Gum Disease is caused by Plaque and Bacteria and number one cause of tooth loss.

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Page Index

Overview of gum disease

Home Oral Hygiene

Brushing Technique

Flossing Technique

Stages Of Gum Disease

We strongly believe that prevention and good oral hygiene is one of the most important aspects in maintaining your oral health. Our experienced hygienists will work closely with you, providing you with customized home care instructions, advising on your special needs and doing everything possible in early recognitions of your problems and preventing of new ones. You will be advised on your personal needs and special hygiene accessories for you home use. If you have gum disease we will evaluate it, and we will do our best to treat it conservatively. We believe that surgery should be the last resort.

Timely office visits and prophylactic cleanings should prevent you from developing gum disease. You should be aware of the following symptoms: foul smell, red and/or bleeding gums, high sensitivity, mobility of the teeth. If you have any of these symptoms you should immediately seek professional help.

During your routine dental check up appoitment we will do a full examination of your teeth and necessary X-rays. We will advise you if you are in need of any dental treatment. If you have a small cavity, it is in your best interest to treat it  in it’s early stages.

Overview of Gum disease

 

Gum disease or periodontal disease is the inflammation of the tissue supporting and surrounding the tooth. The teeth are held in the mouth by the root, which is embedded in your jawbone. The roots are connected to the bone by hundreds of thin “elastic threads” called periodontal ligament. The bone is covered by the gum, also called gingiva, which is attached to the bone thru periosteum. The top part of the gum (gingival crest) next to the tooth is not attached forming a little pocket, which should measure less than 1 mm in the healthy individual.

 

In order to successfully treat periodontal diseases we have to understand the reasons of the disease.  Our oral cavity is always populated by bacteria even in the healthiest individuals.  It takes a 24-hour period for these harmless bacteria to turn pathogenic and cause periodontal inflammation. 

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 If the teeth and gums are not properly cleansed, then the remaining bacteria along with the food remnants will build on the tooth and below the gum. This bacterial build up is called plague. Bacterial plaque, a sticky, colorless film that constantly forms on your teeth, is the main cause of gum inflammation and periodontal disease.  As plaque builds, it becomes calcified and hard and dental calculus (tartar) appears, depositing on the teeth. Tartar build up spreads below the gum, destroying bone and ligaments supporting the tooth. The inflammation of gums increases. Your body starts to produce special enzymes in response to the bacteria to combat the onset of gum disease. These enzymes are trying to fight the bacteria, but along with bacteria it also starts to destroy the bone surrounding the teeth.

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The pockets (empty space defined by the root of the tooth, the level of the bone and the top edge of the gum) appear. These pockets trap the bacteria and are the perfect incubators.

X-ray showing calculus and bone lose on both left and right sides of the mouth

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Home Oral Hygeine

                                  

In order to successfully treat any disease, one should try to eliminate the reasons. And as we talked before the main reason for gum disease is accumulated bacteria. But we cannot live in sterile environment. So we have to try to reduce plaque and tartar formation to minimum. That’s why your good home oral hygiene is step number one in prevention and treatment of gum related problems.

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We all brush our teeth, but do we do it right? Our experienced dental hygienists will work closely with you to choose the right brushing methods for you, we will advise you on the tooth brush and others hygiene tools you need to use. Each patient is different and we will customize oral hygiene instructions especially for you.

Bass Brushing Method

 

The most recommended brushing technique is modified Bass cleaning technique. It has proven its worth both for people with healthy gums and for gingivitis and periodontitis patients. This technique concentrates on cleaning at the gum margins. The toothbrush must be soft, so as not to damage the gums when positioning the toothbrush.

 

Outer surfaces:

Place the toothbrush on the gums at an angle of 45°.

Always start at the back.

 

Inner surfaces:

Small circular movements (vibratory motion).

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Front teeth:

Place the toothbrush in an upright position behind the front teeth.

 

Lastly, brush the chewing surfaces using to and from vibratory motions, from the back to the front

Flossing Technique

  

Wind 18" of floss around middle fingers of each hand. Pinch floss between thumbs and index fingers, leaving a 1"- 2" length in between. Use thumbs to direct floss between upper teeth.

 

Keep a 1" - 2" length of floss taut between fingers. Use index fingers to guide floss between contacts of the lower teeth.

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Gently guide floss between the teeth by using a zig-zag motion. DO NOT SNAP FLOSS BETWEEN YOUR TEETH. Contour floss around the side of the tooth.

 

Slide floss up and down against the tooth surface and under the gum line.

 

Floss each tooth thoroughly with a clean section of floss.

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There are many other helpful hygeine devices available today(such as eletcric tooth brushes, electro floss, water pick, interproximal brushes and etc.) We will advise you on particular tools you should use as a part of you oral hygeine.

Stages of Gum Disease
 
If left untreated, gum disease progresses thru different stages, causing more and more destruction, and making each next step more difficult to treat. The following illustrations, courtesy of OralB company shows the diagrams of gum disease development.

 

HEALTHY GUMS

  • Firm and light pink
  • Hug the teeth tightly
  • Don't bleed when brushed
  • Pocket depth when measured is no more than 2mm

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HEALTHY GUMS

  

 

 

 

 

 

GINGIVITIS

First stage of periodontal disease which involves soft tissue only: bone has not been affected at this point.

  • Gums bleed when brushed or probed
  • Inflammation and redness present
  • Possible bad breath

 

 

 

 

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GINGIVITIS

MILD PERIODONTITIS

This is the second stage of periodontal disease where bone starting to get affected

  • The bleeding and swelling is more pronounced
  • Pocket depth reach 3-4mm
  • Bad breath/taste
  • Loss of firmness and texture
  • Bone loss may be evident on x-rays

 

 

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MILD PERIODONTITIS

MODERATE PERIODONTITIS

  • Gum line starts to recede and teeth appear to be longer
  • Sensitivity may appear
  • Abscesses or gum boils may appear
  • Teeth may shift and spaces can form between teeth
  • Redness and bleeding is very apparent
  • Further inflammation and loss of texture
  • Mobility of teeth
  • Pocket depths 4-6mm
  • Significant bone loss is detected with x-ray

 

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MODERATE PERIODONTITIS

ADVANCED PERIODONTITIS

  • All of the above symptoms are very pronounced
  • Pocket depths exceed 6mm
  • Severe mobility and bone loss
  • Possible need for extractions 

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ADVANCED PERIODONTITIS

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*The information contained on this site is intended for educational purposes only. It is not intended and should not be construed as the delivery of dental/medical advice and it does not substitute for diagnosis, treatment, or treatment planning. Persons requiring diagnosis, treatment, or with specific questions are urged to contact your family dental/health care provider for appropriate care.
 
Copyright 2005-2008 by Dr. Vadim Khrakovsky