Understanding Terms Associated With Gum Disease

Posted on Jan 23, 2017 by William J. Claiborne, DDS MS

Occasionally, I catch myself using dental terminology during patient conversations. As a Periodontist, ‘perio-talk’ is second nature to me. Deep down, however, I know it isn’t always clear to my patients.

I believe that patients are better participants in their oral health when they understand specifics of their individual needs. When I say ‘perio’ instead of ‘gum tissue,’ the patient doesn’t always ask for a better explanation, even though they may not be sure of the term’s meaning. This leaves us both at a loss – the patient doesn’t fully grasp their needs and recommended solution and I have a patient who is unsure of the ‘why’ and ‘how.’

Although dental implant placement and gum recontouring are regular treatments we provide, periodontal (gum) disease is the most frequent problem we treat. Gum disease affects over 47% of American adults and is the nation’s leading cause of tooth loss. It has been linked to heart disease, high blood pressure, stroke, memory loss, arthritis, diabetes, preterm babies and impotency.

Because gum disease begins without obvious symptoms, people often ignore the warning signs. This tends to allow the disease to progress further. As a basic explanation of how gum disease forms, I’ve listed the progression below — with dental terminology omitted!

• Oral bacteria – Bacteria in our mouths is normal. However, an overload of bacteria is how the problem begins. When oral bacteria are not removed on a daily basis, they amass and form plaque.

• Plaque – This is a sticky film that coats teeth and covers the gums and tongue. It can be felt by running the tongue over teeth at the end of the day before you brush. Plaque forms quickly, from the time you brush in the morning to the time of your evening brushing. The presence of plaque signals that your mouth is harboring more bacteria than saliva flow can rinse away. When plaque is not removed on a daily basis, oral bacteria thrive, reproduce, and harden into calculus.

• Calculus – Also known as tartar, calculus is a cement-hard mass of bacteria that develops from plaque. This colony of bacteria attaches to tooth enamel and can only be removed with special instruments used by dental professionals. This is why your 6-month check-ups and cleanings are so important. By preventing the formation of calculus or having it scraped off on a regular basis, you can avoid damage to gums and enamel.

• Gingivitis – This is the first stage of gum disease. Here, oral bacteria reproduce at a rapid rate while attacking gum tissues and tooth enamel. Signs of gingivitis are gums that bleed easily when brushing, sore gums, and frequent bad breath. When tended to promptly, gingivitis can be halted and reversed. Treatment requires twice daily brushing (at least two minutes) with a soft to medium bristle tooth brush and flouride toothpaste. Daily flossing is also needed to remove food particles and bacteria between teeth. Tongue scraping is advised to remove oral bacteria embedded in the grooves of the tongue. An alternative to a tongue scraper is to brush the tongue with your tooth brush. Be sure to get to the back of the tongue where the greatest concentration of bacteria are embedded. Drink lots of water and swish daily with an oral rinse that kills bacteria. Limit sugar-laden foods and beverages as well as caffeine (which is drying to oral tissues).

• Periodontal (Gum) Disease – When gingivitis progresses, the next stage is periodontal disease. This is when oral bacteria are at a deeper level, eating gum tissues and tooth enamel while creating inflammation. Typical symptoms are red and swollen gums, gums that recede and expose sensitive tooth root areas, and persistent bad breath.

• Periodontitis – This advanced stage of gum disease includes infectious bacteria that cause the gums to be red and tender all the time. In addition to the symptoms of previous stages of gum disease, pus pockets form at the base of some teeth. Some teeth will loosen as bacteria attack the structures that support tooth roots. Eventually, teeth will require removal. Even worse, this potent bacteria can enter the bloodstream through tears in diseased gum tissues. This has been found to trigger internal inflammation that has been found to contribute to the severe health problems mentioned prior (heart disease, arthritis, etc.).

I believe if the general population were more aware of the sequence that leads to full-blown gum disease, we’d have healthier adults, far less people who wear dentures or partials, and people who are enjoying confident smiles. If you are experiencing symptoms of gum disease, please remember that these will only worsen when treatment is delayed.

I hope I’ve provided a helpful explanation of how oral bacteria progresses and how it effects your oral and overall health. For an examination to assess the health of your gums along with recommended treatment options, call 828-274-9440 to arrange a consultation appointment. We will discuss your current situation and potential treatment options.