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Gingivitis is simply inflammation of the gum tissue in the mouth. It is a reversible, non-destructive form of periodontal disease. While there are many causes of gingivitis, the

Gingivitis Marielaina Perrone DDS

Gingivitis Can be Prevented!

number one cause is poor dental hygiene.

Gingivitis can arise as -a side effect to medication, surges in hormones, mouth breathing, dry mouth,poor nutrition, disease state, tobacco use, or poor oral hygiene. When hygiene is insufficient, bacteria in dental plaque release acids that stimulate the inflammatory response by the body. This in turn cause the gums to appear puffy, red, and bleed easily upon brushing. It takes some work to restore the gums back to a healthy state. Frequent professional cleaning along with regular tooth brushing and flossing can help to remove plaque and keep it from building up on the teeth and gums.

Signs Of Gingivitis

-swollen, shiny, and tender gums

-blood on toothbrush while brushing

- pink toothpaste when spitting out

-pus around teeth

-bad breath

-gum redness

-visible tartar deposits

-bad taste in mouth

-gums bleed easily

-gum ulcers

Other Causes Of Gingivitis

-Medications. Many prescription and over-the-counter medications come with the side effect causing dry mouth or xerostomia, and sometimes gum overgrowth. Saliva is important to help keep your teeth clean by controlling the growth of bacteria as well as maintaining a neutral environment to prevent tooth decay. That means that the less saliva you have, the greater your risk for gingivitis (and tooth decay!). Many common medications including antidepressants, blood pressure meds,  asthma inhalers, and cold medications can reduce the amount of saliva in your mouth. Seizure medications, and some blood pressure medications can cause the gum tissue to grow. This extra tissue, makes it more difficult to keep clean. It is important you always read the side effects for any medications you are taking to ensure you take the proper steps like drinking more water and brushing more often following meals.

-Infection/ Disease: Various types of viral infections or fungal infections can cause periodontal disease. Oral Thrush is an example. Thrush occurs when a type of fungus that occurs normally in the mouth gets out of control and forms lesions that can infect the tongue and gums. Also, an infection caused by the herpes virus can cause

Gingivitis Marielaina Perrone DDS

periodontal disease. It is important to get these infections under control as soon as possible as they are quite treatable in most cases. There are also other diseases that can effect the oral tissue, such as oral cancer, and diabetes.

-Nutrition: If you follow a fad diet or a diet that is severely lacking in calcium and vitamins B and C, you may be at increased risk for periodontal disease.

-Mouth Breathing: leaving the mouth open to breathe while awake or sleeping, dries the mouth substantially. Oral dryness  allows gingivitis to occur more readily.making healing more difficult

-Tobacco use: Smoking directly effects the gums by decreasing blood circulation and thereby increasing inflammation. Smokeless tobacco cause irritation in direct response to the product eroding the tissue.

-Hormone surges: Hormonal imbalance during puberty, menstruation, pregnancy, and menopause can cause gingivitis. The drastic hormone changes allow gum tissues to become inflamed quite readily.

Possible Complications From Gingivitis

In most cases, if gingivitis is properly treated and the patient follows good dental hygiene there will be no complications. However, if left untreated, gingivitis can worsen and develop into a more advanced version of periodontal disease called periodontitis. This form of periodontal disease is quite destructive and will cause loss of bone and eventually loss of teeth.

Possible complications from gingivitis can include:

-Abscess in the gum tissues.

-Abscess in the jaw bones.

-Infection in the jaw bone or gum tissues.

-increased susceptibility to heart disease.

-Loss of esthetic gum contours. The points of gum tissue between the teeth disappear, leaving behind a “black triangle”. Red, jelly-roll margins at the gum line of the tooth. Pink stippling disappears.

-Periodontitis.

-Recurrent gingivitis.

-Trench mouth, or ANUG.  Ulcerations of the gums caused by bacterial infection.

Gingivitis can cause damage in other areas of the body if allowed to remain untreated. The bacteria from the gums can enter the bloodstream and cause infections elsewhere. Periodontal disease has been linked to heart disease, stroke and erectile dysfunction. It may also cause the delivery of premature infants as well as low birth weight infants to gingivitis-infected mothers. Those with diabetes may have problems controlling blood sugar levels if they also suffer from gingivitis.

