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Periodontitis
is the most serious of the periodontal diseases, commonly
referred to as gum diseases. It is remarkably common in
adults over the age of 35, with some sources estimating that
up to one third of American adults (more than 50 million
people) suffer from some form of periodontitis.
Periodontitis is the number one cause of tooth loss in
adults, and is particularly prevalent in smokers and those
with complicating diseases such as diabetes and
osteoporosis. There are also some individuals who are
genetically predisposed to developing this disease.
Periodontitis
is the end result of a complex interaction between the
bacteria (or plaque) that accumulates on tooth surfaces and
your own body's efforts to fight this bacterial infection.
Everyone has bacteria in their mouth; if you follow normal
oral hygiene procedures (brushing and flossing) and see your
dentist regularly, under most circumstances these bacteria
live in balance with your body's defense mechanisms.
However, if the bacteria build up on the tooth near the
gums, and particularly if your body's defense mechanisms are
compromised, then an imbalance can arise and your gums will
become red and inflamed. This inflammation, if left
untreated, eventually results in damage to the ligaments and
bone which hold your teeth in place, and in the worst cases
can cause the teeth to become loose or to be lost.
In
its earliest stages, gum disease is referred to as
gingivitis inflammation of the gums. Every day a clear
sticky film called plaque builds up on the surface of the
tooth. Plaque is made up of bacteria and their secretions,
and it is easily removed by proper brushing and flossing.
However, if plaque is allowed to build up, then eventually
the gum tissue in contact with the plaque becomes red and
inflamed. You may have observed that sometimes your gums
bleed when you brush your teeth. This is because of the
inflammation, and is often the first sign that you have the
earliest stages of periodontal disease. In most cases, a
thorough professional cleaning from your dental
professional, and more attention to brushing and flossing
can reverse the inflammation and bleeding associated with
gingivitis.
If
the plaque is not removed, it hardens into deposits called
tartar, which cannot be removed by just brushing and
flossing. These deposits and their associated bacteria can
cause a more severe form of inflammation as your body tries
to fight the infection. One of the most important tools your
body has to fight infection are white blood cells, which are
loaded with substances designed to help the white cell get
out of the bloodstream and pass through the gum tissue to
then kill the bacteria. Some of these substances, known as
enzymes, have an unfortunate side effect they can attack
your body's own tissues.
In
the case of gum disease, the long-term, chronic nature of
the infection means that these tissue-destroying enzymes
build up. Eventually they start to eat at the ligaments and
bone which support your teeth. First, a small
"pocket" forms between the tooth and the gum where
food can be lodged and bacteria can live. If left
undisturbed, the bacteria will continue to cause
inflammation and tissue destruction, and they will gradually
move down the tooth surface. This results in tooth pockets
that get deeper and deeper. The depth of the pocket is a
good measure of the severity of your disease, and your
dentist will use a probing device to measure how deep your
tooth pockets are. Your dentist will also take radiographs
(X-rays) which show the extent of the loss of the supporting
bone. If pockets are deep and bone loss is evident, this
stage of gum disease is known as periodontitis.
Eventually,
if left untreated, the disease progresses to the point where
the bone loss is so severe that the tooth becomes loose, and
in the worst case, is lost. However, don't despair. If your
condition is treated early and aggressively by your dental
professional, it is possible to slow the progression of the
disease.
If
you suffer from periodontitis, there might be more at risk
than just your oral health. Obviously, loose or missing
teeth have an impact on your appearance and your
self-confidence, and may affect the types of food you can
eat. Restoration of your teeth can be costly and
time-consuming.
Recent
research has suggested that the effect of an untreated
infection such as periodontal disease may be far more
wide-reaching than just your mouth. For example, researchers
have identified a link between periodontitis and the risk
for a fatal heart attack or stroke. Indeed, untreated
periodontitis may be as significant a risk factor for heart
disease as elevated cholesterol!
In
other studies, pregnant women with untreated periodontal
disease were much more likely to have preterm babies with
low-birth-weights than were a control group of pregnant
women without the disease. Some very exciting preliminary
findings have suggested that this risk can be reduced if the
periodontal disease is treated. Other studies have suggested
that treating periodontal disease can have a positive impact
on the ability of those with diabetes to maintain proper
blood sugar levels.
As
stated in the 2000 U.S. Surgeon General's Report on Oral
Health, all of these findings suggest that, in order to
maintain optimum general health, you should also maintain
optimum health of your teeth and gums.
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