Did you know….?
- Gum disease is extremely common and afflicts 3 out of every 4 adults over the age of 35 in the UK.
- Gum disease, not tooth decay, is the biggest cause of tooth loss.
- Only 60% of women in the UK aged 45 can claim to have all their own teeth.
- Gum disease isn’t just something that happens later in life, more than half of teenagers have some form of gum disease.
- Smoking causes 50% of all cases of gum disease in the UK.
- Gum disease is linked with many diseases that affect your general health.
Periodontal gum disease–also known as Periodontitis-stems from a bacterial infection under the gums. This infection damages the attachment between the gum tissue and the roots of the teeth. Once the attachment is destroyed, the bone is no longer sealed and protected. This leads to a deepening area called a “pocket” where bacteria can multiply out of the reach of regular cleaning efforts. The symptoms of the disease include bleeding gums, recession, shifting teeth, bad breath, pain on chewing, swelling, and sensitivity. In time, periodontal disease can lead to the loss of teeth and can contribute to the spread of other diseases. A large percentage of the population is not affected by any obvious symptoms and so is unaware that they suffer from gum disease. Recent medical data has linked these bacteria to other serious health problems, which include:
- Heart disease – those with adult periodontitis may have increased risk of fatal heart disease.
- Stroke – there is evidence linking gum disease to an increased risk of strokes.
- Uncontrolled diabetes – chronic gum disease can disrupt diabetic control. Conversely, diabetes can contribute to bacterial overgrowth in the mouth. Smokers with diabetes increase their risk of tooth loss considerably. It is recognised that sufferers of type II diabetes are three times as likely to develop periodontal disease as non-diabetics.
- Respiratory and sinus infections – inhaled bacteria from the mouth and throat can end up in the lungs.
- Digestive problems.
- Osteoporosis – this condition, which leads to a reduction of bone mass, resulting in brittle bones, is associated with gum disease and related tooth loss.
- Premature birth and infertility – women with advanced gum disease are more likely to give birth to an underweight or pre-term baby. In fact, oral bacteria can cross the placental barrier, exposing the foetus to infection.
What Causes Periodontal Disease?
Periodontal gum disease starts when bacteria, supported by parasites, yeast, or viruses, encounter a weak immune response from an individual. The general state of the immune system is therefore an important factor in the onset of periodontal disease. The immune system’s efficiency and susceptibility to infectious disease is linked to a number of factors. These factors include smoking, a person’s level of stress and fatigue, and a number of life-style factors such as diet, exercise, and general health habits. Genetics also play a role in making some people more susceptible than others.
The infection itself is caused by bacteria that thrive inside of the plaque that is under the gums. These anaerobic bacteria–living where there is no air–are very mobile and can invade into other tissues. They produce chemical products such as enzymes, acids, and toxins, which cause damage to the gum tissue, the bone, and the attachment. Some of the chemicals depress the neutrophil, which is one of our main defensive cells. Others can break the attachment from the gingival tissue over to the root surface, exposing the bone.
As a result, a pocket is formed where bacteria can multiply rapidly out of the reach of hygiene efforts. In this pocket, the roots and surface of the bone are exposed to bacteria and chemicals. Bacteria then dissolve the protective layer of the bone, named the cortical layer, which exposes the internal bone to further attack. Additional damage is caused by the body’s immune components, which will often destroy tissue as they fight the infection. As more time passes the pockets deepen, bacteria levels increase, and chemicals contaminate the bone and the root surface.
Traditional periodontal treatment begins with non-surgical scaling and root planning (deep cleaning) to remove the plaque and calculus from the teeth. Disinfectants and at-home oral hygiene techniques are then used to control the bacteria.
Some pockets, however, are too deep to resolve with a deep cleaning. When the pockets are deeper than 5-6 millimeters, dentists can choose to perform invasive surgery. This entails creating a periodontal incisional flap that creates access to the deep pockets. In the case of severe infections, antibiotics are often prescribed.
Due to the nature of the incision and the damaged state of the tissue, the gums, bone, and attachment are left in a very weak state after the surgery. In addition to fighting the infection from the gum disease, the body is now also burdened with trying to repair the damage done from the surgery. Under these conditions, healing deep pockets proves to be very challenging. Abscesses tend to occur with some regularity. While antibiotics are used, they often suppress the immune system and lead to additional health problems. Frequent cleaning routines and rigorous home care are required to keep the disease under control.
Attempts to restore the attachment and cure the disease have been met with mixed results. Locally targeted antibiotics (atridox, actisite, arestin, perio-chip) or disinfectants and soft tissue lasers can alleviate the symptoms but cannot be considered long-term solutions.
While traditional periodontal surgery can still be useful in some cases, new technology allows us to effectively heal a wider range of periodontal cases without invasive surgery. With the introduction of special laser radial tips for the Water laser what was only a dream has now become reality – the regeneration of lost bone in gum disease.