Prevention of Gingivitis

Gingivitis may be prevented or cured by following some simple preventative measures:

-Brush teeth, gum line, and tongue daily. Teeth should be brushed at least twice a day. Both morning and night and after meals when possible.Gingivitis Marielaina Perrone DDS

-Use a soft bristled toothbrush, which is less likely to damage teeth or gums. Replace toothbrush every three months or sooner if needed.

-Use a fluoride toothpaste.

- Do not snack in the middle of the night. Chew gum after daytime snacks.

-Floss at least once a day.

-Rinse with an effective mouthwash, such as listerine.

-Visit the dentist at least once every six months for cleaning and examination to keep gingivitis away.

-Avoid sugary foods, tobacco and drinking excessive amounts of alcohol.

Conclusion

Gingivitis is very treatable. The first step, is understanding what is making it occur. Following a regular dental hygiene regimen will keep gingivitis at bay and not allow it to progress to periodontal disease. A few minutes a day is all it takes to maintain a healthy teeth and gums. Remember to visit your dentist regularly for dental examinations and professional cleanings to avoid the onset of gingivitis.

 

Periodontal Disease – is a progressive inflammatory disease, that affects the tissues that support and anchor the teeth. These support tissues include, gums, bone, cementum, and ligament attachments.

The main area in which periodontal disease is diagnosed and treated is in “the pocket”. The pocket is the unattached tissue between the tooth and gum, measured with a tiny ruler-like instrument called a periodontal probe. A healthy tooth generally has pocket measurements of 0-3 mm, whereas diseased tissue can be 4-15 mm deep, ( The deeper the pocket, the more difficult to fully clean). The measurements vary in what they measure, for example, in Gingivitis measurements indicate how swollen the tissue is, while in Periodontitis, the measurements indicate the loss of bone and gum tissue. If  left untreated, periodontal disease results in the destruction of the support structure, bacteria growth down into pockets, toxin release (to breakdown attachments),  loosening of teeth, and subsequent tooth loss.

Stages of Periodontal Disease

Periodontal disease is said to affect over 50% of all Americans. Periodontal disease advances in 4 stages:

1. Gingivitis- Swollen, red, inflamed gum tissue. There has not been loss of attachment at this stage. Reversible with proper hygiene.

2. Early Periodontitis- Less than 25% attachment loss, as determined by x-ray and measurement with a probe.

3. Moderate Periodontitis-25-50% attachment loss as determined above.

4. Advanced Periodontitis-50% or more attachment loss.

Periogen Marielaina Perrone DDS

Periogen Used to Fight Tartar

Periodontal disease can be reversible in its earliest form. This form of periodontal disease is called gingivitis. But if the periodontal disease progresses to periodontitis then the damage is not reversible by the body on its own. Patients and dentists alike are always looking for ways to combat periodontal disease with newer and better ways to treat the disease and maintain good oral hygiene at home. The tried and true home methods have generally consisted of varying types and techniques with  tooth brushing, flossing, and antibacterial rinses. All of these methods have the same limiting factor, none of the at home methods could target the deeper pockets of 5 mm and above, until a new product was formulated in conjunction with the waterpik utilizing a special tip which places a tartar dissolving liquid  directly where it is needed. This new rinse is called Periogen.

What Does Periogen Do to Fight Against Periodontal Disease?

Periogen is a patented oral rinse that has been proven capable of dissolving tartar buildup between professional cleanings and dentist visits. Periogen works by exploiting a weakness (discovered by the research team at the Periogen Company) in the fundamental structure  of oral tartar, and its adhesive nature.

Tartar (or calculus as it is sometimes called) can be found above and below the gum line. Tartar above the gum line is referred to as supra gingival tartar and tartar below the gum line is referred to as sub gingival tartar. Dental Tartar is comprised almost entirely of Calcium Phosphate Salt. Calcium Phosphate is the basic component of tooth material. Calcium phosphate salt differs from calcium phosphate in its electron structure. The calcium phosphate salt has two less electrons than the calcium phosphate which makes it electrically unstable. This process of losing electrons happens in nature all the time. The best comparison is the buildup of lime deposits in water pipes and faucets. Microscopically, tartar is layer upon layer (can be in the tens of thousands layers) of fossilized bacteria trapped between the calcium salts.

