Dr. Mitchell Pohl
2900 N. Military Trail
Boca Raton 33431
South Florida Dentistry
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is gum disease?
Gum disease or periodontal disease, a chronic inflammation and infection
of the gums and surrounding tissue, is the major cause of about 70 percent
of adult tooth loss, affecting three out of four persons at some point
in their life.
causes gum disease?
Bacterial plaque - a sticky, colorless film that constantly forms on the
teeth - is recognized as the primary cause of gum disease. Specific periodontal
diseases may be associated with specific bacterial types. If plaque isn't
removed each day by brushing and flossing, it hardens into a rough, porous
substance called calculus (also known as tartar). Toxins (poisons) produced
and released by bacteria in plaque irritate the gums. These toxins cause
the breakdown of the fibers that hold the gums rightly to the teeth, creating
periodontal pockets, which fill with even more toxins and bacteria. As
the disease progresses, pockets extend deeper and the bacteria moves down
until the bone that holds the tooth in place is destroyed. The tooth eventually
will fall out or require extraction.
some factors increase the risk of developing periodontal diseases?
Yes, some factors can increase the risk of developing periodontal diseases.
If one or more of the following apply to you, it is especially important
that you practice good oral hygiene and follow your dentist's advice to
maintain healthy teeth and gums.
- People who smoke
or chew tobacco are more likely to have periodontal disease. And
it's more likely to be more severe than in those who do not use any
- Some systemic
diseases, such as diabetes, can lower your body's resistance to
infection, making periodontal diseases more severe.
- Many medications,
such as steroids, some types of anti-epilepsy drugs, cancer therapy
drugs, some calcium channel blockers, and oral contraceptives can affect
the gums. In addition, medications that reduce your salivary flow can
result in a chronically dry mouth, which can irritate your oral soft
tissues. Let your dentist know about your medications and update your
medical history files at the dental office when any changes occur.
- Bridges that
no longer fit properly, crooked teeth or fillings that have become defective
can contribute to plaque retention and increase your risk of developing
- Pregnancy or
use of oral contraceptives increases hormone levels that can cause
gum tissue to be more sensitive to the toxins and enzymes produced by
plaque and can accelerate growth of some bacteria. The gums are more
likely to become red, tender and swollen, and bleed easily.
there other factors?
Yes. Genetics is also a factor, as are lifestyle choices. A diet low in
nutrients can diminish the body's ability to fight infection. Smokers
and spit tobacco users have more irritation to gum tissues that non-tobacco
users, while stress can also affect the ability to ward off disease. Diseases
that interfere with the body's immune system, such as leukemia and AIDS,
may worsen the condition of the gums. In patients with uncontrolled diabetes,
where the body is more prone to infection, gum disease is more severe
or harder to control.
are the warning signs of gum disease?
Signs include red, swollen or tender gums, bleeding while brushing or
flossing, gums that pull away from teeth, loose or separating teeth, puss
between the gum and tooth, persistent bad breath, change in the way teeth
fit together when the patient bites, and a change in the fit of partial
dentures. While patients are advised to check for the warning signs, there
might not be any discomfort until the disease has spread to a point where
the tooth is unsalvageable. That's why patients are advised to get frequent
does periodontal treatment involve?
In the early stages, most treatment involves scaling and root planning
- removing plaque and calculus around the tooth and smoothing the root
surfaces. Antibiotics or antimicrobials may be used to supplement the
effects of scaling and root planning. In most cases of early gum disease,
called gingivitis, scaling and root planning and proper daily cleaning
achieve a satisfactory result. More advanced cases may require surgical
treatment, which involves cutting the gums, and removing the hardened
plaque build-up and recontouring the damaged bone. The procedure is also
designed to smooth root surfaces and reposition the gum tissue so it will
be easier to keep clean.
do you prevent gum disease?
Removing plaque through daily brushing, flossing and professional cleaning
is the best way to minimize your risk. Your dentist can design a personalized
program of home oral care to meet your needs. If a dentist doesn't do
a periodontal exam during a regular visit, the patient should request
it. Children also should be examined.
is the role of the general dentist?
The general dentist usually detects gum disease and treats it in the early
stages. Some general dentists have acquired additional expertise to treat
more advanced conditions of the disease. If the general dentist believes
that the gum disease requires treatment by a specialist, the patient will
be referred to a periodontist. The dentist and periodontist will work
together to formulate a treatment plan for the patient.
Sticking to a regular oral hygiene regimen is crucial for patients who
want to sustain the results of therapy. Patients should visit the dentist
every 3-4 months (or more, depending on the patient) for spot scaling
and root planning and an overall exam. In between visits, they should
brush at least twice a day, floss daily, and brush their tongue. Manual
soft nylon bristle brushes are the most dependable and least expensive.
Electric brushes are also a good option, but don't reach any further into
the pocket than manual brushes. Proxy brushes (small, narrow brushes)
are the best way to clean in between the recesses in the teeth, and should
be used once a day. Wooden tooth picks and rubber tips should only be
used if recommended by your dentist.
Reprinted from AGD.
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Palm Beach County Southern Florida
2900 N. Military Trail, Suite 105
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