Gingivitis and Periodontitis

Have you ever brushed or flossed your teeth and seen BLOOD?

Many of us have and don’t realize that bleeding gums are never normal, okay, or something to be dismissed. Bleeding gums are one of the signs of gingivitis and periodontitis, and if left unattended, can lead to serious health problems. The good news is, if caught early enough, a few simple changes in your dental hygiene routine can eliminate the problem altogether.

What is the Difference Between Gingivitis and Periodontitis?

Both are stages of gum disease caused by bacteria, with gingivitis being the first stage and periodontitis being the more advanced stage. Gingivitis has moved into being periodontitis when the supporting bone starts to be eaten away by the perio-bacteria.

The image below shows the progression from healthy gums to gingivitis to periodontitis, also known as periodontal disease. As you can see the picture on the left shows the gums right up on the base of the tooth and at the correct height. The gums are also a healthy pink color. As gingivitis sets in, the gums swell, start to redden and pull away from the tooth. This starts causing pockets between the gums and tooth. These pockets are breeding grounds for bacteria which exponentially propels the progression of the disease. If left unimpeded, this bacterial growth starts eating away the tissue and the bone supporting the tooth causing it to become unstable.

Causes of Gingivitis and Periodontitis

Often it is poor oral hygiene that precipitates gum disease. Leaving bacteria between the teeth and the gums allows it to grow at an alarming rate. Consistent flossing, along with regular and proper brushing, can remove much of this bacteria. However, only a professional cleaning can reach some surfaces of the gums and teeth and should be done at least twice a year. Dental hygienists have the means and tools to clean deeper than can be achieved at home. Other contributing factors to gingivitis and periodontitis are smoking, poor nutrition, and diabetes.

Symptoms of Gum Disease

As already mentioned, bleeding gums are a frequent symptom of gum disease. The gums may also be red, swollen, and tender. Additionally gingivitis and periodontitis can cause bad breath or you may be able to see visible tartar buildup at the base of the teeth.

Dr. Taylor explains that using a dental probe, he measures the pocket depth around the teeth during an exam. This is a good indicator of whether a patient has gingivitis, or if the disease has progressed to periodontitis. Dr. Taylor also states that annual dental x-rays show whether there is deterioration of the supporting bone, thus indicating progression of the disease.

Treatment and Prevention

Ever heard the joke where a patient says to his doctor, “It hurts when I do this” and the doctor’s response is, “Then don’t do that!” Well just the opposite is true when it comes to gum disease! If brushing and flossing causes your gums to bleed or become swollen and tender, you need to  floss and brush MORE, not less. This doesn’t mean brushing and flossing more aggressively or vigorously; it means brushing and flossing more frequently and properly! The goal is to clean bacteria off all the surfaces of your teeth, not to further damage the tissue. Many have discovered that the bleeding and tenderness totally goes away once they start to floss and brush at least twice a day. Mouth rinses can also help wash away bacteria, but should always be used in tandem with brushing and flossing.

And here’s a tidbit, flossing is not just a means to remove food you can feel from between your teeth. Flossing is actually needed scrape the tooth surfaces between and around teeth to remove plaque and the bacteria it fosters.

Clearly, if the cause for gum disease is that the patient smokes, they need to quit. If a patient is diabetic or has poor nutrition, care and advice from their family doctor on better management of their health may be in order.

Treatment for gum disease obviously is dependent on the severity of the disease. As we said, if caught early enough, complete resolution of the problem can be achieved. The first step is a prophylaxis cleaning by a dental hygienist followed by an improved home dental care routine.

If, however, the disease has progressed to the point where the bone has deteriorated and the tooth’s stability is compromised, more involved treatment may be necessary. In more advanced cases, a deep cleaning involving scaling and root planing, will be performed. Because the regrowth period of periodontal bacteria is around 90 days, the recall for perio-maintenance is most often every three months in order to stay ahead of the bacterial growth. In some cases of severe periodontal disease, patients may need to be referred to a periodontist for even more extensive treatment.

Sadly, there are times the disease has progressed to a point that the tooth is completely unstable and there is no way to save it. In that case the tooth needs to be extracted. The good news is that with the advancements in dentistry, options like implants, dentures and bridges can restore a person’s smile.

One Last Note about Periodontitis

It is very important to remember that your oral health can definitely impact other parts of your body. Keep in mind that because gum disease is the effect of bacteria in the mouth, this bacteria can spread to other parts of the body via the bloodstream. Some patients may need to be put on an oral antibiotic or be given a local injection of antibiotics. Dr. Taylor notes there is a definite correlation between severe periodontitis and heart disease. The health of your teeth and gums can definitely affect your overall health.