There are two classifications of periodontal diseases based on the severity of the disease: gingivitis and periodontitis. Gingivitis is a gum infection caused by bacteria and plaque, it affects only the gums and is reversible. Gingivitis, however, may lead to more serious harmful forms of periodontal disease called periodontitis. Periodontitis is one of the main contributors to premature tooth loss.
You may have periodontal disease and have none of these symptoms. This is where regular dental checkups, your dentist and hygienist play a pivotal role in diagnosis and prevention. Periodontal disease is an infection of the gums and supporting bone as a result of high levels of bacteria that start a release of tissue-destroying enzymes. There is a part of your gum that is actually not attached to your teeth. It is a shallow v-shaped crevice between the tooth and gum and is called a sulcus. Gum disease attacks the area within the sulcus just below the gum line. The disease causes a breakdown of the attachment of the tooth and its supporting tissues. As the disease progresses the tissues are damaged and the sulcus now becomes a pocket. Typically, the more severe the disease or infection, the greater the pocket depth. Treatment is aimed at stopping further damage and reversing the progression of the disease.
To help further educate our patients on the topic of gum disease, we’ve provided the articles below.
Are Your Gums Healthy? What is Gum Disease?
Are your gums in a healthy state or are you suffering from gum disease? This is something that you need to know the answer to, but probably don’t. However, the CDC reports that 47% of adults in the US suffer from gum disease, making it one of the most common oral health problems in the US.
Unless you have been diagnosed by your dentist, you probably don’t know if you are suffering from some form of gum disease (also known as periodontal disease) or not. The reason for this, is that periodontal disease does not present many signs or symptoms. The few you can look for include unexplained bleeding while brushing or flossing, and your gums appearing bright red and inflamed.
If you notice either of the above signs, you should schedule a dental appointment ASAP. Your dentist’s office will have specialized tools to determine the health of your gums. Additionally, these tools will determine how far your gum disease has developed and what treatment is necessary. The earlier you catch gum disease, the better off you will be, as, if you let gum disease develop too far, it will not be able to be fully cured. Your dentist will be able to put together a personalized treatment plan to improve the overall health and wellness of your gums. Please note that a treatment plan may include the work of a periodontist.
Determining if you have periodontal disease, and receiving necessary treatment, is critical for your oral health. Along with this, gum disease has been associated with many other diseases including:
- Cardiovascular Disease
- Rheumatoid Arthritis (RA)
As with any health issues, you are better off preventing periodontal disease from ever forming. Gum disease can be usually avoided by following instructions below:
- Brush twice per day for two minutes
- Floss daily
- Brush your tongue, roof of your mouth, and gums
- Use mouthwash
If gum disease does develop, there is treatment available, such as scaling and root planing, also known as a deep cleaning.
What is the Difference Between Gingivitis and Advanced Periodontitis?
Although gingivitis and advanced periodontitis both affect your gums, they are two different health issues.
Your teeth are held in position by a number of things including bone tissue, ligaments, and your gums. If you do not properly care for your teeth, plaque can begin to form around your gums. Your gums begin to retreat and create “pockets.” These pockets allow for more bacteria to build up. This is gingivitis.
There are different severities of gingivitis, which is tested by measuring the deepness of the pockets around your teeth. You generally want pockets that are 1-3mm deep. Your pockets will be deeper if you have an infection.
Gingivitis, if left untreated, can form advanced periodontitis. Advanced periodontitis occurs when plaque and tartar infect your gums and begin to deteriorate the soft tissue that supports your teeth. If you do not treat advanced periodontitis, it can begin affecting the bone of your tooth. When this happens, the tooth is at risk of needing an extraction.
For minor plaque buildup, Dr. Aerni will be able to clean away the bacteria before it advances. If you are in a more advanced stage, a procedure called “scaling and root planing” will be done to clean around the gums and below your gums to remove tartar.
A Deep Cleaning - What is Scaling and Root Planing?
