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Toothcare Bad Breath

Teeth are meant to last a lifetime. Periodontal disease (previously known as Pyorrhea) is a major cause of tooth loss in our population. Most of the time, periodontal disease is preventable. 

"Gum disease" describes a range of conditions that affect the supporting tissues for the teeth. The supporting tissues comprise both the surface tissues that can be seen in the mouth and also the deeper tissues of the bone, root surface and the ligament that connects the teeth to the bone.

Periodontal disease is caused by bacteria. Bacteria form a 'plaque' which is a sticky, colourless film that forms on your teeth, particularly around the gum line. Other bacteria thrive deep in the gap between the gum and the tooth (the 'pocket'). Some people are much more at risk of developing periodontal disease - smoking is one of the major risk factors. Other conditions such as diabetes, stress, pregnancy and various medications can all be contributing factors.

Infection affecting the surface tissues is called Gingivitis. This may progress to affect the deeper supporting tissues and is called Periodontitis (previously called pyorrhea). The effects of gingivitis are largely reversible with appropriate care. Once this has progressed to periodontitis there is permanent damage to the ligament and bone that supports and holds the teeth. Often a space develops between the gum and the tooth called a pocket. The pocket forms a protected environment for more bacteria and the condition progresses. If left untreated periodontitis may cause abscesses and tooth loss.

Gum disease can be treated successfully.

In the vast majority of cases the progression of gum disease can be arrested with appropriate care. Management of gum disease becomes more difficult and less predictable the more advanced the disease. Therefore, the sooner periodontitis is diagnosed and treated the better. Regular dental examinations are important to check for the presence of gum disease.

The cause of gum disease is bacteria. To manage it, the bacteria must be reduced to a level the body's defense mechanisms can handle. Treatment classically involves:
> achieving the best possible home care
> professional cleaning of the teeth above and below the gum line (into the pockets) to remove the plaque and hard deposits (calculus / tartar), and
> regular reviews
> trying to remove risk factors such as smoking.

Gum disease causes permanent damage to the supporting tissues; therefore the aim of treatment is to stop the progression of the disease through controlling the bacteria. This is an ongoing, lifelong activity.

Prevention is best. To a large extent periodontitis can be prevented by good oral hygiene and early intervention when problems are identified.

Bleeding gums are common but not OK. In a healthy state gums do not bleed. Bleeding is often an indication that the gums are inflamed. The inflammation is generally a response to the bacteria on the surface of the teeth. The surface inflammation is Gingivitis. The bleeding may also arise from Periodontitis or traumatic cleaning. Bleeding gums are sometimes associated with serious medical conditions.

Anyone can get periodontitis.

Many people will have a small amount of periodontitis, which gradually increases with age. However approximately 15% of the population will have a significant degree of periodontitis. The destruction of the tooth's supporting tissues caused by periodontitis gets worse over time when left untreated, and is often seen more severely in the 45+ age group. However the different types of periodontitis may affect people of all ages.

The risk for periodontitis is increased with poor oral hygiene, smoking, diabetes, a family history of periodontitis and a range of medical conditions, in particular those affecting the immune system.

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