How and why to treat periodontal disease


LEE — As he scrubbed his teeth, Joe Furgal would notice blood on his tooth brush. His gums were bleeding.

What Furgal, a Lee resident and active community member, did not know back in the late 1990s was that his bleeding gums was a symptom of periodontal disease, or gum disease.

In Furgal’s circumstance, plaque and tarter had likely built up on his gums, causing them to inflame. Then scrubbing led his sensitive gums to bleed, said Pittsfield-based periodontist Erich Schmidt. In the worst case scenario, teeth could be lost.

“They bled anytime there was a cleaning,” Furgal said. He regularly brushed his teeth, but he said he didn’t floss. “I was known as a bleeder. The dentist had in their charts I was a bleeder.”

Periodontal disease can lead to gum inflammation or, in more severe circumstances, to damage to the gums and bone that support the teeth.

According to a report commissioned by the Center for Disease Control, “Prevalance of Periodontitis in Adults in the United States: 2009 and 2010,” an estimated 64.7 million American adults, 47.2 percent, have a mild, moderate, or severe case of periodontal disease.

Severe symptoms of periodontal disease can include swelling or bleeding, Schmidt said.

In Furgal’s case, he would undergo surgery on all four quadrants of his mouth. The surgery included cutting his gums so they would regrow around his teeth, eliminating pockets where bacteria could build up.

The condition can go unnoticed, Schmidt said, but can have long-term consequences.

Q: What is periodontal disease, and how common is it?

A: Periodontal disease is a chronic inflammatory disease that affects the gum tissue and bone supporting the teeth. If left untreated, periodontal disease can lead to tooth loss.

Q: What are common risk factors for periodontal disease?

A: The main cause of periodontal disease is plaque, but other factors affect the health of your gums. Secondary factors include: age, smoking, genetics, stress, medications, clenching or grinding your teeth, systemic disease diabetes, cardiovascular disease and rheumatoid arthritis.

Q: What are common symptoms associated with periodontal disease?

A: Gum disease is often silent, meaning symptoms may not appear until an advanced stage of the disease. However, warning signs of gum disease include the following:

• • Red, swollen or tender gums or other pain in your mouth.

• • Bleeding while brushing or flossing, or eating hard food.

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• • Gums that are receding or pulling away from the teeth, causing the teeth to appear longer than before. \

• • Loose or seperating teeth.

• • Pus between your gums and teeth.

• • Persistent bad breath.

Q: What are the health risks associated with periodontal disease?

A: Research has shown that periodontal disease is associated with several other diseases. The main ones are diabetes, heart disease, and premature and low birth weight in babies. For a long time, it was thought that bacteria was the factor that linked periodontal disease to other disease in the body; however, more recent research demonstrates that inflammation may be responsible for the association. Therefore, treating inflammation not only helps to manage periodontal disease but in some cases also helps with the management of other chronic inflammatory conditions.

Q: What happens if a patient doesn’t get the periodontal disease treated?

A: If periodontal disease is not properly diagnosed and treated, an individual will lose bone around the teeth over time. This will lead to eventual mobility of the teeth, at which point it can often be too late to save them.

Q: Can gum disease lead to other health problems beyond the gums?

A: Gum disease can cause significant other problems in the body beyond just the mouth. For example, patients with active periodontal disease who have diabetes or are prediabetic will have a harder time controlling their blood sugar.

Also, people with and periodontal disease who have heart disease are more likely to suffer from a heart attack.

Q: What are treatment options for periodontal disease, and why are they

A: There are many new and less invasive options to treat periodontal disease. Previously, periodontal treatment was geared toward removal of infected bone and tissue. These types of procedures often left people with significant post-operative discomfort.

However, therapy is designed to be less invasive and more geared to heal and re-grow lost bone and tissue. Not all case or treatment options even require surgery. However, when there is severe bone loss, surgery becomes the best option to retain the teeth. Without treatment of the disease, the teeth will be lost.

Q: Does health insurance cover periodontal disease?

A: Most dental insurance plans, including Blue Cross, Blue Shield and dental plans, cover periodontal treatment. In fact, patients who have medical conditions such as diabetes and have the same insurer for both medical and dental now get reminders from the medical insurer to see the dentist. The reason is very simple: medical insurance costs have been shown to decrease with patients that have their periodonal disease treated.

Q: Once treated, what’s the best way to assure that your gums stay healthy?

A: Besides brushing twice a day and flossing, the next important step is to have a regular checkups and cleanings. Patients with moderate to severe periodontal disease have been shown to remain stable with four cleanings a year. Not all patients with periodontal disease need to be treated by a gum specialist. Only those with moderate to severe periodontal disease need to see a gum specialist.


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