It has been estimated better than 75-80% of Canadians have some form of gum disease, which has been linked to serious health complications and causes various dental problems most of which are often avoidable. There are thousands of multi-center, peer reviewed studies which demonstrate a direct correlation between the presence of gingivitis and periodontal disease and the increased the risk of heart disease and stroke due to the high levels of pathogenic bacteria which have been isolated in inflamed, bleeding gingival tissues. As the level of periodontal disease increases, so does the risk of cardiovascular disease. Numerous other studies have also show that there is a well-established link between poor oral hygiene and oral cancer, bone loss, strokes, hypertension, kidney and liver disease as well as Type 2 Diabetes. Research also indicates that pregnant women with periodontal disease are three to five times more likely to have a baby born preterm compared to women without any form of gum disease. Women are more susceptible to gingivitis when pregnant and should follow their regular brushing habits, and continue with dental cleanings and examinations. Because this is such a serious issue, Dr. Willoughby and our staff offer complimentary checkups to any of our pregnant female patients.
What is Gum Disease?
Periodontal disease, also called gum disease, is mainly caused by bacteria from plaque and tartar build up. What is plaque? Plaque is that soft, sticky, and colorless deposit of “fuzzy film” that is continually forming on our teeth and gums. Often undetected, plaque attacks the teeth and gums with the acid it produces from bacteria in your mouth. The bacteria uses the sugars from foods and beverages along with saliva, to thrive and multiply. This acid attack breaks down the tooth’s enamel, causing tooth sensitivity and ending with varying degrees of tooth decay. Plaque is also responsible for gum disease and contributes to bad breath.
Other factors that have the potential to cause gum disease may include:
- Tobacco use
- Clenching or grinding your teeth
- Certain medications
- Excessive Alcohol
Types of Gum Disease Include:
- Gingivitis – The beginning stage of gum disease and is often undetected. This stage of the disease is reversible.
- Periodontitis – Left untreated gingivitis may lead to this next stage of gum disease. With many levels of periodontitis including mild, moderate and advanced, as well as acute, chronic and suppurative, the common outcome is a chronic inflammatory response – a condition when the body breaks down the bone and tissue in the infected area of the mouth, ultimately resulting in tooth and bone loss.
Signs of Gum Disease Include:
- Red, bleeding, and/or swollen gums
- Mobility of the teeth
- Bad Breath (Halitosis)
- Tooth sensitivity caused by receding gums
- Abscessed teeth
- Tooth loss
Brushing and flossing are an essential part of maintaining good oral hygiene but they are not always enough. Plaque, tarter and biofilm buildup around and below the gum tissues which can only be removed by a professional cleaning performed by either a Dentist or hygienist.
In patients with pre-existing heart disease, a condition called Bacterial Endocarditis can lead to serious cardiac complications when pathogenic bacteria in the mouth (can be disrupted from a simple Dental procedure) and get into the blood stream infecting the lining of the heart muscle. During dental treatment, a common organism found in the mouth known as Streptococcus Viridan may enter the bloodstream and travel to the heart. This may cause infected blood clot formations that are able to travel to the brain, lungs, kidney liver and spleen. Dangerous medical conditions that may result from bacterial endocarditis include: neurological changes, brain abcesses, , jaundice, kidney disease, severe valve damage, irregular heartbeats and stroke.
Researchers have identified numerous pathogens associated with gum disease which are known to carry an increased risk of developing heart disease. Although these pathogens have been identified, the findings of this study suggest the total count of bacteria — regardless of its type — has a greater impact on the health of the heart. And that’s another reason our office recommends regular dental cleanings to prevent gum disease and minimize the amount of bacteria in the mouth. Regular checkups and cleanings can prevent these problems as well as provide you with good oral hygiene.
Professional cleaning (also known as Prophylaxis, literally means a preventative treatment of a disease) is a procedure designed to remove plaque, tartar (mineralized plaque) stain deposits which build up over time and which the patient cannot get rid of on their own.
Dental Cleanings give the Dentist and Hygienist the opportunity to identify potential problems with your teeth and gums early on. Prevention and early detection of dental and gum conditions will help you maintain your teeth, save you time, money, and the discomfort of periodontal disease. Early diagnosis and treatment leads to interceptive, less invasive therapies which can be designed to correct problems before they get out of control.