If you have developed gum disease—whether you have been properly caring for your teeth, or neglecting them—there is treatment available. How far your gum disease has advanced will determine what type of treatment your case demands. The most common form of treatment for gum disease is a deep cleaning. This type of cleaning will be necessary if you develop gum disease, as your regular cleanings will no longer properly clean your teeth and gum line.
Deep cleanings utilize special tools and techniques and include two steps: scaling and root planing.
The first step, scaling, removes tartar and plaque from the surface of your tooth and beneath your gum line.
The second step, root planing, is a process of carefully smoothing the surface of your tooth’s root to decrease inflammation, and shrink the pockets that have formed in your gums. If these pockets are left untreated, they will continue to allow plaque and tartar to build up under your gums and on your gum line.
Typically, a deep cleaning will require 2-4 visits to your dentist, and also may involve a local anesthetic during treatment.
Unfortunately, if your gum disease has developed too far, it cannot be fully cured, only treated. Gum disease is a systemic disease, very similar to diabetes or high blood pressure (HBP). After you have received a deep cleaning, it is important to continue treatment and schedule routine cleanings at Aerni Dental. If you do not receive routine cleanings, gum disease can cause tooth loss, loss of jaw bone, and lead to many other health problems.
What Is the Oral-Systemic Link?
It’s frequently said that the mouth is the gateway to the body. More and more, medical professionals have been discovering just how true this really is. This is referred to as the oral-systemic link.
Dentists are often the first to detect conditions such as Crohn’s disease, diabetes, or cancer because the early symptoms may first show up in the mouth. Going in the other direction, we’re learning more and more how what happens in your mouth affects the health of the rest of your body.
The brain has the blood-brain barrier which protects it from toxins in the blood. In our mouths, there is a barrier between our gums and teeth and the rest of our body as well. In the case of periodontal disease, this barrier can break down and may cause disease or other problems in the rest of the body. Previously, it was thought that bacteria were the main factor in this, but more recent research has been indicating that inflammation may play a bigger role.
While the details of this connection between oral health and the health of the rest of the body is still being explored, it’s becoming increasingly clear that treating the inflammation of periodontal disease can help with the treatment of other inflammatory conditions (and, in some cases, vice versa).
Diseases with oral connections
Some conditions with strong connections to oral health include:
Diabetes - Gum disease can make diabetes harder to control, and diabetes can exacerbate gum disease. We explore the topic in more detail on the linked page, here.
Heart disease and stroke - Conditions causing chronic inflammation, such as periodontal disease, have connections to the likelihood of heart disease and stroke. Read more about them on the page dedicated to the topic, here.
Respiratory disease - The bacteria that grow in the mouth can find its way into the lungs as well. Respiratory diseases, such as pneumonia, can be caused by the same bacteria responsible for periodontal disease.
Cancer - According to the American Academy of Periodontology, those with periodontal disease were more likely to develop cancer than those without:
-54% more likely to develop pancreatic cancer
-49% more likely to develop kidney cancer
-30% more likely to develop blood cancers
Other diseases that may be caused or complicated by oral infections include:
- Breast cancer
- Prostate cancer
- Weight gain
- Alzheimer’s and dementia
- Low birth weight and premature birth
- Rheumatoid arthritis
Some diseases can influence your oral health, as well, such as osteoporosis. Osteoporosis can lead to bone loss in the jaw which, in turn, can result in tooth loss, as there is no longer sufficient bone to support the teeth.
It’s critical to understand how important oral health truly is to our wellbeing, and to take it seriously in order to help prevent, or reduce the effects of other conditions.
Below, we’ll look at some of these conditions in a little more detail.
The health of your mouth and the rest of your body are linked, and there’s an especially strong connection when it comes to diabetes and periodontal disease. For those who are suffering from diabetes, gum disease is often more likely and cases can be more severe.
How is diabetes linked to gum disease?
Diabetes is a disease that occurs when the amount of glucose, or blood sugar, in the body is too high. A hormone known as insulin is responsible for helping the cells in your body to use this glucose for energy. For those with diabetes, the body doesn’t produce enough insulin, so too much glucose stays in the bloodstream.
