Tooth decay and periodontal disease are two of the main conditions that affect our dental health. Most people have a good knowledge of tooth decay. We know that to prevent decay, it is important to brush our teeth and watch the sweets in our diet. We know that a tooth that has a cavity needs to have it cleaned out and a filling placed. We are aware of the role that fluoride plays in preventing tooth decay. And we know that an untreated cavity can lead to a toothache.
Many people are surprised to learn that more teeth are lost to periodontal disease than to tooth decay. While public awareness of the periodontal disease, gingivitis, is increasing, general knowledge of the most serious periodontal disease, periodontitis, is limited. For all the advertisements about the importance of preventing gingivitis, it is significant that the chief cause of tooth loss in adults is periodontitis, and not gingivitis.
Like many other diseases, tooth decay and periodontal disease are caused by certain bacteria. Just as some bacteria in the lungs cause pneumonia and other bacteria cause tuberculosis, so some bacteria in the mouth cause tooth decay and others cause periodontal disease. Both of these oral diseases are bacterial in origin – and when we brush and floss our teeth, we do it to remove the bacteria that cause the problems and to preserve our oral health. In a way, it’s like washing our hands.
The bacteria that cause periodontal disease like to live in places where there is little oxygen to be found, such as in the crevices around and between our teeth. These bacteria cause inflammation of the tissues that support the teeth — the gums, the bone support of the teeth, and the ligament that holds the teeth in their sockets. Gingivitis refers to inflammation of just the gum tissues. Periodontitis is when the inflammation causes destruction of the bone support and ligaments.
The symptoms of gum diseases may be hard for people to detect. In the earlier stages, some people may experience redness, slight swelling or bleeding of the gum margins. This is a sign that something is not right in our mouths and indicates that gingivitis is present. Gingivitis is easily treated. Proper oral hygiene and a routine cleaning of the teeth take care of it.
When the inflammation moves deeper, people may lose the signs of gingivitis and not be aware that the infection is causing a slow loss of the support of their teeth. Smoking can make a person more susceptible to periodontitis. Some medical conditions, such as diabetes, also increase risk. In addition, there is recent evidence to suggest that people who have periodontitis are also more likely to have heart disease, stroke, or premature delivery. It is important that periodontitis is detected by your dentist at its earliest, most treatable stage.
Establishing good home care is important in treating periodontitis. A more involved cleaning of the teeth may also be needed, occasionally with the help of a local anesthetic. In some cases, minor office surgery may be necessary, to tip the tissue away from the teeth to improve access for cleaning and gain reattachment. In some cases, dentists or periodontists, specialists in treating periodontitis, can even regenerate bone support for the teeth.
Your dentist can detect periodontitis by measuring the depth of the space between the tooth and gum with a gauge, and use X-rays to detect bone loss. Periodontal disease is easy to prevent, and it’s best treated in its earliest stages. So, it’s important to see your dentist on a regular basis for cleaning and a check up, even if you’ve never had a cavity!