Gum or periodontal disease is a condition in which “biofilms” or dental bacterial plaque sticks to teeth around the gum line in the absence of good oral hygiene. If left untreated, it causes inflammation of the gums and surrounding tissues of the teeth that can result in “pocketing,” gum recession and bone loss that eventually leads to loose teeth, followed by no teeth! And for about 10 to 15% of those having gingivitis or stage 1 periodontal disease, it can get worse by progressing into chronic periodontal disease. However, the good news is that a conservative and simple treatment called root planing combined with good daily oral hygiene may return your gum tissues to health, and even eliminate the need for gum surgery.

Most of the time, root planing is performed with local anesthesia (numbing shots) in the areas requiring treatment. Anesthesia is an important part because you should always feel relaxed and comfortable during treatment. Because inflamed gum tissues may be quite sensitive, these numbing shots enable us to accomplish our goals and thoroughly remove the problematic material from your teeth's roots.

Root planing or deep cleaning is a routine dental procedure usually done in conjunction with scaling, the removal of the more superficial deposits on the tooth surfaces. Root planing involves physically planing (scraping) the root surfaces of the teeth to remove calculus, bacteria and toxins that are ingrained into their surfaces so that the attached gum tissues can heal. It is carried out with manual hand instruments, ultrasonic electronic instruments or a combination of both for your comfort and best results.

You can learn more about this procedure by reading, “Root Planing.” Or if you want to schedule an appointment to discuss your questions, contact us today.

Since the dawn of man, periodontal (gum) disease has impacted humans. And while dental health has dramatically improved over the generations, the facts are still clear — millions of Americans are suffering from gum disease and probably do not even know that they have a problem. This is because periodontal disease most often starts without any symptoms or ones that most people tend to discount or ignore.

Stage 1: Gingivitis. The first stage of gum disease is inflammation of the gingiva (gums) without bone loss. While nearly all people will develop gingivitis in the absence of good oral hygiene, only 10 to 15% of them will go on to develop more advanced stages of the disease.

Stage 2: Early periodontitis. With this stage, gingivitis progresses into the deeper periodontal structures — the tissues that attach the teeth to the bone resulting in early or beginning bone loss. About 10% of the population develops full-blown periodontitis with progressive bone loss.

Stage 3: Moderate periodontitis. The third stage of gum disease results in moderate bone loss (20 to 50%) of root surfaces of the teeth due to continued destruction of the surrounding tissues and bone. Periodontal disease is “cyclical” — it goes in cycles with bursts of activity, followed by a period in which the body tries to recover. This is called chronic inflammation, or frustrated healing.

Stage 4: Advanced periodontitis. With the final stage of gum disease, there is severe bone loss (50 to 85%) from the tooth's root. This stage includes looseness of teeth, moving teeth, abscess formation with red, swollen and painful gums. The end results — eating and even smiling is difficult and uncomfortable, and you could lose all your teeth.

You can learn more about gum disease in the Dear Doctor article, “Understanding Gum Disease.”

Have We Described Your Mouth?

If any of the above stages sounds like we are talking about your mouth, contact us today to schedule a consultation, discuss your questions and receive a thorough exam. If addressed promptly and with commitment to following your treatment plan, your mouth can return to good oral health.

If you see blood when you brush or floss your teeth, it generally indicates a problem with your oral health. You may think you are brushing too hard, but this is not usually why gums bleed. The usual culprit is dental plaque.

Plaque is the sticky, whitish film of bacteria that forms on your teeth every day. If you brush regularly, you probably remove most of it — but some may remain behind and accumulate where your teeth meet your gums, particularly between your teeth. As the bacteria build up, along with by-products of their metabolism (the chemical reactions that maintain their lives), they cause inflammation, called gingivitis, in the adjacent gums.

Bleeding gums are an early symptom of gingivitis. Continuing contact with plaque at the gum line can cause your gum tissue to separate from nearby teeth, creating pockets in which the inflammation becomes even worse. The process leads to periodontal disease (“peri” – meaning around, “odont” – tooth). The increasing infection can eat away the bone that anchors the teeth, leading to possible tooth loss. Periodontal disease is not an uncommon problem. About 90% of the population has bleeding gums at some time or another, and approximately 10% go on to develop periodontal disease.

When you lose bone around your teeth, the gums separate from the tooth and “pockets” form between your teeth and gums. The inflammation and infection may continue within the pockets even if your gums have stopped bleeding when you brush. That's why it is important to have regular dental exams — to check up on and stop periodontal disease before it has a chance to cause serious damage.

