GUM DISEASE

Periodontitis is a serious gum infection that damages the soft tissue and destroys the bone that supports your teeth. Periodontitis can cause tooth loss or worse, an increased risk of heart attack or stroke and other serious health problems.

Factors that can increase your risk of periodontitis include:

  • Gingivitis
  • Heredity
  • Poor oral health habits
  • Tobacco use
  • Diabetes
  • Older age
  • Decreased immunity, such as that occurring with leukemia, HIV/AIDS or chemotherapy
  • Poor nutrition
  • Certain medications
  • Hormonal changes, such as those related to pregnancy or menopause
  • Substance abuse
  • Poor-fitting dental restorations
  • Problems with the way your teeth fit together when biting

Signs and symptoms of periodontitis can include:

  • Swollen gums
  • Bright red or purplish gums
  • Gums that feel tender when touched
  • Gums that pull away from your teeth (recede), making your teeth look longer than normal
  • New spaces developing between your teeth
  • Pus between your teeth and gums
  • Bad breath
  • Bad taste in your mouth
  • Loose teeth
  • A change in the way your teeth fit together when you bite

DIAGNOSIS

During a dental exam, your dentist typically checks for these things:

  • Gum bleeding, swelling, firmness, and pocket depth (the space between the gum and tooth; the larger and deeper the pocket, the more severe the disease)
  • Teeth movement and sensitivity and proper teeth alignment
  • Your jawbone, to help detect the breakdown of bone surrounding your teeth

To determine how severe your periodontitis is, your dentist may:

  • Use a dental instrument to measure the pocket depth of the groove between your gums and your teeth. Your dentist or a hygienist inserts a metal probe beside your tooth beneath your gumline, usually at several sites throughout your mouth. In a healthy mouth, the pocket depth is usually between 1 and 3 millimeters (mm). Pockets deeper than 5 mm may indicate periodontitis.
  • Take dental X-rays to check for bone loss in areas where your dentist observes deeper pocket depths.

 

RECOMMENDED MEDICATIONS

Antibiotic treatments can be used either in combination with surgery and other therapies, or alone, to reduce or temporarily eliminate the bacteria associated with gum disease or suppress the destruction of the tooth’s attachment to the bone.

Chlorhexidine (marketed as the prescription-only brands Peridex, PerioChip, PerioGard, and by numerous other over-the-counter trade names) is an antimicrobial used to control plaque and gingivitis in the mouth or in periodontal pockets. The medication is available as a mouth rinse or as a gelatin-filled chip that is placed in pockets after root planing and releases the medication slowly over about 7 days. Other antibiotics, including doxycycline, tetracycline, and minocycline may also be used to treat gum disease, as determined by your dentist.

In addition, a nonprescription toothpaste that contains fluoride and an antibiotic to reduce plaque and gingivitis, called triclosan, is often recommended.

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