Many people tend to equate good dental health with strong healthy teeth. This is only part of the equation. In order for our mouths to get the gold star rating for overall hygiene, our gums and the anchoring bone must be healthy as well.
The gums, or gingivae, blanket the jaws and act as a protective covering. The ends of the gingivae overlap the bone and encircle the teeth forming an attachment with the teeth. This attachment, the periodontium, is crucial to the health of the underlying bone because it acts as a barrier between bone and the bacteria that inhabit our mouths. This attachment however does not come right up to the edge of the gingivae. In fact, there is an outer edge of unattached gum tissue such that a natural pocket or space occurs between the teeth and the gingivae. A healthy depth for this periodontal pocket is 2-3 millimetres. Part of our job in maintaining good oral hygiene requires keeping these pockets free from food debris. The best way to do this is to use proper brushing techniques and dental floss.
Flossing and brushing are important because our mouths naturally harbour bacteria. Food that is left around our teeth attracts and feeds these bacteria. Initially, this combination of food debris and bacteria is called plaque, which is soft. Plaque that is not removed hardens over time and is then called tartar or calculus, which is not so easily removed. Now the bacteria have a place to hide from your oral hygiene efforts. This is akin to "a kid in a candy store". As the bacteria grow in number and change in character, they begin to invade and inflame the gum tissue. The gingivae become darker red and swollen, and they bleed more easily. This is called gingivitis, which simply means, inflammation of the gums. Most people have this problem if only to a slight degree in some areas of their mouths. With improved flossing and brushing and a visit to the dentist, this state is easily reversed and the gums will return to health.
If this situation is not corrected, the bacteria will begin to encroach upon the attachment between the teeth and gums and violate it. This will result in deeper gum pockets that are harder to keep clean. This disease state is no longer referred to as gingivitis, but is now called periodontitis (inflammation of the periodontium). This indicates that the gums and the bone are infected with bacteria. The gum pockets might be 5-6 millimeters or more in depth at this point. The gingivae may look more purple and have no sharp edges but instead swollen, rolled margins which bleed at even light touches. Luckily, this disease is also treatable, often with improved home care and professional hygiene visits.
If this problem is still not corrected, the bacteria will continue to flourish and now the supporting bone will begin to melt away from the teeth. Now the pockets may have become deeper and you are no longer able to floss or brush to the full depths of these pockets. Now, regardless of how well you brush and floss, you cannot adequately get or keep these pockets clean. At this stage, if you do not seek dental treatment, there will always be harmful bacteria in these pockets and the disease will continue until there is little or no bone around the teeth. The teeth will have lost anchorage and will fall out or have to be extracted.
In cases of moderate to severe periodontitis, antibiotic and/or surgical interventions may be needed. Periodontal surgery is often done in order to decrease the depths of the periodontal pockets so that you are able to keep them clean at home. At Sleep For Dentistry, this treatment can be performed by a periodontist with sedation, if desired.
Over the years, improvements in the quality of dental care and oral hygiene products have allowed us to keep our teeth longer than ever before. On the other hand, this means that we are seeing an increase in the prevalence of gum disease. It has been estimated that approximately ¾ of adults have some level of periodontal disease. For this reason, much of the current dental research is concerned with the effects, treatments and prevention of periodontal disease. Studies have associated periodontal disease with smoking and poor diets. As for effects, there is some suggestion that periodontal disease is detrimental to your overall health, including the cardiovascular system.