Understanding Periodontal Disease
I often get a lot of questions about periodontal disease. Today, I am going to go over some of the common questions I get about periodontal disease.
What is Periodontal Disease?
Periodontal disease also has another name: gum disease. Periodontal disease and gum disease are the same thing, just two different names. Where the gums are pink and tight, this is the picture of healthy gums. As it progresses, the gums are starting to turn red and puffy right before the gums start to recede. This stage right is what's called gingivitis, or puffiness, or inflammation of the gums.
Usually, at this stage, patients can experience bleeding, but they won't necessarily know where the bleeding is coming from. Most patients will brush, then rinse, swish, and spit, and that's when they will see some blood when they spit. That is one of the symptoms that a patient will see when the gums go from healthy to gingivitis. This is the stage right before gum disease or periodontal disease.
There are different stages to gum disease, and that is the hallmark of gum disease when the gums start to recede. This would be early stage periodontal disease or gum disease, middle stage periodontal disease, and then late stage. Once a patient gets to late-stage gum disease, usually one of the symptoms they'll report to me is, "I don't know what's going on, but my tooth or my teeth are starting to feel loose or they feel like they're moving." That's because enough gums that are holding onto our teeth have receded so much that there's not very much holding onto the teeth to make them steady. That is how a patient goes from healthy to gingivitis and can progress through the different stages: early, middle, and late-stage gum disease.
What are the causes for periodontal disease?
The main cause would be buildup. Here you see this speckled yellow stuff, which would be hardened plaque. If any of you out there are normal and allow dishes to sit in the sink and get crusty when you're too lazy or too tired, the food gets hard and stuck on the plate.
Once you're finally in the mood or feel like doing the dishes, you have two choices. You can either soak them in super hot soapy water for a long time, which we cannot do with our mouths or with our patients, or you have to sit there and use the rough side or a Brillo pad and scrub the dish or the pots and pans. Food acts the same way on our teeth. Plaque is just a fancy word for chewed-up food that's staying around our teeth. The longer food has the opportunity to sit on any surface, just like with those crusty dishes, the harder and more stuck the food will get.
Once food starts to get hard and stuck, even if you try brushing with all your might, it's like trying to clean those crusty pots and pans with a soft sponge. It's not going to work. After you rinse the dish, you feel the surface to make sure you got all the stuck-on hard food, but if you miss a spot, it feels like a small little pebble. That stuck-on plaque or tartar feels like small pebbles stuck around and underneath the gums, just like what you felt on those dishes.
I tell my patients that gums are like people. You irritate them long enough, they're just going to want to run away. That's why the gums are starting to recede. The best way to handle gum disease or prevent gum disease is to go to your dentist to get your regular checkups and cleanings, so we can clean whatever you miss when you're brushing and/or flossing or water picking. Together, we can help you stay here.
It's a cycle, just like when you eat off your dishes. You eat off your dishes, the dishes are dirty, and then depending on how long or how short of a time span it takes you to clean them. If it's a shorter time span, it's a lot easier to clean. If it's a longer time span and the food has been allowed to sit there, then it's more difficult to clean. It's the same thing with our teeth.
If you want easier, friendlier dental appointments, go see your dentist on a regular basis. Those are the type of dishes you clean right away. If you've left the dishes in the sink for a while, then it's going to be a little more difficult, and that's when the dentist or the hygienist will often recommend a deep cleaning.
What other conditions are connected to periodontal disease?
There's enough research out there to correlate or link gum disease with diabetes. It's like the question, which came first: the chicken or the egg? We don't know, but chickens and eggs are related to each other.
Often, when a patient has diabetes, they will have gum disease. Just like diabetes, they're almost very similar. Once a person has diabetes, there's no cure for diabetes, but that person can live a very normal and healthy life if the diabetes is kept under control through medication. Same thing with gum disease. Once a patient has gum disease, there's no cure for it. The gums will never grow back up on their own. There's no cure for it.
However, there are plenty of people out there with controlled gum disease, meaning it's not getting any worse. The gums are no longer red and inflamed. They're no longer continuing to recede. We've been able to maintain and stop the progression of gum disease. But just like the patient with diabetes, we need to continue to maintain it. Often, because there is enough research to show, I have patients that have dental insurance.
Once they show the official diagnosis that they have diabetes, their dental insurance will actually cover periodontal maintenance or cleanings four times a year because there has been enough research to show that those two conditions are often linked. A patient with diabetes usually will have gum disease, and often I have had patients come in here, we've done a deep cleaning, and it hasn't gotten better. That's what makes me suspect it may be a more systemic condition, and that's when I've recommended that patient to go see their physician and check them out for diabetes.
Usually, after a deep cleaning and laser therapy, if the inflammation and bleeding haven't gone away, that clues me in as their dentist to have them get checked out by their physician because it might be something from their diabetes causing this. Once the diabetes is under control and the patient is coming in for their regular checkups and cleanings, then we can also get the gum disease under control.
Can periodontal disease be cured?
That one's a tricky one. Yes and no, depending on what your idea of the word cure is. Periodontal disease can be stopped, meaning the progression of it, but once the gums have receded, they will stay at that new lower level. Once the patient has gums that have receded, they officially have gum disease. The trick is to stop the gums from continuing to recede.
If gum disease is under control, then the gums go back to this nice pink and tight color. The gums are no longer puffy. The gums are no longer inflamed or puffy. They're no longer bleeding. They're no longer receding. It's just under control. In a sense, that is a cure in that the disease is not progressing.
But if your idea is, "Okay, my gum disease is cured, my gums are going to go back to that same level before they've receded," that is not possible without gum surgery where we do a gum graft. We'll take gums usually from the roof of the mouth, transfer that piece of gum to where the gums are missing now because it's receded, and that is called a gum graft surgery.
Are deep teeth cleanings painful?
Teeth cleanings, deep cleanings, laser treatment—are they going to be painful? The answer again depends on the degree of damage. If you're healthy, again, I'm going to go over with the skin because we've all experienced paper cuts, scrapes, and things like that. Paper cuts are shallow, very small damage. It stings, it's annoying, but it heals quickly because it's shallow. That would be like gingivitis. We clean you up, gums spring back to the level they are, the inflammation goes down, there's no more bleeding.
Then, when you have different stages of gum disease, the cleaning is not painful. It's the condition that the gums are in. If you've scraped your arm, like if I were roller skating and I scraped my arm and it's a large wound, and I have asphalt encrusted in my skin, I hated that. When I went to wash it, just the water touching my skin because it was so damaged hurt. The water isn't painful. It's just the condition of my wound is much larger and deeper, so cleaning it off, the initial part of healing hurt. It's the same thing.
Depending on the degree of damage, that will give you a good idea of what you can expect to feel. When we see patients having any stage of gum disease, we don't want the treatment to be painful. So, automatically, we will numb our patients so that during the treatment all you can expect to feel is pressure, like pressing on my hand just like this during the treatment.
Once the numbing wears away, depending on the stage of gum disease, you may feel some soreness, that feeling like, "Yep, I definitely went in and got some dental work," but it should not be painful.
At Sunbrite Dental, your dental health is our priority. If you have any questions, don't hesitate to call our team at (702) 819-0866, or you can email us at [email protected]. Our staff would love to talk with you!
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