Periodontal Disease

ADVICE SHEET FOR PATIENTS WITH PERIODONTAL DISEASE

Periodontal disease causes the loss of more teeth in adults than all other dental ailments together. Before the age of 35, decay is the primary cause of tooth loss: thereafter periodontal disease is responsible for over 80% of tooth loss. Periodontal disease is second only to the common cold as the most common of human diseases.

An understanding of periodontal disease is essential to assist in its prevention and its successful treatment. It is for this reason that this advice sheet has been prepared.

It is intended primarily for patients suffering from periodontal disease in order that they may acquaint themselves with some of the problems that have arisen in their mouths. This information will also be of interest to any individual wishing to prevent its occurrence.

WHAT IS PERIODONTAL DISEASE?

The word "periodontal" literally means "around the tooth". Periodontal disease, also known as gum disease, is a chronic bacterial infection that affects the gums and bone supporting the teeth. Periodontal disease can affect one tooth or many teeth. It begins when bacteria in plaque cause the gums to become inflamed [gingivitis]. Untreated gingivitis can advance to periodontitis, this is when the tissues and bone that support the teeth are broken down and destroyed.

WHAT CAUSES PERIODONTAL DISEASE?

Plaque is the culprit, which means that without proper at¬ home oral hygiene and regular dental visits, your risk clearly increases. However, even perfect oral hygiene isn't enough to ward off periodontal disease in everyone. Other factors that are thought to increase the risk, severity and speed of development of periodontal disease include tobacco use, general health conditions, medications, trauma, stress, genetics, hormonal changes and poor nutrition.

WHEN SHOULD I HAVE A PERIODONTAL EVALUATION?

If you value your oral as well as your overall health, anytime is a good time to go for a periodontal evaluation. Sometimes the only way to detect periodontal disease is through a periodontal examination.

A periodontal evaluation may be especially important if you:

Notice any symptoms of periodontal disease, which include:

• Gums that bleed easily, such as during brushing or flossing.

• Red, swollen or tender gums.

• Gums that have pulled away from the teeth. Persistent bad breath.

• Pus between the teeth and gums.

• Loose or separating teeth.

• A change in the way your teeth fit together when you bite.

Are thinking of falling pregnant.?

Pregnant women who have periodontal disease may be seven times more likely to have a baby born prematurely pr too small.

In addition, about 50% of pregnant women experience "pregnancy gingivitis". However, women who have good oral hygiene and no gingivitis before pregnancy are very unlikely to experience this condition.

Have heart disease, diabetes, respiratory disease or osteoporosis?

Ongoing research is showing that periodontal disease may be linked to these conditions. The bacteria associated with periodontal disease can travel into the bloodstream and pose a threat to other parts of the body. Healthy gums may lead to a healthier body.

PLEASE REMEMBER AN ADVANCED STATE OF PERIODONTAL DISEASE CAN BE REACHED WITHOUT HAVING EXPERIENCED ANY PAIN OR DISCOMFORT WHATSOEVER.

HOW CAN PERIODONTAL DISEASE BE PREVENTED?

• Correct oral hygiene will prevent the formation of bacterial plaque.

• Learn the correct tooth cleansing technique under the supervision of a dentist or oral hygienist.

• Have this technique checked regularly.

• Have regular oral hygiene appointments.

• Have regular periodontal evaluations and periodic x ¬rays to reveal otherwise undetectable changes in the jaw bone.

Remember that there will usually be no pain or discomfort to warn you.

WHAT DOES TREATMENT INVOLVE?

Treatment usually consists of the following:

• Learning an effective oral hygiene technique.

• Having your teeth scaled and polished.

• Root planing - where an attempt is made to decontaminate the surfaces of the roots of your teeth, using special dental instruments in order that the gum tissue may become reattached to the tooth surface. This usually requires local anaesthetic to avoid pain.

• Where the periodontal condition is advanced, minor surgical procedures may be necessary to gain access to the roots requiring decontamination; as well as to correct any major bone changes that may have resulted from the disease.

• Each patient will have different problems which will have to be handled on an individual basis. It is impossible to mention them all in this pamphlet. Your dentist will discuss these with you.

WHAT HAPPENS ONCE TREATMENT HAS BEEN COMPLETED?

You will be scheduled to commence a periodontic maintenance programme, which will consist of three monthly visits to the oral hygienist. The interval may be reduced or extended, depending on several factors such as the original extent of the disease, your progress following treatment, as well as your ability to remove plaque.

CAN PERIODONTAL DISEASE BE INHERITED?

YES!!!

Recent research has established that a predisposition to periodontal disease can be passed from parent to child. This tendency may exist in 1 in 8 of the population regardless of race, nationality or social background.

WHY DO SOME PEOPLE, WHO LOOK AFTER THEIR TEETH, SUFFER FROM PERIODONTAL DISEASE,

WHEREAS OTHERS WHO HARDLY EVER USE A TOOTHBRUSH, MAY NOT?

Plaque is the main and possibly the only initiating factor in causing periodontal disease, yet only 1 in 8 individuals will contract the disease.

There must, therefore, be some difference between the one who is susceptible to the disease and the seven who are not. Modern research has provided us with new information explaining that the difference results from the fact that some individuals have a predisposition or weakness that allows plaque to initiate the disease process.

The two main predisposing factors that we are aware of thus far, are the genetic tendency, already mentioned and smoking. However, in the absence of plaque periodontal disease will usually not occur, irrespective of whether one is susceptible to the disease or not. Patients who require or who have undergone extensive periodontal treatment must be regarded as being susceptible to the disease.



The above information has been supplied by Milnerton Dental

Milnerton Medi-Clinic, Racecourse Rd, Milnerton, Cape Town

Dr. Jonathan Cohen and Dr. David Sheinbar

Tel: +27 (0)21 551 6604 or +27 (0)21 551 6560