There are two main stages of periodontal disease. The first is a disease of the gums, or gingivitis. The second is called periodontitis, which is a disease of the ligament and bone that hold your teeth in your jaws. Although these two forms of periodontal disease are the most serious forms of dental disease, they’ve never been given enough recognition by the public for the destruction they can cause. Tooth decay wounds, but the real killer of teeth is periodontal disease. If we had a criminal penal code for classifying dental disease, decay would be considered a misdemeanor and periodontal disease would be a felony. Most tooth decay can be repaired, but once advanced gum disease destroys the bone that supports the teeth in your jaws, those teeth will be lost forever.
It’s one thing to think you might have a little gum problem; it’s another thing entirely to realize that this disease is actually destroying the tissues, ligaments, and bones of your body.
CAUSES
Oral hygiene is the main cause of periodontal disease, there are other significant factors that affect its onset, extent, and severity: the germ population of your mouth, your general health, genetics, your bite, your age, diet, your life-style.
The Beginning
Plaque Formation — All periodontal disease begins with plaque formation. Plaque is initiated when millions of disease-causing germs attach themselves to the tooth by releasing a glue like substance. They especially love areas of the tooth that don’t get cleaned properly. They also love the gingival crevice, the little groove where the tooth meets the gum, and the gum pocket, because there areas offer them a protected place to hang out.
As soon as the germ-laden plaque starts to form at the gum line, your body musters its defensive forces to battle the bacteria. The germs that come in contact with the gum tissue release toxins that irritate and inflame the tissue. Soon the inflammation stimulates the release of germ-fighting cells in the immediate area of the plaque formation, causing an increase of blood flow to the surface of the gum tissue, which causes the gums to swell. The result is a buildup of dead germs and used-up, dead defense cells. As the fight continues, the battlefield debris is added to the growing plaque, and more and more plaque is formed. Once it has begun, this process goes on minute by minute, hour by hour, until you step in to have the plaque removed to control the germ population, or until your tooth fall out.
As the infection proceeds, the gums lose their ability to grip the tooth firmly at the top of the gum line, and the pocket between the gum and the tooth loosens and becomes more accessible to the invasive plaque.
The Formation of Calculus
Soon, this massive onslaught of germ-filled plaque moves into its next phase. The portion of the plaque that lies next to the tooth begins to mineralize. You now have the beginning of calculus.
As more gum tissue comes in contact with the spreading plaque and calculus, the infection intensifies, and the substance that holds your gum cells together is weakened. This weakening makes the gum more fragile, and soon the gums are no longer able to protect themselves even from the most mild forms of stimulation, such as brushing and eating hard foods. As a result, bleeding takes place.
Ligament
Once plaque begins to form in the pocket, it is protected against most forms of oral hygiene. As plaque moves into the once healthy gum pocket, the infection begins to involve the place where the ligament attaches the gum to the tooth surface. As the calculus grows and spreads, it pushes against the swollen gum tissue. When this happens the inflammation and infection spread more rapidly than ever. The infection reaches the place where the ligament attaches the gingiva to the tooth, the ligament is forced to let go of its hold on the tooth surface, and the pocket now begins to deepen.
How Gingivitis Becomes Periodontitis
Once the infection involves the ligament that holds the tooth to the bone, you have officially moved from gingivitis to periodontitis. As the infection destroys the ligament, both the root and the bone are exposed to the bacterial hoards and the toxins they release.
The bone surrounding the tooth is also now at risk. The bone of the jaw is extremely susceptible to any form of irritation and infection. The bone resists this invasion on its own in the best way it knows, but without help from you, the hygienist, and the dentist, it is overwhelmed and soon has to retreat. The retreat begins with osteoclasts, which are cells that dissolve bone, start breaking down your jawbone to remove it from the plaque invasion and its accompanying germs and toxins. This is how bone loss occurs.
Over time, as more and more bone is lost, the tooth begins to loosen. There is now very little you can do about it on your own. If left untreated the disease will soon pass the point of no return and it will be too late to save the tooth.
PREVENTION
Regular checkups are important. During an examination, your gums are evaluated for periodontal disease.
Even if you brush and floss regularly, you may not remove all the plaques, especially around the gum line. Calculus can be removed only in the dental office during your regular cleaning.
Contact your Tacoma dentists at Advanced Dental Care to discuss your gum health.