PERIODONTAL DISEASE
AND PREVENTION

Periodontal disease, or gum disease, is a bacterial infection that causes chronic inflammation of the gums and surrounding tissue. Some of the most common dental health concerns, periodontal disease is the cause of approximately 70% of adult tooth loss, affecting nearly 80% of people at some point in their life.

Almost anyone can get periodontal disease, which could go on for months before you notice symptoms. Being that it can cause permanent and extensive damage to your health, it’s important to understand its causes, how to detect early signs of the disease, and how to prevent and treat it.

• Genetics. Studies show that up to 30% of the population may be genetically predisposed to gum disease.
• Diet. A diet low in nutrients and vitamins can lessen the body’s ability to fight infection and increase a person’s susceptibility to gum disease.
• Smoking and tobacco. Smokers and those that use smokeless tobacco have more irritation to gum tissues than non-tobacco users, increasing the susceptibility to gum disease.
• Stress. Stress is also known to affect the ability to ward off disease and may contribute to an increased incidence of periodontal disease.
• Diseases. There are several diseases that interfere with the body’s immune system, including diabetes, leukemia, lymphoma, rheumatoid arthritis and HIV. Any of these could be contributing factors to periodontal disease.
• Pregnancy. Pregnant women experience elevated levels of hormones that cause gums to react differently to the bacteria found in plaque. As a result, it may cause a temporary condition known as “pregnancy gingivitis.” If left untreated, it can progress to periodontal disease.
• Medications. Certain medications, including steroids, cancer therapy drugs, types of anti-epilepsy drugs, and some calcium channel blockers and oral contraceptives may also contribute to periodontal disease.
Dry mouth, older age and dental restorations that don’t fit properly (or crooked teeth that are difficult to clean) are also known to contribute to periodontal/gum disease. This is why it’s so important to see your dentist on a regular basis in order to help prevent periodontal disease at its early stage.

While you’re brushing or flossing, you may notice warning signs such as red, swollen or tender gums. You may also notice bleeding gums. It’s important to note that there may not be any discomfort until the disease has reached an advanced stage – and that’s another reason why it’s so important to visit your dentist regularly for cleanings. Your dentist will monitor your oral health and help you identify and prevent problems before they become more serious.

Additional warning signs that you may have periodontal disease include:

• Gums that are pulling away from your teeth (receding gums)
• Teeth that are loose or separating from each other
• Persistent bad breath and/or a bad taste in your mouth
• A change in the fit of partial dentures, if you wear them

The early stage of gum disease is called gingivitis. The primary effects of gingivitis on the body include tender and swollen gums that sometimes bleed. If the disease progresses, it can cause gum tissue to pull away from teeth, allowing bacteria to destroy the underlying bone supporting the teeth. This can cause painful lesions on the gums, loose teeth, and loss of bone structure.

The more advanced stage of gum or periodontal disease is called periodontitis. This stage commonly increases inflammation throughout the body, which in turn can be an underlying factor in diseases including heart disease, diabetes, dementia and rheumatoid arthritis.

Treatment for periodontal diseaseis performed by a periodontist. For those who do have periodontal disease, there are several nonsurgical options and surgical options for treatment. These include: 

Nonsurgical treatments

If periodontitis isn’t advanced, treatment may involve less invasive, nonsurgical procedures, including:

• Scaling. Scaling removes tartar and bacteria from your tooth surfaces and beneath your gums. Scaling is performed using instruments, a laser or an ultrasonic device.
• Root planning. Root planning smooth’s the root surfaces, discouraging further build-up of tartar and bacteria. It also removes bacterial by products that contribute to inflammation and delay healing or reattachment of the gum to the tooth surfaces.
• Antibiotics. Topical or oral antibiotics can help control bacterial infection. Topical antibiotics include antibiotic mouth rinses or insertion of gels containing antibiotics in the space between your teeth and gums, or into pockets after deep cleaning. Oral antibiotics may be necessary to completely eliminate infection-causing bacteria.

Surgical treatments

For those with advanced periodontitis, treatment may require surgical treatment, including:

• Periodontal flap surgery. In this procedure, your periodontist makes small incisions in your gum so that a section of gum tissue can be lifted back, exposing the roots for more effective scaling and root planing. Because periodontitis often causes bone loss, the underlying bone may be recontoured before the gum tissue is sutured back in place. After you heal, it’s easier to clean these areas and maintain healthy gum tissue.
• Osseous surgery. Osseous surgery is used to reshape deformities and remove pockets in the alveolar bone, which is the bone surrounding the root of the tooth that anchors it in place. The goal of osseous surgery is to reduce or eliminate the periodontal pockets that cause periodontal (gum) disease.
• Ridge augmentation. Ridge augmentationis a common dental procedure often performed following a tooth extraction and before the placement of dental implants to help recreate the natural contour of the gums and jaw that may have been lost due to bone loss as a result of the extraction.
• Soft tissue grafts. When you lose gum tissue, your gumline recedes. You may need to have some of the damaged soft tissue reinforced. This is commonlydone by removing a small amount of tissue from the roof of your mouth (palate) or using tissue from another donor source and attaching it to the affected site. This procedure can help reduce further gum recession, cover exposed roots and give your teeth a more pleasing appearance.
• Bone grafting. Bone grafting is performed when periodontitis has destroyed the bone surrounding your tooth root. The graft may be composed of small fragments of your own bone, or the bone may be donated. The bone graft helps prevent tooth loss by holding your tooth in place. It also serves as a platform for the regrowth of natural bone.
• Guided tissue regeneration. Guided tissue regeneration allows the regrowth of bone that was destroyed by bacteria. In this procedure, your periodontist will place a special piece of biocompatible material between existing bone and your tooth. The material prevents unwanted tissue from entering the healing area, allowing bone to grow back instead.
• Tissue-stimulating proteins. Another surgical technique involves applying a special gel to a diseased tooth root. This gel contains the same proteins found in developing tooth enamel and stimulates the growth of healthy bone and tissue.

Removing plaque through daily brushing and flossing as well as scheduling regular dental appointments for professional cleanings are the best ways to minimize your risk for gum disease. If necessary, your dentist can design a personalized program of home oral care to meet your needs.

In addition to home care and professional care by your dentist, it’s also important to eat a healthy diet that provides nutrients such as vitamins A and C to prevent gum disease. Starchy and sugary foods increase plaque and the prevalence of the disease. It’s also important to avoid cigarettes and smokeless tobacco, which may contribute to both gum disease as well as oral cancer.

At Park Smiles NYC, we offer a comprehensive array of dental services and specialties in the convenience of one office. Led by Dr. Ruben Cohen , a renowned board-certified oral and maxillofacial surgeon, our skilled and experienced team includes the top dentists, pediatric dentists, periodontist, orthodontist, endodontist, and anesthesiologists in New York.

If you notice any signs and symptoms of gingivitis, schedule an appointment with us at your earliest convenience. The sooner you seek care, the better your chances of reversing damage from gingivitis and preventing its progression to periodontitis.

Achieving a healthy, beautiful smile is like a Walk in the Park at Park Smiles NYC!