Gingivitis, also called gum disease or early periodontal disease, describes the events that begin with bacterial growth in your mouth and may end – if not properly treated – with tooth loss due to destruction of the structures that support your teeth.
By completing the recommended course of scaling and root planing and the follow-up visits, we can potentially save you thousands of dollars in future treatment, not to mention the embarrassment of covering your mouth when you smile or difficulty chewing because of missing teeth.
Gingivitis (gum swelling and bleeding) usually occurs before periodontitis (bone loss). However, it is important to know that not all gingivitis progresses to periodontitis.
In the early stage of gingivitis, bacteria in plaque (a sticky deposit on teeth where bacteria accumulate) cause the gums to become inflamed (red and swollen) and easily bleed during tooth brushing. Although the gums may be irritated, the teeth are still firmly planted in their sockets. No irreversible bone or other tissue damage has occurred at this stage.
When gingivitis is left untreated, it can advance to periodontal disease, also known as periodontitis. In a person with periodontitis, the inner layer of the gum and bone pull away from the teeth and form pockets. These small spaces between teeth and gums collect food and bacteria and can become infected. The body’s immune system fights the bacteria as the plaque spreads and grows below the gum line.
Poisons produced by the bacteria start to break down the bone and gums that hold teeth in place. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. When this happens, teeth are no longer anchored in place; they become loose and tooth loss occurs. Gum disease is the leading cause of tooth loss in adults.
Plaque is the primary cause of gum disease. However, other factors can contribute to periodontal disease. These include:
Gum disease may progress painlessly, producing few obvious signs, even in the late stages of the disease. Although the symptoms of periodontal disease often are subtle, the condition is not entirely without warning signs. Certain symptoms may point to some form of the disease. The symptoms of gum disease include:
Even if you don’t notice any symptoms, you may still have some degree of gum disease. In some people, gum disease may affect only certain teeth, such as the the very back teeth. Only a dentist can recognize and determine the progression of gum disease.
During a dental exam in our Philadelphia office, Dr. Cirka, Dr. Meier, Dr. Jeon and Dr. Smith check for these things:
The goals of gum disease treatment are to promote reattachment of healthy gums to teeth; reduce infection, swelling and the depth of pockets; and to stop disease progression. Treatment options depend on the stage of disease, how you may have responded to earlier treatments, and your overall health. Options range from non-surgical therapies that control bacterial growth to surgery to restores supportive tissues.
For almost all patients, we do not recommend surgery. This was common a few years ago and is still completed at some offices. Our Philadelphia dental office is different. Here, at the first visit, your hygienist will remove all the build-up above the gum line and you begin to use a prescription mouth rinse daily. At your second visit, we use a gel that thoroughly numbs your gums – without a needle. For some patients, scaling and root planing can cause discomfort, so we prevent that with a local anesthetic used to numb the portion of your mouth that is being worked on. You should be 100 percent comfortable with the treatment in our office. The teeth are cleaned and below the gum, the roots are smoothed. This begins the healing process. This is known as scaling and root planing.
Scaling and root planing is the most common and conservative form of treatment for periodontal (gum) disease. Scaling is the removal of calculus (commonly called tartar) and plaque attached to the tooth surfaces. The process especially targets the area below the gum line, along the root.
The root surface is made smooth in a process called root planing. Root planing removes any remaining calculus and smooths irregular areas of the root surface.
Scaling and root planing is done with a combination of ultrasonic and hand instruments. Ultrasonic instruments have two components:
These instruments come in various shapes and sizes. Different instruments are used for different teeth, and even for different surfaces of the same tooth. Typically, ultrasonic instruments are used first to remove large deposits of plaque and calculus from the crowns and roots of the teeth. Hand instruments are then used to remove any remaining material and make sure that the tooth surface is clean and smooth. Remember – the entire time you are numb and comfortable.
At a third visit, 2-4 weeks later, we clean and polish your teeth again, checking to see if you healed as predicted. If so, we will see you every 3 months for a periodontal cleaning to monitor and maintain the health of your teeth and gums. If there are areas that have not healed after the initial scaling, we may recommend that you visit a periodontist-a dentist who treats gums. Almost every patient who adheres to our recommendations does not need to see a gum specialist after the treatments in our office.
Gum disease can be reversed in nearly all cases when proper plaque control is practiced. Proper plaque control consists of professional cleanings at least three to four times a year the first year after your diagnosis of gum disease. You do your part by maintaining your schedule with us and brushing and flossing daily. Brushing eliminates plaque from the surfaces of the teeth that can be reached; flossing removes food particles and plaque from in between the teeth and under the gum line. Antibacterial mouth rinses, like Listerine, can reduce bacteria in the mouth that cause plaque and gum disease. We provide you additional recommendations catered to your particular situation which may include an electric toothbrush, special rinses, or particular devices made especially for patients who have gum disease.
Other health and lifestyle changes that will decrease the risk, severity, and speed of gum disease development include:
Despite following good oral hygiene practices and making other healthy lifestyle choices, the American Academy of Periodontology says that up to 30% of the Americans may be genetically susceptible to gum disease. If anyone in your family has gum disease, it may mean that you are at greater risk. If you are more susceptible to gum disease, we may recommend more frequent check-ups, cleanings, and treatments to better manage your gum health.
If left untreated or if periodontal disease is severe, surgery may be necessary to stop the progression. We work with you to prevent long term loss of your teeth and to get your teeth and gums as healthy as possible. Our recommendations work. If you follow our recommendations, you will get and stay healthy.
So, if you have bleeding gums that are not healthy, we can help. Healthy gums are just a few visits away. At our dental office in Center City, Philadelphia, Dr. Cirka, Dr. Meier and our hygienists will provide you excellent care. They are the best anywhere and have each been licensed to practice for many years.
Approximately 75% of adults in the United States are affected by some form of periodontal disease, ranging from mild cases of gingivitis to the more severe form, periodontitis. However, recent research conducted by the American Academy of Periodontology and the Centers for Disease Control (CDC) suggest that periodontal prevalence rates may have been underestimated and the rates may be higher than 8 of 10 people have some form of gum disease.
Studies suggest gingivitis may increase the risk of heart disease and stroke because of the high levels of bacteria in infected areas of the mouth. As the severity of gum disease increases, the risk of heart disease may increase with it. Other studies have suggested that the swelling and bleeding in the gums may create a chronic inflammation response in other parts of the body, increasing the risk of heart disease and stroke.
People with diabetes often have some form of gum disease, likely caused by high blood sugar. People with diabetes need to take extra care to ensure proper brushing and flossing techniques are used to prevent the advancement of the gum disease. Regular check-ups and cleanings with your dental hygienist should be followed.
Babies that are born premature — before 37 weeks — may face numerous health complications. Research indicates that women with gum disease are three to five times more likely to have a baby born prematurely compared to women without any gum disease.
Women are more susceptible to gingivitis when pregnant and should follow their regular brushing habits, and continue with dental cleanings and examinations. If you are pregnant and your gums become very sensitive and bleed, it is likely due to the hormonal changes that your body is experiencing. If that is the case, call us. We routinely help you with an additional cleaning during your pregnancy to prevent “pregnancy gingivitis”.
Call our Center City Philadelphia dental office today for a free gum disease assessment and free x-rays 215-568-6222.
or contact us today for a free consultation with Dr. Cirka, Dr. Meier, Dr. Jeon or Dr. Smith in our Center City, Philadelphia office.