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After the age of about 25, the most common reason for the loss
of teeth is gum disease. Gum disease is generally characterized
by swollen, red, bleeding, and receding gums often times associated
with localized abscesses. Affected teeth loose clinical support
which eventually become painful and need to be removed. Gum disease
is caused by one thing, Bacteria. Other secondary factors contribute
to advancing periodontal conditions. These include Genetics, Smoking,
Systemic disease, Open contacts, Malocclusion, bad margins on current
restorations, and Calculus. Gum disease may be prevented by proper
brushing and cleaning between the teeth with floss and can be treated
predictably with definitive periodontal therapies if it occurs.
The goal of definitive treatment is to control the environment
where the bacteria live while also to preserve/ maintain function
and esthetics.
The progression of the disease is often painless. By the time the
disease is first diagnosed, some teeth may already have un-repairable
defects. Remember, the first sign of Periodontal/ Gum disease is
bleeding gums. |
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In order to understand gum disease, you must first
understand the way the teeth and supporting structures are built.
The part of the tooth you can see in your mouth is called the crown
of the tooth. It is held in the mouth by the root which is embedded
in your jaw bone. It is attached to the bone by way of a
thin "stocking" called the periodontal ligament .
The bone is, of course covered by the gums which are called the
gingiva .
The gingiva attach to the teeth slightly below the highest level
they reach on the tooth.
The topmost part of the gingiva is called the
gingival crest, and the inside of the little pocket between
the gingival crest and the bottom of the pocket is called the
gingival sulcus . All the bony and soft tissue
that supports the tooth is called the periodontium and when this
organ becomes sick, we say the patient has Periodontal disease.
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Gum disease and tooth decay are invisible and largely painless
when they first start, but left untreated will always result
in the loss of your teeth. It is important to maintain a strong
relationship with your Dental health provider. Regular dental
checkups are important to evaluate current radiographs, to recognize
clinical signs and symptoms of periodontal disease and to evaluate
current Oral Hygiene techniques. Especially, if you have a family
history of Periodontal disease, a Comprehensive Periodontal Evaluation
should be completed at least one time per year. During this type
of exam, each tooth is evaluated for periodontal pocketing (probing
depths of 5mm or greater), mobility, recession, Furcation involvement,
occlusal discrepancies, and radiographic bone loss/ defects.
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I encourage patients to brush twice per day,
in the morning upon getting up and in the evening before going
to bed and to use floss at least one time per day. Oral
rinses or irrigators are also good adjuncts.
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