Gum Disease / Infections - Periodontal Disease.

As can be seen from this xray of my wife's teeth, the gum disease has caused bone loss from around her teeth. 

Looking at this xray picture, the number 1 points to the line where you can see the existing bone level height around the teeth.

  The number 2, is where the bone line originally was before the gum disease destroyed and ate away the bone. 

The number 3 points to two dark areas between two teeth, see how the xray shows the bone dipping down either side next to the two teeth - that's because the gum disease has started around these two teeth and are dissolving the bone - before the gum infection, the bone would have been seen as a straight line and not the curved one you now see in the picture / photo.

The bottom teeth appear much less affected by the periodontal disease at this time.  A momentary thing, as the gum disease will continue, if untreated, to destroy and eat away the bone from the top and bottom teeth, most likely reaching the point where all the teeth would fall out.  Gum infections should be dealt with quickly, long before they reach this advanced stage.

Gum disease - Definition and Causes.

If you have an infection and inflammation of the gums, by definition it is referred to as "periodontal disease".

The cause of gum disease is primarily the build up of plaque, bacteria that can live on teeth and thrive when food is left on the teeth - that occurs from improper cleaning of teeth / poor oral hygiene practices.

  The plaque manages to get under the gum line, something I didn't know was possible.  The plaque can turn into tartar (hardened plaque), which also then does damage through the bacterial action on the gum.  One would expect tooth decay, but the plaque and tartar below the gum line, causes infection and inflammation to the gum and does not eat into the tooth!

I couldn't understand how my wife could have gum disease, when she had cleaned her teeth so meticulously for the whole time I have been with her - married 20 years.  I mean she cleaned her teeth with special toothpastes, used dental floss two or three times a day and had regular dental check ups and cleans.  So how could she have gum disease now, in her forties? 

We went for a second opinion, the dentist confirmed the diagnosis and when questioned about the cause, he said the plaque could have gotten into the gum line at any time since the adult teeth formed, where it can just remain basically dormant for thirty years or more, but at this time in my wife's life cycle, the tartar for some reason, begun doing it's damage.  As a young adult, Ms. X recalled she had become very ill and for a while she was too ill to clean her teeth as well as she usually did.

Hard to believe that gum disease can act like that, but it does.

Anyway, the sad part, is that with Ms. X, the dentists - at least three different ones - failed to diagnose the gum disease, even though the symptoms were quite obvious to a trained eye - so now she has a big fight on her hands to try and save most of her teeth and she may end up losing some, which really isn't fair.  I get so angry about professionals who take lots of money for very little work and do a lousy job that jeopardizes you even more - Ms. X is one of those people who always attended for the routine six monthly checkups as well.  We have had so many bad dentists, that the good ones seem to be a rarity.

By way of yet another experience: It is really important to choose a dentist you can trust.  We became highly suspicious when the dentist doing the gum disease treatment, more than doubled the price.  We went to another dentist in another town and he said, your wife had gum disease years ago, but not now and did NOT require any gum disease treatment.  He said the other dentist just took the $600 for the first 1/2 treatment because he wanted the money and didn't care about the pain, discomfort and fear he caused Ms. X - he was just after the money.

My wife had gum disease, but all that meticulous cleaning not only controlled it, but got rid of it. 

I was diagnosed with gum disease, easy bleeding with flossing by the dental hygienist, but was told it's in the very early stage and that all I had to do was floss my teeth regularly - I was under the impression my toothbrush could do that when I moved it up and down - Live and learn. 

Anyhow, the symptoms of gum disease normally include one or more of the following:

1... Inflammation of gum or areas of gum - inflammation symptoms being redness, swelling, tenderness, pain and or bleeding.

2... Teeth that appear longer than they should - the gum has receded from them.

3... Bad breath that is either constant or keeps returning.

4... Sores /abscesses on the gum ( which are near or next to the tooth or teeth with the gum disease )

5... Mouth has a frequent of constant bad taste in it.

6... Gaps between teeth getting wider, teeth seem to be moving into different positions and teeth may be loose, even wobbly.

7... If you wear partial dentures or such, the denture may no longer be fitting right.

The Stages of Gum Disease / Periodontal Disease

The Early stages:

In the early stage of gum disease, the main symptom or characteristic is inflammation of the gum and this early stage of the disease process is called "gingivitis".  This early stage is easily treated by the dentist or dental hygienist removing the plaque and tartar, this process is called " Scaling" ,  followed by the sufferer paying strict attention to the cleaning of their teeth.  Sometimes a filling may be suspected as causing the gum disease and your dentist may want to reshape or take the filling out.  Depending on what your dentist finds, he may suggest other alterations to life style, like stop smoking, use a different mouth was...

The advanced stages:

If your dentist didn't pick up on it earlier when the symptoms were present, I would suggest changing your dentist.  This advanced stage of gum disease is called "periodontal".   This stage of gum disease is very nasty.  The symptoms of gum disease typically worsen lots more. 

