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Periodontics/Gum health


Periodontitis(gum disease) is due to a local inflammatory response reaction by the body’s natural defence system in response to pathogens found in the gum and surrounding structures.

These pathogens (bacteria) are naturally found in the mouth and live in harmony with other bacteria and organisms in a healthy mouth(over +- 700 species of bacteria in the mouth). When the oral environment shifts into a negative balance these pathogens increase in numbers and initiate a reaction from the host tissues. 

This shift in the oral environment is mainly caused by an accumulation of food debris and bacteria (plaque) which if left undisturbed (on and between the tooth surfaces) for a lengthened period creates a breeding ground for bacteria. The increased plaque deposits produce the ideal environment (tartar)for the more harmful bacteria to increase in numbers, releasing their harmful products (enzymes) that causes an over stimulation of the body’s defensive inflammatory response in the gums. 

This is a slow forming process that can take place over several years and as the disease progresses the inflammatory response becomes more chronic causing destruction to the tissues surrounding the tooth which includes the periodontal tissue as well as the bone. This leads to loss of support around the teeth and eventually tooth loss. 

Except for the destruction of supporting tooth structure and tooth loss patients can experience painful abscesses, difficulty eating (drifting of teeth) and very unsightly lengthening of teeth because of recession of the gum.

Another concern is that untreated periodontal disease have been proven to have an effect on the individuals general health (because of the spread of these harmful pathogens in the circulatory system to other organs) and increase the risk diabetes, heart disease and cause complications during pregnancy to name a few.

How do I know if I have Periodontitis (gum disease)?
Periodontitis is preceded by gingivitis (inflammation of only the gums). The gums will present as red and swollen, bleeding easily when brushing or eating. Normally one would recognise a layer of plaque on the teeth next to the swollen gums.

If the plaque is not properly removed and the gums left untreated the disease process will progress into periodontitis. This transition is not always evident but normally there would be signs which include bad breath, shifting in the position of the teeth, increased spontaneous bleeding of the gums and gum recession accompanied by “longer” looking teeth (smoking patients bleed less and it might be more masked).

Screening for periodontal disease is very important and at Bergvliet dental we try to incorporate a periodontal screening at every routine dental visit by taking appropriate x-rays and measuring the depth of the gum pockets around the teeth.This gives us the opportunity to detect the disease and treat it accordingly.

What are the risk factors for periodontal disease?
The following factors that can increase your risk of periodontitis include:

  • Gingivitis
  • Poor oral health habits
  • Smoking or chewing tobacco
  • Hormonal changes, such as those related to pregnancy or menopause
  • Recreational drug use, such as smoking marijuana or vaping
  • Obesity
  • Inadequate nutrition, including vitamin C deficiency
  • Genetics
  • Certain medications that cause dry mouth or gum changes
  • Conditions that cause decreased immunity, such as leukemia, HIV/AIDS and cancer treatment
  • Certain diseases, such as diabetes, rheumatoid arthritis and Crohn's disease

How can one prevent and/or treat periodontitis?
Oral hygiene is the key and by adopting thorough oral hygiene habits in combination with regular professional support (deep cleanings and screenings) periodontitis can be prevented and/or managed. 

Good oral hygiene practice includes:

  • Brushing twice a day with the correct size toothbrush and a good toothpaste
  • Cleaning between teeth (interdental spaces) by either using floss or interdental brushes at least once a day
  • Antibacterial mouth rinse as an additional measure to inhibit bacterial growth (optional)
  • Regular visits to your dentist and oral hygienist (every 6 months) to monitor your overall dental health and cleanliness of your teeth

With a good oral exam and proper periodontal assessment it is possible to manage and halt the process of the disease completely by eliminating the bacterial plaque and establish excellent oral hygiene programs. Regular follow ups and maintenance. We will do the following at the practice:

  • Professional cleanings by your dentist or oral hygienist
  • Effective oral hygiene instruction and practices to use at home
  • Reassessment every 4 – 6 months
  • Corrective surgical treatment if there are deposits under the gum and between the roots that is not possible to clean by other means (furcation areas)

The long-term success of periodontal treatment is dependant on both the efforts and treatment form us (your dental team) as well as your own efforts at home.  Periodontal therapy is a lifelong commitment and the frequency of visits needed will be dependant on the severity of the disease and your personal risk disease risk.