If your gums are puffy, tender or bleed when you floss, then you may be among the 75% of American adults who have some form of gum disease.
Gum disease, which is also called periodontal disease, starts as gingivitis. Many people are shocked to realize gingivitis is an infection caused by bacteria. Untreated gum disease causes the gum to separate from the teeth, forming a bacteria-filled pocket. Having bacteria beneath your gums is like having termites in your house. No matter how much you paint the walls, the foundation will weaken and collapse unless you treat the infestation.
And here's a scary new statistic from the Centers for Disease Control and Prevention (CDC): Half of all Americans over the age of 30 have gum disease beyond that first, reversible stage of gingivitis. In fact, periodontal disease is the number one cause of tooth loss in American adults.
So what can you do to restore your oral health? Dr. Asia Richardson, a doctor who practices at Coast Dental Sprayberry near Atlanta, says that depends on how much the disease has advanced. Our clinicians use a tiny ruler called a probe to measure the depth of the pocket around each tooth. As the disease advances, the pockets become deeper and the treatment becomes more extensive, more expensive and more time-consuming to treat.
Gingivitis is the only stage of periodontal disease that is reversible. Patients with gingivitis typically have a few 4-millimeter pockets filled with bacteria and their gums have become infected and swollen. If the infection is not treated, the pockets will deepen, and the teeth will start to loosen as the infected gum pulls further way.
"For gingivitis, we do a full mouth debridement, which removes plaque and tartar both above and below the gum line," said Dr. Richardson. "We'll also irrigate the infected areas with a chlorhexadine rinse to flush out and kill more bacteria. In addition, we give patients an intensive home care regimen, so they don't have the infection return while the gums are healing. We like to see patients about four weeks later to polish their teeth and ensure the disease was effectively treated. After that, the patient usually can return every six months for a regular cleaning as long as their home care keeps the infection from returning."
Treating Mild Periodontitis
If the disease advances, it's called periodontitis. The pockets deepen to about 5 millimeters, but the teeth are not yet loose. Mild periodontitis is usually treated with a cleaning called scaling and root planing therapy. Scaling removes the plaque and tartar from your teeth above the gum line. Root planing goes beneath the gum line to clean the tartar from the root surface and make it harder for bacteria to adhere. In some cases, your dentist may also prescribe an antibiotic. Once the disease has advanced to this stage, patients will need to return to the dentist for cleanings more frequently than people who have healthy mouths.
Treating Moderate Periodontitis
If you have deeper pockets of bacteria, your gum line has receded, exposing the root surfaces and loosening your teeth. In addition to the scaling and root planing therapy, your dentist may give you an antibiotic, which is placed directly into the pocket to eliminate any bacteria that the cleaning alone can't reach. Some doctors choose to treat periodontitis with laser therapy to remove the unhealthy part of the gum because it's less invasive and may be less expensive than surgical treatment. Also, laser therapy can be used on anyone, even patients with medical allergies or expectant mothers. Regardless of the method of treatment, you will need to return for follow up visits, typically 8 to 12 weeks after the initial treatment so your teeth can be polished, and then every three to four months for periodontal maintenance. Periodontal disease is a systemic disease like diabetes and it can return if it's not closely monitored.
Treating Severe Periodontitis
Severe periodontitis often requires surgery to repair the gums. Typically, the pockets are deeper than six millimeters and there is permanent bone damage. Some teeth may be so loose, they can't be saved. In that case, the dentist will need to extract the teeth and you will need a denture, bridge or dental implant to fill the space left behind.
So the next time you notice your gums are a little red and puffy, call your dentist for an appointment. The faster the infection is diagnosed, the cheaper it is to treat. If you can stop it while it's still just gingivitis, then you can reverse the damage and, with proper care, keep the infection from coming back.
"Periodontal disease, or periodontitis, is an equal opportunity infection," Dr. Richardson said. "It doesn't matter how old you are. It depends on your home care routine, including how well you brush and floss, and genetics."
Asia Richardson, DMD, is a family dentist at Coast Dental Sprayberry near Atlanta. Services include bone grafting, crown lengthening, dental implant restorations, extractions, Lumineers, laser therapy, root canal therapy and retreatment, periodontal disease management, veneers and teeth whitening. Dr. Richardson earned her dental degree at the University of Alabama School of Dentistry and stays current with the latest advancements in dental technology by attending seminars and training courses. She is a member of the American Dental Association and the Academy of General Dentistry. She treats patients age 5 and older and can be reached at Coast Dental Sprayberry, 2550 Sandy Plains Road NE in Marietta, Georgia. The phone number is (770) 321-2755.
Written by: Beth Gaddis
Reviewed by: Asia Richardson, DMD
Reviewed by: Cindy Roark, DMD