Gum disease or periodontitis is caused by the build-up of bacteria under the gumline and along the root surface of the teeth. If the bacteria is not properly and frequently removed, the plaque along these areas will calcify into calculus or tarter and stick to the side of the tooth similar to barnicles on the side of a ship. This tarter is teeming with bacteria that causes an immune response in which you begin to break down the bone holding the teeth in place.
Gum Disease Progression
If the disease is not treated, then you will continue losing bone until the tooth becomes mobile and is lost due to lack of support or infection of the tissue around the tooth. Tissue will also be lost, but at a much slower rate than the bone leading to deeper and deeper periodontal pockets. This is the depth of the gums from where they start to the point that they attach to the tooth. A healthy mouth has 3 mm or less pocket depth. 4 mm is classified as gingivitis while 5 mm and more falls in the periodontitis category. The bone loss seen in gum disease is what is seen when someone is referred to as “long in the tooth” as it takes time to progress.
Treatment for Gum Disease
Initial treatment is a deep cleaning or periodontal scaling and root planing. In this, the patient is numbed and instruments are taken below the gumline to remove all of the tarter and bacteria. The patient is often placed on an anti-bacterial rinse such as chlorhexidine to further kill off the bacteria in the mouth. For deeper pockets, an anti-bacterial agent may need to be placed under the gums as well to further decrease the pocket depth, and sometimes tissue removal may be necessary. Once the bone is lost, there is no way to really get it back, treatment is meant to stop any further disease progression and decrease pocket depth to the manageable 3 mm or less (this depth can be cleaned by a toothbrush and floss at home). The goal of treatment is to cause shrinkage of the tissue back to the levels of the bone which in turn will expose more root surface and make the tooth look longer. This will make the areas easier to clean and possible to maintain lower bacterial counts.
Prevention of Gum Disease
Gum disease is the most preventable disease in existence. All that is required to prevent it is using proper techniques for tooth brushing, daily flossing, and regular cleanings with your dentist and dental hygienist. In short proper dental hygiene is all that is required to prevent damage from periodontal disease.