Transcript Dental Care and Periodontal Disease

From early infancy, the first
examination will be the first
in a life-long series of
regular dental visits.
Over the life of an
individual, the areas of
focus will change to reflect
his or her changing needs,
but the underlying purpose
remains constant: to
preserve healthy teeth
and gums for life.
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Dental experts recommend that the first
oral examination should occur at the
time the first tooth.
The baby teeth need proper care because
they will set the stage for the permanent
ones that follow.
 Of particular note is the importance of
informing the parents of the dangers of
"baby bottle caries" (tooth decay). This
condition usually occurs when the child is
put to sleep with a bottle containing sugary
liquid.
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During the toddler and
pre-school years exams
should focus on the
preservation of the baby
teeth. The teeth will be
examined for early signs
of decay and treated as
necessary.
Unfortunately, a recent
report from the Centers
for Disease Control and
Prevention (CDC)
indicates that decay is
on the rise in children
aged 2 to 5.
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The elementary school years coincide with the
development of the "mixed dentition,” a time when baby
teeth and permanent teeth coexist. The first permanent
molars come in at about the age of six. Examination may
disclose the need for sealants to prevent decay on the
biting surfaces of the molars and the other back teeth
which will appear between ages 6 and 12. When the pits
and fissures on the teeth are deep, tooth decay may
occur soon after eruption even with appropriate diet and
hygiene. Therefore, regular exams are exceedingly
important for the prevention of decay during this age
period. It is also important to monitor the timing and
sequence of the loss of the baby teeth and appearance
of the permanent teeth. Interventions may be required to
prevent crowding and facilitate the development of
proper alignment and "bite.”
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During the middle school years cavities can become a
greater problem as children have more control over their
diet. They may make poor choices, substituting sugary
snacks for healthy foods. The dental team should continue
to provide reinforcement of proper hygiene and diet and
provide treatment for cavities as necessary. At this stage
some children will require orthodontic treatment (braces)
to straighten their teeth. This period is also a good time for
a frank discussion between dentist, patient, and parents
about the negative effects of tobacco and oral jewelry.
Also during this period gum disease begins to occur with
increasing frequency. Some youngsters will get gingivitis
(inflammation of the gums) during puberty due to the
interaction of fluctuating hormone levels and dental
plaque.
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In the high school years and into early
adulthood concerns continue to include
tooth decay and gum (periodontal)
disease. The regular reinforcement of a
message of prevention including candid
discussions about risky habits continues to
be extremely important. At about the
age of 18 the third molars (wisdom teeth)
come in. Occasionally the area around
these teeth can become infected or
they may only come in part way or not at
all. This may mean removing them to
prevent further infection or other serious
problems.
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If regular preventive and
treatment services have
been a part of the
individual's childhood,
the adult years will be
reached with few
problems, healthy teeth,
and a winning smile.
However, many adults
will face an increasing
risk of gum disease. Dental
examination will thus
include screening for gum
disease and treatment if
necessary, but prevention
through good home care
remains the best strategy.
As one reaches the mature adult years systemic
medical conditions may compromise health. Every
oral examination should include a review of the
health history and medications taken, even nonprescription items. The mouth is the mirror of the body
and the dentist may detect systemic disease or note
changes in the progress of disease. Additionally,
medications can result in oral complications or affect
the body's response to oral disease. A classic
example is dry mouth (xerostomia), seen in several
disease states and with several medications.
Here are a few of the many health problems
that can be aggravated by poor oral hygiene:
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Stroke
› Those with adult periodontitis may have increased risk of stroke.
Respiratory Infections
› Inhaling bacteria from the mouth and throat can lead to pneumonia.
Heart Disease
› Those with adult periodontitis may have increased risk of fatal heart attack.
› And are more likely to be diagnosed with cardiovascular disease.
Severe Osteopenia
› Reduction in bone mass (osteopenia) is associated with gum disease and
related tooth loss.
› Severity has been connected to tooth loss in postmenopausal women.
Uncontrolled Diabetes
› Diabetes can contribute to bacterial overgrowth in the mouth.
› Smokers with diabetes increase their risk of tooth loss by twenty times.
› People with type II diabetes are three times as likely to develop periodontal
disease than are nondiabetics.
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Periodontal Disease (gum
disease) is caused by plaque,
a sticky film of bacteria that
constantly forms on the teeth.
If this plaque is not removed
on a daily basis, it will get
mineralized to form a stony
crust called calculus or tartar.
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is not possible for you to remove this
tartar (calculus) - your dentist will use
a special instrument called a scaler to
remove it. This bacteria creates toxins
that can damage
the gums and bone.
