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What Do You Know About Periodontal Disease?

What Do You Know About Periodontal Disease?


Here is a typical new patient examination at the office:

Dr. Delica: Hello Mr. “Smith”. How are you? And what brings you in to the office today?

Mr. “Smith”: Doc my gums don’t feel right. They bleed sometimes, not all the time, but sometimes. And lately they get a little swollen in “x” area. But I get my cleanings every 6 months. I don’t know what’s going on.

Dr. Delica: How often do your gums get swollen?

Mr. “Smith”: Oh you know, every so often. Maybe every couple of months but then it goes away.

In my head I am busy running through the following questions. Has Mr. Smith ever been told he has gum disease? Was he ever recommended to have a deep cleaning, or scaling and root planing, as it is referred to dentally? Does he know that bleeding gums are one of the first observed symptoms of having gum disease? Does he realize that swollen gums are an abnormal finding? And, the kicker, how long has this been happening to him? Because periodontal disease rarely occurs overnight.

Did you know that 50% of American adults have some level of Periodontal (Gum) Disease?


At the same time, I realize that many people do not understand periodontal disease. In fact, estimates show that half of American adults suffer from some level of gum disease. That translates to 64.7 million adults 30 years and older. How could so many people be affected by this and at the same point be unaware? Much easier than you think. Take into consideration that from a young age we are told that we get cleanings every 6 months, or twice per year. As young adults age out of being covered by their parents’ dental insurance, those visits in many cases shrink to when absolutely necessary. It is especially common if in they do not have dental insurance benefits through their employer or individually. This makes routine examinations and preventative care unlikely. For many the thought of going to a dentist is so frightening that they put it off unless something hurts.

I also realize that for the most part periodontal disease does not hurt. Similar to diabetes or high blood pressure, patients are often unaware that a destructive process is taking place of their gums until the disease process is severe. And severe periodontal disease means several things: bleeding gums; shifting or mobile teeth; reoccurring dental abscesses; pain; and bad breath. I left bad breath last intentionally– you cannot have a severe, long-standing infection in your mouth and not have bad breath. It is a chronic disease, meaning one-time treatment will not make it go away. It requires monitoring and treatment at regular intervals.

The fact that this disease progresses silently makes it all the more important for regular visits to a dentist. Because by the time you’re aware there is a problem, it may be too late!  Periodontal disease is an inflammatory process defined by lose of bone surrounding your teeth. As plaque and calculus on our teeth trigger an inflammatory response, the bone, an innocent bystander, gets destroyed.  This disease process tends to run in families. Smoking, uncontrolled diabetes, and other co-morbidities can increase the severity and progression of the disease process. While antibiotics can alleviate flare-ups, the ultimate “treatment” includes a) removing the causative plaque/calculus from the roots, b) establishing a routine for great oral home care, and c) disease monitoring. In many cases, if addressed early, we can take steps to regenerate (or regrow) bone that has been lost. 

Preventative case is the first line of defense against getting periodontal disease. Get your exams done at a regular frequency. Brush and floss twice per day. If you notice bleeding when you floss or brush, it is an early symptom of having inflammation in the gums. And by all means, do not ignore oral health issues. They tend to get worse over time without treatment. And if you have undergone a deep cleaning in the past, realize that your cleanings should take place every 3 months (or 4 times per year) to build up that can lead to disease progression. Periodontal disease is a chronic condition, but with care, it can be managed. 


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