial buildup in your mouth irritate your gums. This irritation triggers an inflammatory response from the immune system, and the gums begin to swell. Gingivitis is characterized by red, swollen gums that often bleed when you brush and floss. However, because gingivitis is mild, these symptoms are often overlooked and therefore go untreated.
•	Chronic periodontal disease. Chronic gum disease is another common form of periodontal disease. This particular type of periodontal disease is characterized by swelling below the gum line and the growing destruction of your periodontal ligaments and your jawbone. The most common symptom associated with this type of gum disease is gum recession.
•	Aggressive periodontal disease. Aggressive periodontal disease is fairly similar to chronic periodontal disease. The biggest difference is that your gums and your other tissues deteriorate at a much faster rate. The rate of destruction, however, is not consistent with the amount of buildup present on your teeth.
•	Periodontal disease relating to systemic conditions. With certain types of medical conditions, such as diabetes, periodontal disease is a side effect. The symptoms of this type of periodontal disease are similar to aggressive periodontal disease, where the amount of destruction is inconsistent with the amount of buildup present on your teeth.
•	Necrotizing periodontal disease. Necrotizing periodontal disease is a rare condition that often occurs among those who smoke, those who suffer malnutrition, and those who suffer immunosuppression. The necrosis, or death, of the gum tissues, occurs at a rapid rate.

Periodontal Disease and Your Health

Periodontal disease does much more than affect your oral health. It can also significantly affect other aspects of your overall health as well.

•	Respiratory health. When you have periodontal disease, there is a large number of bacteria in your mouth. If you breathe in through your mouth, you may inhale some of these bacteria, drawing them into your lungs. The lungs are a warm, moist environment, perfect for fostering bacterial growth. This can lead to issues such as pneumonia and worsen issues such as asthma and COPD.
•	Periodontal disease and your whole-body health. Bacteria below your gums can enter into your bloodstream. When bacteria are in your bloodstream, they can travel throughout your body, where they can contribute to serious health issues. Bacteria in your bloodstream triggers an inflammatory response, which causes the blood vessels to swell, constricting blood flow, which can lead to atherosclerosis and other heart-related issues. Bacteria in the bloodstream can also interfere with the ability of your body to manage blood sugar levels, which can contribute to diabetes.
•	Mental health complications. When you have periodontal disease, you may become self-conscious about your smile. You may be embarrassed to smile or interact with others, which can significantly impact your work life, your social life, and your romantic life. This can increase your risk for depression.
•	Pregnancy complications. Pregnancy can increase your risk of developing periodontal disease. Moreover, if you have periodontal disease while you are pregnant, you are at risk for experiencing issues such as pre-term birth, or birth before 37 weeks, as well as low birth weight. Low birth weight can lead to issues such as jaundice, respiratory issues, low oxygen levels, trouble maintaining body temperature, and neurological complications in an infant.

How is Gum Disease Treated?

There are some different treatments available for periodontal disease. The type of treatment you receive depends upon the severity of your condition. When you come into the office for treatment, we first perform a thorough oral exam that allows us to assess the extent of the damage. From there, we can determine the best treatment to meet your needs. Treatments for periodontal disease include:

•	Prophylaxis. Prophylaxis is the cleaning you get at your routine dental appointments. This type of cleaning is often performed to treat gingivitis.
•	Scaling and root planing. Scaling and root planing is a deep cleaning of your teeth. This type of cleaning is performed to remove all buildup from all surfaces of your teeth, both above and below the gum line. Scaling is the cleaning of the visible surfaces of your teeth, with special attention given to, and just under, the gum line. Root planing is performed to smooth the surfaces of your roots, allowing your gum tissue to begin reattaching.
•	Periodontal maintenance. Periodontal maintenance involves a series of regularly scheduled cleanings and exams to help your gums and other tissues to heal. We examine your mouth to check your progress and then clean your teeth of any buildup that has accumulated since your last appointment. Depending upon your needs, these appointments are scheduled as frequently as every two months or as little as every six months.
•	Pocket Reduction surgery. Pocket reduction surgery is performed when your periodontal pockets are too deep to effectively clean with scaling and root planing. The procedure involves opening the gum tissues to thoroughly clean your teeth, which then allows the tissue to begin reattaching to the teeth. Reducing the pocket depth makes the teeth easier to clean and maintain.
•	Soft tissue grafting. Soft tissue grafting, or gum grafting, is often recommended following gum recession. The procedure involves taking tissue from another area of your mouth, frequently the roof, and transplanting the tissue to the affected teeth. This procedure restores a healthy, natural gum line, eliminating sensitivity, improving your oral health, and improving the quality of your smile.
•	Bone grafting. Bone grafting is a surgical procedure that involves transplanting bone tissue from one area of your body, or from a donor, to another to restore strength. In this case, the procedure is performed to restore bone mass to your jaw. This procedure is often performed before the placement of dental implants if too much bone mass has been lost to support the titanium posts and your replacement teeth.

How Do I Prevent Gum Disease?

While the right treatment can help to stop the progression of periodontal disease and restore your oral health, these treatments are not a permanent solution. It is important to practice good oral hygiene to protect the health of your mouth and prevent periodontal disease from developing again. To prevent periodontal disease, it is essential that you brush your teeth at least twice a day and floss daily. Routine dental cleanings and exams are also imperative. In addition to good oral hygiene, it is important to quit smoking or using other types of tobacco products, quit drinking, and maintain a healthy diet. We can help to provide you with tips to maintain the health of your mouth and keep your smile beautiful.

If you suspect that you are suffering from periodontal disease, it is important to seek treatment right away. The earlier gum disease is diagnosed and treated; the easier and less invasive treatment needs to be. For more information, and to schedule your consultation, call Sunnyside Dentistry at (503) 451-5104 today.

Periodontal DiseaseClackamas, OR