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Preventing, diagnosing and treating periodontal disease

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The prevalence of periodontal disease continues to be one of the most important oral health issues worldwide. A big part of identifying and ultimately treating periodontitis is explaining to patients just how serious the implications can be, not only for their oral health, but also for their overall health.

According to a report by the Centers for Disease Control and Prevention (CDC), almost half of adults age 30 and older have some form of periodontal disease. Because risk for periodontal disease increases with age, it’s important to begin treating patients as soon as early signs appear. Without early intervention, the CDC predicts that more than 70% of people 65 years and older will su­ffer the consequences.

You can help patients prevent periodontal disease by providing them with at-home care recommendations and explain diagnostic and treatment steps by providing them with information they can easily understand. Consider incorporating the following talking points into patient education opportunities.

Periodontal disease, explained

Periodontal (gum) disease results when sticky bacteria (plaque) aren’t removed with daily brushing and flossing. Unremoved plaque irritates the gums and causes inflammation. The irritated gums then form pockets where bacteria can collect and cause additional irritation. Left untreated, periodontal disease can damage bone and other tissues that support the teeth.

Most often periodontal disease begins with gingivitis, which appears as swollen and red gums that may even bleed. Other early warning signs include:

  • Bad breath or bad taste that persists
  • Red or swollen gums
  • Tender or bleeding gums
  • Painful chewing
  • Loosening teeth
  • Sensitive teeth
  • Gums that have begun to pull away from teeth
  • Changes in the way teeth fit when you bite down
  • Any change in the fit of partial dentures

Watch for these early signs and contact your dentist as soon as they appear.

Several factors can place an individual at risk for periodontal disease. They include:

  • Smoking
  • Diabetes
  • Poor oral hygiene
  • Stress
  • Heredity
  • Crooked teeth
  • Underlying immunodeficiencies
  • Defective fillings
  • Medications that cause dry mouth
  • Bridges that no longer fit properly
  • Hormone changes

E-cigs linked to periodontal disease

As a newer factor that raises risk of periodontal disease and for their many misconceptions, e-cigarettes deserve a special call out. A study at New York University College of Dentistry found that e-cigarette users are at higher risk for developing periodontal disease. The study took a close look at periodontal disease, e-cigarettes, and the immune system and determined that e-cigarettes can be almost as damaging to oral health as traditional cigarettes.

“Unlike smoking, which has been studied extensively for decades,” Scott Thomas, co-author of the study, explained, “we know little about the health consequences of e-cigarette use and are just starting to understand how the unique microbiome promoted by vaping impacts oral health and disease.” Certain groups of bacteria were significantly elevated in the oral microbiome of e-cigarette users, including those features associated with periodontitis.

Periodontal disease diagnostics and treatment

Prevention and treatment of early periodontal disease begin at home with twice-daily brushing and flossing. Seeing a dental professional for a checkup and cleaning at least once a year can help ensure disease is spotted early.

During a dental checkup, the dentist or hygienist will look for signs of inflammation. They’ll use a small ruler (or probe) to measure any pockets around the teeth. In a healthy mouth, pocket depth usually is between 1 and 3 mm. Larger pockets may indicate inflammation or receding gums. The dental professional also will use curettes and scalers to help identify and remove calculus quickly and effectively. Radiography (X-rays) may be used to determine if any bone loss has occurred.

If disease is detected, the goal is to control the infection. This may require more frequent checkups and additional home care. Using a water flosser can aid teeth cleaning and electric toothbrushes can help ensure proper technique, including 2-minute brushing, appropriate pressure and access to hard-to-reach areas.

If periodontal disease has become more advanced, dental professionals can perform deep cleaning below the gums. In addition, prescription medications can be placed directly under the gums to kill bacteria and prescription-strength oral rinses may be provided for at-home use. If necessary, the dentist may recommend corrective surgery. Some of these rinses as well as other washes and sprays can be used to help alleviate pain, particularly after surgery or deep cleaning.

Recommended products

In addition to helping patients understand periodontal disease and treatment options, you should be armed with the tools to ensure your in-office care helps advance good oral health. From periodontal probes to antimicrobial rinses, your Patterson Dental representative can help you in selecting the tools appropriate for your practice.

Selected references

Centers for Disease Control and Prevention. Periodontal disease. July 10, 2013.

Handsley-Davis M. Vaping may worsen gum disease risk. Cosmos. February 23, 2022.

Machado K. 5 tips for treating geriatric patients.

Today’s RDH. July 15, 2019. National Institute of Dental and Craniofacial Research. Periodontal (gum) disease. October 2018.

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This article originally appeared in the May 2022 edition of OnTarget. Read the latest edition and view current promotions at pattersondental.com/dental/ontarget.

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Patterson Dental

At Patterson Dental, we are committed to partnering with dental practices of all sizes to help oral health professionals practice extraordinary dentistry. We do this by living up to our promise of Trusted Expertise, Unrivaled Support every day.



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