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Tobacco smoking or chewing
Systemic diseases such as diabetes
Some types of medication such as steroids,
some types of anti-epilepsy drugs, cancer
therapy drugs, some calcium channel
blockers and oral contraceptives
Bridges that no longer fit properly
Crooked teeth
Fillings that have become defective
Our mouths are full of
bacteria. These bacteria,
along with mucus and other
particles, constantly form a
sticky, colorless "plaque" on
teeth. Brushing and flossing
help get rid of plaque.
 Plaque that is not removed
can harden and form
bacteria-harboring "tartar"
that brushing doesn't clean.
 Only a professional cleaning
by a dentist or dental
hygienist can remove tartar.
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Periodontal (gum) disease is the most
common cause of tooth loss. Gums
gradually shrink as people age. After age
35, about three out of four adults are
affected by some form of gum disease.
 It is a slowly progressing infection and is
mostly painless in the early stages, and
hence most people do not pay any
attention to it till it is too late.
 However, it is a totally preventable disease,
and can be treated if caught early.
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Gingivitis is one of the first signs of
Periodontal Disease.
Some or all of the following signs may be present:
 Visible plaque/tartar build-up at the gum line
 Gums are red and puffy (swollen)
 Gums may bleed when you brush or floss
 Bad breath odor that doesn't go away
Bone and fibers holding your teeth in place have
not yet been affected.
 With treatment, gingivitis can be reversed.
Plaque spreads to the roots of your teeth
Infection continues to worsen
This infection has damaged the supporting
bone and fibers that hold your teeth in
place
 Gums may have begun to pull away from
your teeth forming a "pocket" below the
gum line, which traps food, bacteria,
plaque
 Immediate treatment can stop further
damage and tooth loss.
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Gingivitis may lead to more serious,
destructive forms of periodontal disease
called periodontitis which can damage
gums and supporting tissue.
Periodontitis is an infection of the underlying bone.
Periodontal disease is primarily caused by a "silent" and
"painless" bacterial infection of the bone and ligaments
which hold the teeth in place. Symptoms often do not
appear until later stages.
Some of the signs may be:
 Spacing between teeth
 Mobility of teeth
 Receding gums
 Pain or other discomfort
 When enough bone has been lost, the tooth will
become loose. The progress of the disease depends
on individual health and resistance to disease.
Normal, healthy gums
Healthy gums and bone anchor teeth
firmly in place. Normal gums are pink in
color and have a sharp outline.
Gingivitis
Gums red and swollen. Slight
separation of gum from teeth but
attachment to teeth still intact.
Periodontitis
Unremoved, plaque hardens into calculus
(tartar). As plaque and calculus continue to
build up, the gums begin to recede (pull away)
from the teeth, and pockets form between the
teeth and gums.
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Gums may
have begun to
pull away from
your teeth
forming a
"pocket" below
the gum line,
which traps
food, bacteria,
plaque.
Normal, Healthy
Gums and Teeth
Start of Gingivitis
Progression
into Periodonitis
Advanced
Periodonitis
(large pockets)
At this stage, gums recede further and
separate from the tooth.
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With advanced disease the
gums recede farther, destroying
more bone and the periodontal
ligament. Teeth — even healthy
teeth — may become loose and
need to be extracted.
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If periodontitis is left untreated,
then it can lead to Acute
Necrotizing Ulcerative Gingivitis.
The dentist will look around in your mouth.
 Notice any plaque or tartar build up on the bottom
or your teeth.
 Take x-rays to look at the teeth and bones for any
hidden damage.
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The removal of the plaque from the
tender gums may be uncomfortable. The
gums soreness and bleeding should
lessen within a few weeks.
 Medications can be given to reduce the
swelling of the gums.
 Warm salt water can reduce puffiness.
 It’s good to have strict oral hygiene.
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To prevent gingivitis you need to do is keep the
bacterial populations in balance by flossing,
brushing, and rinsing daily with an antimicrobial rinse which removes excess bacteria.
Professional cleanings during routine dental
visits remove excess tartar which harbors and
nurtures the proliferation of the undesirable
bacteria. If left unchecked, however, gingivitis
may progress to periodontal disease
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gums bleed when you brush your teeth
red, swollen or tender gums
gums have pulled away from the teeth
bad breath that doesn't
go away
pus between your teeth
and gums
loose teeth
a change in the way your teeth fit together
when you bite
Take another
look at the
Progression of
Gum Disease.
http://health.nytimes.com/health/guides
/disease/gingivitis/overview.html
 http://www.emedicinehealth.com/gingi
vitis/page7_em.htm
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