The tartar causes periodontal disease by toxins released by the bacteria in plaque and tartar on teeth. The toxins cause the body to react by starting the inflammatory

Periogen Marielaina Perrone DDS

Periogen Oral rinse for Dissolving Tartar Between Professional Cleanings

process thereby destroying healthy gum tissue and supporting bone structures. Periodontal disease is progressive and without periodontal disease treatment will lead to tooth loss and infections throughout the mouth.

Periogen is used as an oral rinse 1-2 times per day between professional cleanings to reduce the level of tartar buildup and stain. This will in turn make for an easier dental visit but also maintain a healthier state in your mouth for your teeth and gums to heal. Periogen should in no way replace brushing and flossing, or visits to the dentist but just works as an accessory between professional dental cleanings to give you a more effective way to reduce tartar and fight periodontal disease .

Periogen Conclusion

As you know, there are many methods and products on the market to aide you in your dental hygiene and combat periodontal disease. Remember this, “The best  offense is a good defense!”.   It is up to you to find and decide what works best for you to prevent periodontal disease. Visit your dentist regularly for dental examinations and professional cleanings to ward off dental problems and stay healthy.

 

Periodontal disease (or gum disease) is a serious and chronic infection of the gum tissue that can result in the breakdown of the tissue as well as the deterioration of bone that surrounds and supports your teeth. This infection process begins when bacteria and plaque form a sticky bio film on your teeth and causes inflammation of the gum tissue.  Periodontal disease will continue to progress if this is not resolved by maintaining proper dental care and hygiene. Periodontal disease is the leading cause of tooth loss in adults. Studies show that somewhere between 75% and 95% of all adults are suffering some stage of periodontal disease.

Periodontal disease and dental decay (cavities) are caused by different types of bacteria, and are considered to be two different conditions, however, you can suffer from both issues. Poor oral hygiene promotes the risk of both cavities and periodontal disease. Swollen and receding gums open up the more vulnerable areas of the tooth…The root areas, which, are not protected by enamel and can break down quickly to form root cavities.  On the flip side, In patients with significant decay, the broken down teeth allow for food trap areas which keep gum tissue chronically inflamed.

Gingivitis

Periodontitis

Stages of Periodontal Disease

The first stage of periodontal disease is gingivitis (or simply inflammation of the gum tissues). This is the most mild form of periodontal disease. Symptoms include red, swollen (or puffy) and inflamed gums due to plaque-bacteria build-up. The gums may also bleed easily during brushing or eating of hard foods. During the earliest of stages the periodontal disease process it can be reversed thru proper brushing, flossing and professional dental care to remove the excess bacterial plaque. If the required oral hygiene does not occur, the periodontal disease then progresses  to the next stage. The majority of people with this early form of periodontal disease, do not even know a dental problem exists. This is a crucial period for the patient, as the condition can be reversed (since the bone and connective tissue that hold the teeth in place have not yet been affected) at this point if it is recognized and properly treated. Gingivitis is commonly seen during puberty, pregnancy, times of high stress, and menopause, as hormones can make you more prone to inflammation. As for the rest of the population, poor hygiene is generally the most common cause, followed by medication and certain medical conditions.

Periodontitis

As the periodontal disease progresses it is now becoming harder to treat and control. The difference between gingivitis and periodontitis is that gingivitis only infects the gum tissue that surrounds the teeth while the periodontal disease process also invades the bone that provides support and stability for the teeth. The bacteria eventually invades past the initial the gum line area and destruction begins to the point that gums may begin to separate or pull away from the teeth (taking away support and connective fibers with it). What results are called periodontal pockets. These pockets allow for bacteria to invade below the gum line.  They eventually become loaded with toxic plaque and bacteria that moves and works its way deeper. It begins to erode the bone below the gum line. A patient’s bite will be affected (as the teeth shift or loosen) by the lost support which then affects chewing and other functions.

