Kathy recently became a patient in our dental practice. She found us online when searching for a dentist who would view her mouth as a barometer for her overall health. Her last dentist, who she hardly ever saw anyway, didn’t want to discuss important health issues like fluoride, mercury fillings or her root canals. Her dentist and her hygienist always said her mouth and teeth looked great and she needed to stop worrying about those other issues.

At her initial visit with Dr. McGrath, Kathy heard for the first time that she has gum disease (periodontal disease). So, today she and I sat down to discuss what this means for her.

Kathy: I’ve seen my dentist faithfully, every six months. How did I just get gum disease?
Perry: Gum disease happens slowly and often the person experiences no obvious signs until the bacterial infection is in an advanced stage. We all have oral bacteria. As some of these bacteria die each day, they stick to our teeth. Brushing and flossing daily helps remove most of the bacterial debris above the gumline. But the buildup also forms between the teeth and gums and below the gum line. That is not so easy to remove, especially when you don’t even know it is there.

Kathy: How do you know I have gum disease?
Perry: Periodontal disease is a bacterial infection under the gumline. When evaluating the health of the gums, we look at three things. First, we “measure pockets”. Around each tooth is a tiny cuff of gum. Using a small, calibrated instrument to measure the depth of that cuff, gives us a baseline of your “pocket” depths. Measurements of 1-3mm are healthy. A pocket of 4mm or greater is a sign of gum infection. Second, we use x-rays to determine if there is bone loss due to gum infection. The periodontal bacteria erodes bone around the teeth. With time, this is visible on your x-rays.

Finally, we take a sample of the buildup and put it on a microscope slide. You and your hygienist are able to identify periodontal bacterial with the help of our microscope. Using these three pieces of information, we know the number and depths of the periodontal pockets. We can determine the degree of bone loss you have experienced. Lastly, we identify the types of oral bacteria present, both healthy and anaerobic (bacteria that live without oxygen … periodontal bacteria.)

Kathy: So what’s the big deal? Doesn’t everybody have buildup and bacteria in their mouth?
Perry: The short answer is yes. About 80 % of American adults have periodontal disease1. Most people are unaware of their gum disease. The buildup under the gum, gives anaerobic bacteria a place to grow, creating an infection. Infection activates the immune system which in turn activates inflammation in other parts of your body2.

INFLAMMATION … something we’re hearing a lot about these days. The lining of our blood vessels is the endothelial lining. When inflammation in the mouth is present, that lining in our arteries begins to change. These changes lead to “hardening of the arteries” also known as atherosclerosis, a type of heart disease3. Heart disease is the number one cause of death in the world4. Bacteria from the mouth enters the blood stream through the gums. These same bacteria have been found clumped on the endothelial lining of the arteries3. As you can see we need to take inflammation seriously.

Kathy: So how do we treat my gum disease?
Perry: In our office, we treat it non-surgically. Dr. McGrath determines the number of periodontal visits you will need with the hygienist. Our hygienists use ultrasonic equipment to gently remove the buildup. They irrigate each pocket with antibacterial ozonated water to help in killing the anaerobic bacteria. In more advanced cases, Dr. McGrath may also recommend that we culture your periodontal bacteria to determine the most appropriate antibiotic to use in your treatment.

Kathy: Are there things I can do to help my gum disease and the inflammation?
Perry: To get the best results, there are a number of things for you to do. Certainly brushing after meals and flossing daily is a starting point. Our hygienists have seen good results with the use of a water pik or other home irrigating device like “Hydrofloss”. This allows you to daily irrigate your perio pockets, using an appropriate antibacterial solution. A tooth paste and mouthwash that kills periodontal bacteria is an important addition. Specific supplements and probiotic for this type of infection are also useful. The use of ozonated olive oil, applied to the gums at home, helps in the healing process. Once the bacterial infection is under control, it is very important to continue your at-home oral care. It is equally as important to see your hygienist for perio maintenance visits at regular intervals.

1. American Dental Hygienists’ Association Fact Sheet 2012
2. Richard H. Nagelberg DDS, What the Medical Journals Are Publishing About the Mouth, the Bugs and the Body, Dental Economics January 2015
3. Dr. Frank Shallenberger M.D. Second Opinion March 2015, The Real Cause of Most Heart Diseases – And the Surprisingly Easy Way to Stop It
4. World Health Organization, May 2014

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