March 29, 2015

Periodontal Disease – Part 1

Everyone tells you to see your eye doctor once a year to check for eye problems and have a dilated eye exam, but few even talk about seeing your dentist on a yearly basis or more often. I don't understand why this happens. It would seem that this should also be a requirement for people new to diabetes. This will establish a baseline for your dentist to use when he does checkups in the future.

Unfortunately, like eye diseases and other diabetes complications, there are three problems associated with oral health:
  1. Gingivitis
  2. Trench mouth
  3. Periodontitis
I will start with trench mouth, as in most developed countries, it is a rarity today. Trench mouth was named for the condition among soldiers during World War I who were in trenches without the means to take care of their teeth. Trench mouth is not contagious.

Trench mouth is a severe form of gingivitis that causes painful, infected, bleeding gums, and ulcerations.

Now I will turn to gingivitis. When it comes to periodontal disease, gingivitis is the common and mild form of gum disease. And because gingivitis can be mild, you may not be aware you have it. This is the reason to see the dentist annually, if not more often. Gingivitis can lead to much more serious gum disease (periodontitis) and eventual tooth loss.

Signs and symptoms of gingivitis include:
  1. Swollen gums
  2. Soft, puffy gums 
  3. Receding gums
  4. Occasionally, tender gums 
  5. Gums that bleed easily when you brush or floss, sometimes seen as redness or pinkness on your brush or floss
  6. A change in the color of your gums from a healthy pink to dusky red 
  7. Bad breath
The most common cause of gingivitis is poor oral hygiene that encourages plaque to form. Plaque is an invisible, sticky film composed mainly of bacteria. Plaque forms on your teeth when starches and sugars in food interact with bacteria normally found in your mouth. Brushing your teeth at least twice a day and flossing each day removes plaque. Plaque requires daily removal because it re-forms quickly, usually within 24 hours. This means for people with diabetes that this is most important, especially when diabetes is poorly managed/

Factors that can increase your risk of gingivitis include:
  • Poor oral health habits
  • Tobacco use
  • Diabetes
  • Older age
  • Decreased immunity as a result of leukemia, HIV/AIDS or other conditions
  • Certain medications
  • Certain viral and fungal infections
  • Dry mouth
  • Hormonal changes, such as those related to pregnancy, your menstrual cycle or use of birth control pills
  • Poor nutrition
  • Substance abuse
  • Ill-fitting dental restorations
Steps you can take at home to prevent and reverse gingivitis include:
  • Get regular professional dental cleanings, on a schedule recommended by your dentist.
  • Use a soft toothbrush and replace it at least every three to four months.
  • Consider using an electric toothbrush, which may be more effective at removing plaque and tartar.
  • Brush your teeth twice a day, or better yet, after every meal or snack.
  • Floss at least once a day.
  • Use an antiseptic mouthwash, if recommended by your dentist.
  • Use an interdental cleaner, such as a dental pick or dental stick specially designed to clean between your teeth.
If you're consistent with your home hygiene, you should see the return of pink, healthy gum tissue within days or weeks. You'll need to practice good oral hygiene for life, so your gum problems don't return.

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