Patient Focused Explanation of Periodontal Disease
When describing periodontal disease to a patient, I would want to make sure they understand that it is not just a disease of the gum tissue, but the most important effects of it is the possibility of permanent bone loss. I would explain the different types of periodontal diseases first.
Gingivitis is the first type of periodontal disease. It is the disease of the gum tissue that surrounds the teeth. The visual signs of gingivitis can be seen from 4-14 days after the plaque accumulates on the gumline. The two types are acute and chronic gingivitis. Acute is the disease that last for a short period of time, while chronic gingivitis can lasts months or even years. We all have what we call pockets around each tooth. A pocket is much like what it looks like when a woman wears a turtleneck shirt. We measure what would be the space between the neck and the shirt. We would measure down to her shoulder. This is what we call a ‘pocket.’ A healthy pocket would measure 1-3 mm in depth. When a person is diagnosed with gingivitis, the pocket depths are greater than 3 mm. This is due to the gums swelling, which is like the turtleneck getting swollen up towards the head. At this point in periodontal disease, the effects are reversible with a professional dental cleaning and good home care.
The other type of periodontal disease is Periodontitis. This is the step after gingivitis. Periodontitis is gum damage and bone loss that is permanent. This part of the the disease has all the same consequences of gingivitis, except now, the gums start to recede down the tooth and the bone begins to drop as well. Bleeding is often a sign of periodontal disease, but not alway. I would explain that just because a person doesn’t bleed, does not mean they have healthy gums. Their pockets are 4 mm or greater.
Gingivitis can be caused solely from plaque, plaque and modified my systemic factors such as pregnancy, plaque and medications such as seizure medications, or plaque and malnutrition. Gingivitis can also be induced by specific bacteria.
The body’s immune response to the plaque buildup is the primary cause of the damage seen in periodontitis. Other contributing factors of periodontal disease include calcified plaque, cavities, rough fillings, traumatic events, crown overhangs and faulty restorations. It is important to note that these factors only increase the contribute to periodontal infection, it does not start it.
Among types of periodontal disease, there are systemic diseases that contribute to our oral health. These can me blood or genetic disorders. One example of a blood disorder is leukemia. There are many genetic disorders such as Down Syndrome, Cohan Syndrome, Glycogen Storage disease and Hypophosphatia are just a few. These are considered the major predisposing factor of the periodontal disease.
FAQ
1. Can my periodontitis be restored back to perfect health? No. Periodontitis is irreversible. Once we lose our bone in our mouth, it can only be stopped and maintained, it cannot regrow. Gingivitis, which only effects our gums, can be reversed.
2. How can I reverse gingivitis? An individual can reverse a diagnosis of gingivitis with a thorough professional dental cleaning and improved at home oral health. Daily flossing, thorough brushing and a mouth rinse would be a great place to start.
3. How can I stop the periodontitis/bone loss now that I am aware? This is an excellent observation. While we cannot reverse the effects of periodontitis, we can slow down or maintain their current bone level. The same way to reverse gingivitis, with a thorough professional dental cleaning and improved at home oral health. Daily flossing, thorough brushing and a mouth rinse would be a great place to start. It is possible that we incorporate an interproximal aid for new at home care.