If left untreated, this stage of gum disease can cause you to lose every tooth that is afflicted by it, cause your jaw to be seriously weakened and you could end up with your gum being badly deformed.

You probably have "gum pockets" as well, which is defined as the pockets formed in the gums when bone is eaten away by bacteria.  The gum pockets are normally filled with bacteria that will just going on destroying your bone.

Advanced Gum Disease Treatments

Outcomes:

The outcomes of having treatment for gum disease varies from one person to the next.  For many people gum disease can be cured, while for others, treatment may only slow down the disease process.

Treatment gives you a better chance of  keeping your teeth and can alleviate some of the symptoms, such as the inflammation and bad breath.  Cosmetic dentistry and or surgery can help rebuild the look of the teeth and gum back to a more normal appearance, if required.

Costs of Gum Disease Treatments

Treatment for gum disease costs around $600 to $1200.  Where operations are required or other dental cosmetic surgery sought, treatment costs can go up quite markedly.  $10,000 for some people.  Be aware that dentists often give quotes for treating gum disease, based on what they call "quadrants".  A quadrant is one one quarter of your teeth.  So, if they give you a quote for treating gum disease, clarify just how many quadrants are being done and what the all up cost for all your teeth is going to be.  We got caught out like this with one dentist -got a written quote and all - but it turned out he was only doing two quadrants and not two sides as we thought; he had used item numbers instead of naming what he was doing.

Treatment Options for the Advanced Stages of Gum Disease / Periodontal Disease:

There are several treatment options a well trained dentist, but preferably a periodontist ( A dentist with specialized training in periodontal disease ), can use.

1... Obviously, removing the plaque and tartar can help prevent or slow down further deterioration of the teeth through the gum disease.  The removal of the plaque and tartar at this stage is called "root planing".  The process can be quite painful and you may need many pain killing injections before treatment starts.

  The periodontist, using specialized dental planing instruments, cleans the teeth below the gum line.  This means the instrument is pushed down between the tooth and the gum for some distance until the periodontist believes all the calculus has been removed from each tooth.  It takes about 20 or so minutes to do a quadrant (one quarter of the teeth ) and the periodontist will likely do two quadrants at a time, depending on how much work is involved in each quadrant.

2... If you have gum pockets, they will have to be treated to lessen any chance of reinfection.

3... Fillings may cause gum disease as well, so your periodontist or dentist may want to reshape or take out a filling he suspects as contributing to the gum disease.

4... You may be retrained or trained to clean your teeth much better and to attend to your oral hygiene much better.  Be given the names of suitable antibacterial mouth washes to use as well, to keep the risk of infection lower.

5... You may be advised to stop smoking if you are a smoker, as smoking increases the risk of gum disease and works against any successful gum disease treatment.

Side Effects of Gum Disease Treatments

The most common side effects of treating gum infection / periodontal disease include:

1... Pain during the scaling and root planing, hence local anaesthetic may be used beforehand.

2... Gums may be sore and tender, particularly following root planing.  If too sore to use a soft toothbrush, a mouthwash containing chlorhexidine may be used as a temporary replacement.

3... Gums may appear to recede following gum disease treatment, buts it's more than likely just the swelling going down.

4... Teeth may be over sensitive to temperature or touch.

5... Ironically, treating the gum disease can in turn lead to tooth decay, as more of the tooth has been exposed.  A fluoride mouth rinse may help decrease the risk of the tooth decay.

6... In spite of all the treatments, effort and expense to keep the tooth or teeth, they may still be lost.

After the Gum Disease Treatment, Am I Cured? What's Next?

The aim of treatment is to cure gum disease or at least slow the gum disease down as much as possible.  To achieve these aims, a number of things should be pursued following the treatment of gum disease described above, as gum disease will often come back after treatment.

1... Keep your teeth thoroughly clean with soft toothbrushes and dental floss (you may need the "interdental brushes" - they are tiny brushes that look like Christmas trees) and attend for regular checkups.

2... Be aware that root planing may have to occur every three months in some cases, to keep the gum disease under control.

Can't afford professional gum disease teatment?  How about a cheap home remedy?

  You can buy gum disease treatments online. BUT, here's a cheap gum disease home remedy. Clean your teeth properly.  I am quite serious.  Learn how to clean your teeth properly, including the use of the interdenture brushes if the gap between your teeth has widened ( as described on that teeth cleaning page).  My wife put an end to her gum disease and bone loss by adding the interbrushes into her teeth cleaning routine.  Flossing is vitally important in controlling and preventing gum disease / periodontal disease.  If your teeth can tolerate the risk of holding off the expensive dental procedure for gum disease:  If this home remedy for gum disease hasn't worked in about 6 weeks, then go ahead with your expensive dental work.  How will you know if this Home Remedy has likely worked - NO BLEEDING GUMS after the dental flossing!  To prevent the gum disease from returning, try just keep cleaning your teeth and gums properly.

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