Gum / Periodontal Disease
Cause and Treatment of Gum Disease
Progression of Periodontal Disease
Gum Disease and Heart Disease
About Dr. Lynne Heckert
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Periodontal disease is a type of infection.  If you do not clean your teeth for a day you will find sticky, clear-white, material on the teeth called plaque.  If you look closely at this plaque you will see it is made of little lumps.  Each lump is actually a colony of bacteria that has grown from one tiny bacterial cell.
   

Gingivitis is an infection ,and inflammation, of the gum around the tooth.  It is very common, yet very serious and its cause is accumulation of plaque around the tooth. If not removed periodically,  this bacteria/plaque takes on a life of it's own.  It accumulates and changes in nature.  New and more virulent bacteria move in and it becomes more harmful to the tissues around the tooth.  It becomes an entrenched little "town" of bacteria, the bacteria all communicating with each other in a network. This is called a "biofilm." Bacteria inhabiting the plaque cause decay and periodontal disease.

When plaque is allowed to flourish, it secretes byproducts that irritate the gums around the tooth. Gum tissue respond to this infection by becoming inflamed and swollen with blood.  Inflamed gums are red and bleed easily.  This has a cyclical effect: bleeding and soreness make brushing and flossing painful so the patient avoids cleaning well around and under the gum,  allowing the infection to just get worse.

Plaque in some mouths becomes calcified with minerals from saliva if it is allowed to remain on the tooth for a while.  This hard material is called calculus.  It complicates removal of the bacteria and must be professionally removed.

Gingivitis is an early form of gum disease that can be reversed with good cleaning of the tooth and proper plague removal at home by the patient.  Brushing, flossing, tooth picks, etc. are all meant to facilitate removal of plague.  Electric toothbrushes are an excellent aid to good home care, as is floss.  Regular cleanings at the dentist are needed to remove stain and calculus.

Periodontitis is the term used when the disease begins to affect the bone under the gum.   In response to a maturing plaque under the gum tissue and its irritating toxins,  the bone (in susceptible patients) begins to dissolve.   This beginning dissolution, or resorbtion, of bone can often be seen on an x-ray. Periodontitis can continue its destruction, dissolving  more and more bone, until it becomes advanced.  In advanced stages of the disease, teeth become loose and gum abscesses may occur.

Not all people respond to the presence of plaque in the same way and this response is largely genetic.  Also, periodontal disease progresses at different rates in different mouths, and it's  activity level waxes and wanes over time in the individual mouth. Some plaque contains more virulent and destructive bacteria and there may be a place for antibiotics in treatment.

There are people who have extreme gingival inflammation  but the bone remains stable. These patients are said to have 'good bone" and this shows that periodontal disease susceptibility has a genetic  component.  If you have a parent who lost teeth to periodontal disease, that does not mean you will.  Even if you are genetically susceptible, plaque removal and proper dental care can keep your gums healthy. 

It makes sense that a gum infection could be treated with antibiotics and there are antibiotic regimens that can be used to kill destructive bacteria.  Usually this involves a course of two antibiotics used together for ten days or so at various intervals. 

Obviously, the removal of plaque is vital to the prevention and treatment of gum disease. The are many methods of removing plaque and the best one is the one that works for you. My choice is an electric toothbrush and Dental floss and or Soft Picks (made by Gum). 

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Please remember that information on these site is not all-inclusive and it may or may not apply to your situation and you need to call your own dentist.  A dentist needs to see the tooth, take and x-ray, etc. to diagnose and treat.   I cannot respond to email inquiries or phone calls.  Thanks for visiting!