There may also be other reasons for bleeding gums that have to do with your general state of health. Women who have elevated levels of hormones caused by birth control pills or pregnancy may experience an increased response to plaque that makes their gums bleed more easily. Increased bleeding in your gums can also be caused by some diseases or as a side effect of some medications.

The most important way to prevent bleeding gums is to learn proper brushing and flossing techniques so that you effectively remove plaque from your teeth on a daily basis. If you are not sure you are using the right techniques, make an appointment and have us demonstrate at your next dental visit.

With all the best intentions, some plaque may remain. Plaque that is allowed to stay on your teeth hardens into a substance called tartar or calculus. This must be removed periodically with a professional cleaning by me or by our hygienist.

With not too much effort, you can ensure that your teeth are clean and plaque free, and your healthy gums no longer bleed.

Contact us today to schedule an appointment to discuss your questions about bleeding gums. You can also learn more by reading the Dear Doctor magazine article “Bleeding Gums.”

Did you know that recent research has shown diabetes is a risk factor for increased severity of periodontal (gum) disease and that periodontitis is a risk factor for worsening blood glucose (sugar) control in people with diabetes? Periodontitis can even increase the risk of diabetic complications for people diagnosed with diabetes. When you combine these facts with the following, you will clearly see how important it is to understand and manage these two diseases.

• Over 23 million people in the United States currently have diabetes and over 170 million worldwide.
• 14+ million Americans have a condition called pre-diabetes.
• Another estimated 6 million people in the US have diabetes but are unaware and thus not diagnosed.
• Periodontal disease is the second most common disease known to man, only surpassed by tooth decay.
• Diabetic individuals with periodontal disease have a greater risk for cardiovascular and kidney complications than those diabetics not having periodontal disease.

What You Can Do

One of the most important steps you can take if you have either of these conditions or suspect that you might have one or both is to make an appointment with your physician or with our office for a thorough examination. You should schedule an appointment with your physician for an exam and blood work so that your general health and well-being are monitored. Be certain to share your medical information and any family history of diabetes with our office, as it tends to occur in families.

Learn More

Learn the risks and how to take care of types 1 and 2 diabetes, as well as the stages of periodontal disease (with detailed full-color illustrations) when you read the Dear Doctor article, “Diabetes & Periodontal Disease.” Or if you want to schedule an appointment to discuss your questions, contact us today.

At some point in every person's life, they will experience bleeding gums or gingivitis, a mild inflammation of the gingiva (gums), which is the first stage of periodontal (gum) disease. For example, when was the last time you were brushing or flossing your teeth and noticed that your gums were bleeding or that when you spit and rinsed there was some blood? When this occurs, it is a sign that you have gum disease, as healthy gum tissues do not bleed. And no, it is highly unlikely that your bleeding is from brushing too hard. You would have to use extreme force to make healthy gum tissues bleed. However, this is exactly how most people discount or ignore this warning sign.

If this sounds like you or another member of your family, here's what you can expect when you see us for treatment. Depending on the severity of your periodontal disease, all of these treatment options may not be necessary.

Behavior change: We will collect a thorough medical history to obtain facts about your oral hygiene, eating and other personal habits such as alcohol and tobacco use to determine their impact on your periodontal disease. Proper brushing and flossing techniques are necessary for everyone, whether you have early or late stage gum disease; however, you must commit to a good daily oral health routine if you want to achieve success and thus keep you mouth and teeth healthy.

Calculus (tartar) removal: Cleaning is not just your responsibility. We'll clean and polish your teeth to remove calculus (tartar), the calcified deposits of bacterial products that become glued to the teeth and roots that you can’t remove. In fact, routine visits to see us for a thorough cleaning will help ensure that all the unhealthy calculus (tartar) is removed from your teeth.

Evaluation: Usually after three or four weeks, we will want to see you to evaluate your progress and to see the response of your gingival tissues to the treatment thus far. And depending on the severity of your gum disease, we may need another follow-up exam to decide the best maintenance and monitoring regimen necessary to keep your mouth healthy.

Occlusal or Bite Therapy: This treatment, if necessary, usually occurs once your gum tissues have been stabilized and the inflammation and infection have been controlled. It is during this phase that we will address loose teeth or teeth that have shifted or drifted in position.

Surgical Therapy: For more severe cases of gum disease, you may need periodontal plastic surgery to repair and regenerate gum and bone tissue and their attachment to the teeth. It may also be necessary to replace missing teeth with dental implants.

If you are ready to talk to us about the current state of your mouth (or the mouth of another member of your family), contact us today to schedule an appointment. The first step towards achieving optimal oral health could start with this simple call. Or, you can learn more by reading, “Understanding Gum Disease.”