Pocket Depth in Gum Disease

           4 -5 mm or greater

Signs of Gum Disease

* Red, puffy, bleeding, swollen gums

* Gums that pull away or feel loose

* Tender gums

* Persistent bad breath

* Abscesses not related to decay

* Pus between your teeth & gums

* Loose or separating teeth

* Tooth loss, because of looseness

* A change in your bite

* Spaces that are getting larger

* Teeth that appear longer

* Gum recession

* Mobility of teeth

Dry Mouth is caused by many things, including medications, disease, radiation, illness, aging and even stress.  Consistent dry mouth affects your quality of life, making it difficult to swallow, speak and may increase the likelihood of cavities, plaque, periodontal disease and oral irritations. Chronic dry mouth is different than the dry mouth people can experience when they are nervous, upset or anxious. 

Q.  Why is saliva so important?
A.  Saliva provides defense against decay by equalizing the pH in the mouth.  It protects teeth from decay, it prevents infections, and it helps you to digest your food.  The wetting ability of saliva aids in speaking, chewing, and swallowing.  Without it, everything becomes more difficult.

Q.  What causes dry mouth?
A.   Side Effects of medications- there are more than 400 medications that cause dry mouth.  Obviously, the more medications you take, the more likely you will have dry mouth. 

Other causes:

*  Diseases - Some diseases affect the salivary glands such as Sjogren's Syndrome, HIV/AIDS, Diabetes, and Parkinson's Disease.          
*  Radiation Therapy - the salivary glands can be damaged if exposed to the field of radiation, and your dentist needs to know where the radiation is planned or has been used.  It affects dental treatment.

*  Chemotherapy - Drugs from Chemo can make the saliva thicker and can cause stomach sickness and vomiting.  The acids then damage the tooth enamel. 

How do I manage my Dry Mouth?
 * Take frequent sips of water
 *  Dissolve sugar-free candies and lozenges
 *  Moisten food when eating with water, gravies or sauces
 *  Avoid mouthwashes with alcohol
 *  Avoid dry foods like crackers
 *  Avoid drinks containing sugar, alcohol or caffeine
 *  Discuss problems w/ your dentist if symptoms persist.
 *  Use Biotene Dry Mouth products that mimic saliva 

Gum disease is silent and painless in the early stages, and can go undetected for years. Puffy or bleeding gums can be an early sign of this progressive disease. During your first dental visit, and at least annually thereafter, your dentist or hygienist will take up to six measurements around each tooth in your mouth with a dental ruler (probe) and record a map of your teeth and bone.  With the use of these individual measurements, along with xrays, we are able to assess the health of your mouth. When the diagnosis of gum disease is found we will always recommend the least invasive non surgical treatment.  Usually this treatment is root planing and scaling, antiseptic irrigation, and antibiotic treatment. However, in more serious cases, surgery or a referral to a periodontist may be necessary. Good home care and professional cleanings can prevent and delay gum disease, reduce bad breath, and keep your teeth healthy for years.

Non-Surgical Root Planing and Scaling
The first line of defense against gum disease is a unique type of cleaning called “scaling and root planing.”  In this procedure, an ultrasonic irrigating cleaner is used to remove plaque and tartar from your teeth where regular cleaning devices can't reach: under the gum line, on the tooth, and around the root. Tartar and calculus make the tooth root rough, provides a hiding place for bacteria to grow, and contains toxins which causes inflammation in the body.  Removal of this tartar smoothes out (planes) the root surface and provides a healthy, clean surface that allows the gum tissue to reattach to the tooth.

Healthy Mouth, Healthy Body

Don't delay treatment.  Catching gum disease before it loosens your teeth is vitally important.  If you address your gum disease before it becomes severe, scaling and root planning, and regular maintenance visits, may be the only treatment you need. However, as with any dental procedure, after-care is vital. In order to keep your teeth in good shape and resist future occurrences of gum disease, you must brush and floss daily, eat a healthy diet, avoid tobacco use, and have regular dental checkups and cleanings. Even after a successful scaling and root planing, if you don't attend to your teeth properly, or if time lapses between professional dental cleanings, it's quite likely that you'll develop gum disease again. Additionally, it is important to note that medical conditions can contribute to the progression of gums disease, especially diabetes.  It is vitally important to keep you teeth and gums healthy for your overall health.  Heart disease, stroke, diabetes and low birth weight babies are more likely if the bacteria in your mouth, get into your bloodstream or around your heart. Inversely, treating gum disease can help manage these diseases.

Antibiotic Treatment

After root planing and scaling are performed.  If the pockets that create space around your teeth still exist, it is recommended to irrigate with antibacterial rinses, and use site specific antibiotic treatments to heal the gum and reduce the bacterial count in the pocket.  Bacteria like warm, moist environments to grow.  Using a topical antibiotic along with root planing & scaling can increase the success of treatment. Antibacterial rinses that contain chlorohexidine have been found to be especially helpful.  Topical antibiotics, such as Arestin and Atridox, remain around the tooth and do not go throughout the bloodstream systemically.  These antibiotics are designed specifically for the mouth, to reduce the types of bacteria found in gum disease. They are tetracycline, minocycline based, so they cannot be used by pregnant mothers or those allergic to tetracycline. Unfortunately once bone loss occurs, you cannot get it back, the idea is to maintain what you currently have.  Antibiotics, in conjunction with root planing and scaling, have been found to be a beneficial and non-invasive therapy for people who have periodontal disease.

Bad Breath - Halitosis
The most common cause of bad breath results from the waste products of anaerobic oral bacteria.  These bacteria create a strong odor because they release volatile sulfur compounds, VSC's.  Bad breath can also be caused by: 

*  Reduced salivary flow, such as in morning breath, when salivary flow slows down   during sleep, bacteria accumulates and grows
*  Foods - such as onions, garlic, foods that contain odor causing compounds.  These compounds enter the blood stream and are transferred to the lungs and exhaled
*  Poor dental hygiene - food basically rots in the mouth and consists of bacteria which release sulfur compounds
*  Dry Mouth Syndrome - xerostomia can be caused by medications, certain disease, like Sjogren's syndrome, HIV-AIDS, Diabetes and Parkinson's disease.  Radiation and chemotherapy often cause damage to the salivary ducts, which reduces the amount of saliva present, resulting in dry mouth.
*  Smoking or tobacco products
*  Dehydration, hunger and missed meals
*  Diets such as Atkins can give your breath an acetone odor from partially broken down fats
*  Medical Conditions - Diabetes, liver & kidney disease, chronic sinus infections, bronchitis,  pneumonia.

Ways to Reduce Breath Odor  
* Brush your teeth 2-3 times daily.  Floss your teeth daily.
* Use an antibacterial rinse like Listerine, Closys, SmartRinse, or Breath Rx.
* Use a tongue scraper to remove bacteria from the back of your tongue where the  bacteria live. 
* Get a check up by your dentist.  Open crown margins, broken teeth, fillings that are open or rough, food traps between teeth, and untreated gum disease can all cause breath odor.
* Make sure you don't have tonsil stones, a sinus infection, or lung infection.
* Check with your physician to see if you have a metabolic disorder such as diabetes, liver disease, or other metabolic diseases.
* Avoid having a dry mouth.  Drink plenty of fluids, chew gum or use a sugar free breath mint. There are also products that help to stimulate your saliva found at the drugstore

​​Angela Hilton-Foley, DMD

(813) 891-1212

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