Advanced Periodontitis

As the periodontal disease process advances, the fibers and bone that provide support for the teeth is destroyed. At least half of the bone support (if not more) will have broken down at this late stage of periodontal disease. It does not grow back naturally. Teeth may begin to loosen. Deep root cleanings and surgical intervention are typical at this stage. This may include cleaning with a periodontal microscope, (Perioscope), grafting of tissue, bone, placement of growth factors, (Emdogain), periodontal antibiotic regimen (Periostat), placement of antibiotics directly into pockets, (Arestin), open flap surgery, and, possibly tooth removal.

How Do I Know If I Have Periodontal Disease?

Periodontal disease can happen to a person of any age. It is most common among adults. Remember if periodontal disease is detected in its earliest stages it can be reversed so it’s important to see your dentist if you notice any of the following symptoms:

-Gums that are red, puffy or inflamed, or tender.

Periodontitis

X-Ray showing Periodontal Disease Progression

-Gums that bleed easily during routine brushing or flossing.

-Teeth that appear longer due to recession of gum tissue.

-Changes in the way your teeth fit together when you bite or chew.

-Pus coming from between your teeth and gums

-Bad breath odor or bad taste in your mouth.

Treatment of Periodontal Disease

Periodontal Disease

Arestin use in Periodontal Disease

The earliest stages of periodontal disease is reversible. This is accomplished thru proper brushing, flossing, and maintaining a regular schedule with your dentist. A professional cleaning by your dentist or hygienist is the only way to remove plaque and tartar. The hygienist will clean (also called scaling) your teeth to remove the tartar and plaque buildup from above and below the gum line. If the periodontal disease condition worsens, then a root planing procedure may be necessary. Root planing helps smooth irregularities on the roots to make it more difficult for plaque to deposit there. Also makes it easier for you to keep your teeth clean at home. , treatment can also include use of antibiotics.

If you have advanced periodontitis, your gum tissue may not respond to nonsurgical treatments and good oral hygiene. In that case, your periodontitis treatment may require dental surgery. These may include:

-Pocket Reduction Surgery (also called Flap surgery). In this procedure, your periodontist makes tiny incisions in your gum so that a section of gum tissue can be lifted back, exposing the roots for more effective scaling and planing. Because periodontitis often causes bone loss, the underlying bone may be recontoured before the gum tissue is sutured back in place. The procedure generally takes from one to three hours and is performed under local anesthesia.

-Soft tissue grafts. Gum tissue is often lost as part of the periodontal disease process making your teeth appear longer than normal. You may need to have damaged tissue replaced to return your cosmetic appearance back to normal. This procedure can help reduce further gum recession, cover exposed roots and give your teeth a more cosmetically pleasing appearance.

-Bone graft. This procedure is needed when periodontitis has destroyed the bone surrounding your tooth. The bone graft helps prevent tooth loss by holding your tooth in place. It also serves as a platform for the regrowth of natural bone.

-Antibiotics and medicaments – A wide array of antibacterial rinses(Peridex), antibiotics taken in pill form, (Periostat) or localized placement directly into the affected pockets(Arestin), can aide in and promote healing of the affected gum tissue.

-Guided tissue regeneration. This allows the regrowth of bone that was destroyed by bacteria. In one approach, your dentist places a special piece of biocompatible fabric between existing bone and your tooth. The material prevents unwanted tissue from entering the healing area, allowing bone to grow back instead.

-Enamel matrix derivative application. Another technique involves the application of a specialized gel to a diseased tooth root. This gel contains the same proteins found in developing tooth enamel and stimulates the growth of healthy bone and tissue. An example of this is the use of emdogain.

To insure a successful result following periodontal therapy, patient cooperation in maintaining excellent oral hygiene is essential. More frequent professional cleanings can help reduce the likelihood of the periodontal disease ever returning.

By scheduling regular checkups, early stage periodontal disease can be treated before it leads to a much more serious condition. If your periodontal disease is more advanced, treatment in the dental office will be required.