GUM DISEASE
Many people tend to equate good dental health with strong healthy teeth. This is only half of the equation. In order for our mouths to get the "gold star" rating for overall hygiene, our gums must be healthy as well. Read below to find out why.
First let us take a look at the basic anatomy of the oral environment. We all know that
our teeth are anchored to the jaw bone. This along with some of our facial
muscles, provide us with the strength to masticate or chew. If this anchorage were not
sound, our teeth would move, break and be unable to chew food. The gums (called
gingivae) blanket the jaw bone and act as a protective skin. The edge of gingivae
overlap the bone and encircle the teeth forming an attachment with the teeth. This
attachment is crucial to the health of the underlying bone because it acts as a barrier
between bone and the natural bacteria that live in our mouths. This attachment,
however, does not come right up to the edge of the gingiva. In fact, there is an outer edge
of unattached gum tissue such that a natural pocket or space (called a periodontal
pocket) occurs between the teeth and the gingiva. A healthy depth for a periodontal
pocket is 2-3 millimeters.
Part of the job of maintaining good oral hygiene requires keeping these pockets free
from food debris. The best way to do this is to use dental floss. What happens if we
do not use dental floss on a regular basis? As mentioned above, our mouths naturally
harbor bacteria. Food that is left around our teeth is initially called plaque when soft and
if allowed to remain on our teeth it hardens and is then called tartar or calculus. This leftover food becomes an excellent growth medium for bacteria. A likely place for
food to be left in our mouths is in our gum pockets. If food is left there, it is a sure bet
that bacteria are there as well. The periodontal pocket is the perfect place for bacteria to
grow and flourish. It is dark, wet and if our oral hygiene is not excellent, it provides a
source of nutrition for the bacteria. This is akin to "a kid in a candy store". As the
bacteria grow in number, they begin to invade the edges of the gum tissue. The
gingivae become darker red and swollen. They bleed easier. This is called
gingivitis, which simply means swollen gums. Most people have this problem if only to
a slight degree in some areas of their mouths. With improved flossing and brushing
and a visit to the dentist, this disease is easily reversed and the gums will return to health.
If this situation is not corrected, the bacteria will begin to encroach on the attachment between the teeth and gums and violate it. This will result in a deeper gum pocket and one that is harder to keep clean. As this negative cycle continues, the bacteria can completely penetrate the attachment between the gums and the teeth and invade the jaw bone. This disease is no longer referred to as gingivitis, but is now called periodontitis. This indicates that the gums and the bone are infected with bacteria. The gum pockets might be 5-6 millimeters deep at this point. The gingivae may look more purple and have no sharp edges but instead swollen, rolled margins which bleed to only slight touch. Luckily, this syndrome is also treatable with improved home care and professional hygiene visits.
However, if this problem is not corrected, the bacteria will continue to flourish and now the jaw bone will begin to melt away from the teeth. Now the pockets may have become 7 millimeters or more and at this point, and we are no longer able to floss or brush the full depths of these pockets. This means that at this stage of the disease, regardless of how well we improve our flossing and brushing techniques, we will never be able to clean out these pockets. Therefore, if we do not seek dental treatment, there will always be plaque, tartar and bacteria in these pockets and the disease will continue until there will be little if any bone around the teeth. The teeth will have lost anchorage and will have to be extracted.
The treatment that is usually rendered is done by a periodontist and involves a minor surgical procedure to decrease the depths of the periodontal pockets so that we may be able to keep them clean at home.
Over the years, an aging population, an improvement in the quality of dental care and better oral hygiene products have resulted in the fact that we are holding on to our teeth longer than ever before. Because of this, dentists are seeing an increase in the prevalence of gum disease. It has been estimated that approximately three quarters of adults have some form of periodontal disease. For this reason, much of the cutting edge in dental research centres around the treatment and prevention of periodontal disease. Other studies have shown that there is an increased risk for gum disease in smokers and in those who have a high sugar diet. As well, periodontal disease has been linked with heart disease.
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