To maintain optimal dental health Dr. Willoughby recommends you get a regular dental checkup and cleaning two times a year. If your gums are “puffy” or swollen and bleed when you brush or floss or your gums have receded and you have sensitive exposed roots then you may have periodontal disease. You will need to get this periodontal infection treated and under control and this can mean dental cleanings three or sometimes four times per year.
The Dental cleaning is usually performed by a certified dental hygienist, and should at a very minimum include scaling, root planning and polishing.
This is the removal of plaque and tartar from all tooth surfaces. Dental hygienists perform traditional scaling by hand. Advances in technology have led to more modern methods such as ultrasonic scalers which allow dental cleaning to be done quicker and more efficiently. For best results both ultrasonic and manual scaling methods should be should used by the Hygienist.
This involves placing hand scalers called “curettes” down into the periodontal pockets surrounding the teeth and gently scraping away the bacterial endotoxins, tarter and stain deposits which form on the root surface of the tooth. This debridement of the periodontal pocket is a non-surgical procedure sometimes done with the help of local anesthetic and is especially helpful in preventing or at least slowing the progression of moderate and advanced periodontal disease. Depending on the degree of difficulty root planning sessions can take several dental visits and require more frequent recall visits.
If heavy tenacious stain deposits are present on either the enamel or the root surfaces then often time a mechanical Prophy-Jet polishing system is utilized to literally sandblast the stain away. Despite its name the “Prophy-Jet” system does not truly “polish” the teeth as much as it micro-abrades the tooth surface. Care must be taken when using a Prophy jet because, over time it can and does erode enamel and cementum.
is usually the last thing done at a Dental Cleaning appointment prior to the application of a fluoride gel/foam or liquid rinse. There are two kinds of polishers, a) a mechanical system called a Prophy Jet polishing & rubber tip polishing with Prophy paste. Prophy Jet polishing works by spraying high pressured water mixed with baking soda paste onto the surface of your teeth. This powered water can wash away the residue and plaque while the baking soda removes the brown and yellow stains and neutralizes the acidic conditions in your mouth. Rubber cup polishing employs a low-speed hand piece with a rubber cup tip mounted on the top that contains a polishing paste that is made of abrasive ingredients ideal for removing stains.
The amount of time needed for dental cleaning depends on factors such as plaque deposits, complication of dental restorations, and your gingival health. People with more tartar and plaque buildup need longer appointments than those who have relatively cleaner teeth. In a moderate case dental cleaning should take about 25 to 30 minutes. Cleaning should be performed every six months to prevent excessive plaque buildup. Lack of cleaning allows the growth of plaque which if left unchecked can lead to the various types of conditions involved in tooth decay.
With the latest research pointing towards the damaging effects of biofilm the first thing our Hygienists do for their patients is polish away as much of the bacterial biofilm as possible. Next the ultrasonic scalers are used and the tissue are manually irrigated with a chemotherapeutic solution.
The very latest research had shown that a large part of managing periodontal disease now involves the removal and control of dental bio-films and there are now new ultrasonic and piezoelectric handpiece technologies specifically designed to disrupt these bio-films and flush out the pockets using chemotherapeutic agents such as Chlorhexidine, Silversol and hydrogen peroxide.
Treatments for Gum Disease
Depending on the type of gum disease, some of the available treatment options are:
- Removal of plaque and calculus by way of mechanical and manual scaling done by your dental hygienist or dentist.
- Medications such as chlorhexidine gluconate, or Silversol with hydrogen peroxide – which are mouth rinses prescribed by your dentist to help kill the bacteria in your mouth, along with frequent cleanings.
- Sub-gingival irrigation of the infected tissues using the above noted medications.
- Use of a diode or erbium laser to help kill bacterial bio-film in the pockets.
- Use of take home mouth trays with can be worn at night time and loaded with wound healing, disinfectant gels like Silversol to further combat bacterial bio-films.
Surgery may be necessary in certain cases to stop, halt, or minimize the progression of periodontal disease. With new guided tissue membrane procedures, Surgery can also be use to replace bone and restore more natural contours that were lost in advanced stages of the disease.