Inflammation in the mouth, such as the type responsible for periodontal disease, have an impact on the body’s ability to regulate blood sugar levels as well. This means that people with diabetes, whose bodies are already struggling with processing sugar, can find themselves having an even harder time if they are suffering from gum disease.
This link can go both ways, too, as high blood sugar levels provide an environment that can make gum infections more likely,
Heart Disease & Stroke
The potential links between periodontal disease and heart disease and stroke have been the subject of medical research in recent years. While a clear cause-and-effect relationship has yet to be established, findings lend a lot of credibility to the connection between oral inflammation and cardiovascular disease.
Researchers have found that chronic inflammation in the body is a major contributor to health problems in the body. This means that long-term inflammation, such as that in gum disease, may lead to narrowing or blockages in blood vessels—a situation that can lead to a heart attack or stroke.
In an article that looked at a number of related studies, it was found that having periodontal disease increases a person’s risk of cardiovascular disease by around 20%. One stroke expert reported that periodontal disease could make a person almost twice as likely to experience a stroke.
While research is still ongoing, what’s already been discovered should only put more emphasis on the need for a healthy mouth and gums.
If you have any concerns about the health of your mouth, or if you haven’t had a dental appointment in a while, make sure to get in touch to schedule your next visit.
Links have been established between gum disease and many types of cancers.
Studies performed at Brown University Harvard New York University and others have looked into the link between gum disease and pancreatic cancer. Pancreatic cancer is extremely hard to detect and causes death within six months of diagnosis. It is approximated that pancreatic cancer is responsible for nearly 40,000 deaths per year in the US. So, what is the connection between gum disease and pancreatic cancer?
The connection comes from changes in the microbial mix in your mouth. Those who have porphyromonas gingivalis in their mouth were at a 59% higher risk of developing pancreatic cancer. In addition to prophyromonas gingivalis, those who had aggregatibacter actinomycetemcomitans were one 50% more likely to develop pancreatic cancer.
While the names may not mean much to the average person, the important thing to understand is that both of these types of bacteria have been tied to gum disease.
Unfortunately, the majority of Americans do not take proper care of their gums. It is reported that nearly half of American adults over the age of 30 have some form of periodontal disease. If you look at Americans over the age of 65, the percentage suffering from periodontal disease increases to 65%. Although not nearly as talked about, gum disease is almost 2.5 times more common than diabetes.
However, there is some good news! Gum disease responds extremely well to treatment and can easily be reversed after detected by your dentist.
A study done by the Federal University of Santa Maria Dental School in Brazil found that women with periodontitis are 2-3x more likely to develop breast cancer. In this instance, the researchers believe that breast cancer may be triggered due to systemic inflammation resulting from gum disease.
The study was based on 67 women who have been diagnosed with breast cancer and 134 controls from 2013 to 2015. It is important to remember that this study has not proven that gum disease causes breast cancer, but the findings do provide further support for the idea that oral health is vital to our overall wellbeing.
In the United States, for every 100,000 women, there are 124.9 new cases of breast cancer. Breast cancer continues to be studied, and this possible connection to oral health provides another avenue to be explored when learning to treat this type of cancer.
A 10-year study performed by NYU Langone Health’s Perlmutter Cancer Center has found that two types of bacteria that are present in individuals with gum disease can increase the chances of being affected by esophageal cancer.
The eight most common type of cancer in the world, esophageal cancer can be highly fatal and is the sixth most common cause of cancer-related deaths. In the US, it affects around 1 in 125 in men and 1 in 417 in women. The American Cancer Society says that currently, only around 20% of those diagnosed with this form of cancer will live for more than five years following diagnosis.
The study by NYU Langone found that bacteria associated with periodontal (gum) disease can find its way into the upper digestive tract, and in the case of one of the types of bacteria in the study, tannerella forsythia, its presence may increase the chances of this kind of cancer by 21%.
It is important to note that while the bacteria involved demonstrates a link between gum disease and esophageal cancer, it has not yet been proven that periodontal disease directly causes the cancer. However, the connection should be reason enough to reinforce the importance of proper oral hygiene and treatment of gum disease.