Do you know why your gums are bleeding when you brush them? If your answer is No, then you are in luck. My goals for this research paper are to explain what the root causes of Periodontal Disease are. This includes the definition or background of the disease and what bacteria are involved. I will also discuss what the symptoms are, how it is diagnosed, what treatments are available and what techniques are useful for prevent ion of the disease. We will also look at who might most likely be affected by this disease?
First, I would like to define the background of periodontal disease. It is a chronic inflammatory disease of the gum and tissues that surround and support the teeth. If left untreated, periodontal disease can lead to tooth loss. This disease is divided into two types:
1. Gingivitis: causes lesions (wounds) and affects the gums. Gingivitis is due to the long-term effects of plaque deposits. Plaque is a sticky material made of bacteria, mucus, and food debris that develops on the exposed parts of the teeth. It is a major cause of tooth decay. If you do not remove plaque, it turns into a hard deposit called tartar that becomes trapped at the base of the tooth. Plaque and tartar irritate and inflame the gums. Bacteria and the toxins they produce cause the gums to become infected, swollen, and tender.
2. Periodontitis: damages the bone and connective tissue that support the teeth. In periodontitis, plaque builds and hardens under the gums. The gums pull away from the teeth, forming “pockets” of infection. The infection leads to loss of the bone that holds the tooth in its socket and might lead to tooth loss. The following picture should help you to understand the root cause of this disease better.
Periodontal disease is caused by “plaque” bacteria. The three types of bacteria most likely to cause aggressive periodontal disease are: Actinobacillus actinomycetemcomitans (A. actinomycetemcomitans), Porphyromonas gingivalis (P. gingivalis), and Bacteroides forsythus. These bacteria are also known as gram negative anaerobic bacteria. Both A. actinomycetemcomitans and P. gingivalis are caused gum disease. In our mouth, the sulcus is teeming with harmless varieties of bacteria. However, increasing the bacteria quantity and changing the balance of bacterial types from harmless to disease-causing bacteria will cause problems. To be exact three-hundred fifty species of microorganisms are found in the typical health mouth, but only four percent of these species are linked to periodontal disease. The helpful bacteria are usually known as gram positive aerobic bacteria. These harmful bacteria increase in mass and thickness until they form a sticky film. Below is the picture of a tooth to help you to understand this disease better
According to “Periodontal Disease”, an article on the About Health website, plaque actually provides a barrier against outside bacterial invasion. It is only when it accumulates to excessive levels that bacterial plaque sticks to the surfaces of the teeth and adjacent gums and causes infection. It is also when transforms into calculus (commonly known as tartar), which is much more difficult to remove than plaque. The bacteria that cause periodontal disease thrive in acidic environments. Eating sugars and other foods that increase the acidity in the mouth increase bacterial counts. The bacterium that causes periodontal disease may be able to be passed to others through saliva.
The development of disease is also dependent on several other factors. According to “Gingivitis and Periodontal Disease (Gum Disease)”, an article on the WebMD website, these factors are:
· Hormonal changes, such as those occurring during pregnancy, puberty, menopause, and monthly menstruation, make gums more sensitive, which makes it easier for gingivitis to develop.
· Illnesses may affect the condition of your gums. These include diseases such as cancer or HIV that interfere with the immune system. People with diabetes are more likely to have periodontal disease than people without diabetes, because many kinds of bacteria (germs) thrive on sugars, including glucose -- the sugar linked to diabetes. When diabetes is poorly controlled, high glucose levels in mouth fluids may help germs grow and set the stage for gum disease.
· Medications can affect oral health because some lessen the flow of saliva, which has a protective effect on teeth and gums. Some drugs, such as the anticonvulsant medication Dilantin and the anti-angina drug Procardia and Adalat, can cause abnormal growth of gum tissue.
· Poor oral hygiene habits, such as not brushing and flossing on a daily basis, make it easier for gingivitis to develop.
· Family history of dental disease can be a contributing factor for the development of gingivitis.
According to “Gingivitis and Periodontal Disease (Gum Disease)”, an article on the WebMD website, four symptoms of this disease are:
Ÿ Red, tender and swollen gums.
Ÿ Bleeding of the gums. Even during brushing, bleeding gums are a sign of inflammation and the major marker of periodontal disease.
Ÿ Debris and bacteria. They can cause a bad taste in the mouth and persistent bad breath.
Ÿ Loose teeth. They can sometimes cause a change in the way the upper and lower teeth fit together when biting down or in how partial dentures fit.
The following picture should help you to understand symptoms of this disease better.
The main approach in the diagnosis of this disease is to check the color and shape of gingival tissue on the cheek (buccal) side and the tongue (lingual) side of every tooth. Redness, puffiness, and bleeding upon probing indicate inflammation and possible periodontal disease. Deposits of plaque and tartar may be seen at the base of the teeth. The gums are usually painless or only mildly tender. At the dental office, dental bone measurements may be done to determine whether the inflammation has spread to the supporting structures of the teeth. Below is a picture of how a dentist performs the measurement used to diagnose of this disease.
Two approaches can be used to treat periodontal disease:
· Nonsurgical Approaches. Deep cleaning of tartar and bacteria from gum line and tooth root surfaces.
· Surgical Approaches. Periodontal surgical techniques include flap surgery (periodontal pocket reduction), bone grafts, and guided tissue regeneration.
The best method to prevent this disease is daily brushing and flossing. Brushing gets rid of plaque from the easily reached surfaces of the teeth; flossing removes food particles and plaque from in between the teeth and under the gum line. Antibacterial mouth rinses can reduce bacteria in the mouth that cause plaque and gum disease. These steps can be done at home. For proper plaque control one should have professional cleanings at least twice a year. According to “Gingivitis and Periodontal Disease (Gum Disease)”, an article on the WebMD website, four steps for prevention of this disease are:
· Stop smoking. Tobacco use is a significant risk factor for development of periodontitis. Smokers are seven times more likely to get gum disease than nonsmokers, and smoking can lower the chances of success of some treatments.
· Reduce stress. Stress may make it difficult for your body's immune system to fight off infection.
· Maintain a well-balanced diet. Proper nutrition helps your immune system fight infection. Eating foods with antioxidant properties, such as, those containing vitamin E or vitamin C can help your body repair damaged tissue (vitamin E-containing foods include vegetable oils, nuts, green leafy vegetables. Vitamin C-containing foods include citrus fruits, broccoli, and potatoes).
· Avoid clenching and grinding your teeth. These actions may put excess force on the supporting tissues of the teeth and could increase the rate at which these tissues are destroyed.
This disease affects both men and women. According to Periodontal (Gum) Disease Causes, Symptoms, and Treatments, an article on NIDCR website, “People usually don't show signs of gum disease until they are in their 30s or 40s. Men are more likely to have gum disease than women. Although teenagers rarely develop periodontitis, they can develop gingivitis, the milder form of gum disease. Most commonly, gum disease develops when plaque is allowed to build up along and under the gum line.” Why men are more likely to have gum disease than women. According to "5 months average time men go before changing their tooth brush", an article on Health line, "Among women and men in the survey, 86 percent of women brush their teeth twice or more a day, yet only 66 percent of men do so."
Now, you should have a clear understanding of what periodontal disease is, and what bacteria cause this disease. In additional, you should have a good idea of how to diagnose, treat and prevent this disease. It is up to you to take charge of your health, and develop good habits to prevent this disease from damaging your teeth, because this disease might cause other illness such as heart disease, stroke, diabetes, respiratory diseases and worsening chronic lung conditions.
Words Cites/Reference
1. The new Merriam-Webster Dictionary
2. Marjorie Kelly Cowan and Kathleen Park Talaro. Periodontal disease. In Microbiology A System Approach, 2nd edition. Page 691-693.
3. Periodontal disease. Available at: http://adam.about.com/reports/Periodontal-disease.htm
4. Gingivitis and Periodontal Disease (Gum Disease). Available at http://www.webmd.com/oral-health/guide/gingivitis-periodontal-disease
5. Steven R. Pohlhaus, DDS, Balttimore Center for Laser Dentistry. Copy of text available at :http://www.stevedds.com/periodon.htm
6. Periodontal disease. Available at http://www.nidcr.nih.gov/OralHealth/Topics/GumDiseases/PeriodontalGumDisease.htm
Picture of tooth: https://health.google.com/health/ref/graphic/1121
Picture of periodontal disease: https://health.google.com/health/ref/graphic/1136
Picture of how dentist measurement of gum disease: https://health.google.com/health/ref/graphic/9348
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