Periodontal Disease Treatment Questions

To prevent bad breath, practice good oral hygiene and make lifestyle adjustments:

• Brush your teeth at least twice a day and floss daily to remove food particles and plaque.
• Clean your tongue with a brush or tongue scraper, especially focusing on the back.
• Stay hydrated by drinking water frequently to wash away bacteria.
• Avoid smoking and using tobacco products and seek help from your dentist to quit.
• Use mouthwash or antiseptic rinses to reduce bacteria and freshen breath, but avoid relying on them solely to mask odor.

Additionally, visit your dentist at least twice a year for check-ups and cleanings. If bad breath persists despite good oral care, your dentist may refer you to a physician to explore other underlying health issues.

Bad breath, or halitosis, can be caused by various factors, with the most common reason being microbial deposits on the tongue, especially at the back. Morning breath is common because saliva production slows during sleep, allowing bacteria to grow. Other causes include:

• Certain foods like garlic and onions
• Poor oral hygiene
• Gum disease
• Dental cavities or poorly fitted dental appliances
• Dry mouth (Xerostomia), often due to medications or mouth breathing
• Smoking or tobacco use
• Dehydration, missed meals, or certain diets (such as low-carb)
• Underlying medical conditions like diabetes, liver or kidney issues, and chronic sinus infections

Keeping a record of your diet, medications, and any recent illnesses or surgeries can help your dentist identify the cause of bad breath.

Gum disease progresses through several stages:

1. Gingivitis: The early stage with symptoms such as gums that bleed easily during brushing and inflammation or sensitivity in the gums.
2. Early Periodontitis: Gums start to pull away from the teeth, bleeding becomes more pronounced, and bad breath may develop. Probe depths may exceed 4mm during an examination.
3. Moderate Periodontitis: Teeth may appear longer due to gum recession, and x-rays may show bone loss. Probe depths may reach up to 6mm.
4. Advanced Periodontitis: Teeth become loose or mobile, and constant bad breath and gum sensitivity occur. Probe depths can range between 6mm and 10mm, with severe bone loss.

The best way to prevent gum disease is through proper oral hygiene. Brush and floss at least twice daily to remove plaque buildup, especially at the gum line where gingivitis begins. Flossing is essential for cleaning between teeth, and using a mouth rinse can also help maintain gum health. Regular dental check-ups and professional cleanings are also crucial in preventing gum disease progression.

Four out of five people have periodontal disease and don’t know it!  Most people are not aware of it because the disease is usually painless in the early stages.  Unlike tooth decay, which often causes discomfort, it is possible to have periodontal disease without noticeable symptoms.  Having regular dental check-ups and periodontal examinations are very important and will help detect if periodontal problems exist.

Periodontal disease begins when plaque, a sticky, colorless, film of bacteria, food debris, and saliva, is left on the teeth and gums.  The bacteria produce toxins (acids) that inflame the gums and slowly destroy the bone.  Brushing and flossing regularly and properly will ensure that plaque is not left behind to do its damage.

Other than poor oral hygiene, there are several other factors that may increase the risk of developing periodontal disease:

• Smoking or chewing tobacco – Tobacco users are more likely than nonusers to form plaque and tartar on their teeth.
• Certain tooth or appliance conditions – Bridges that no longer fit properly, crowded teeth, or defective fillings that may trap plaque and bacteria.
• Many medications – Steroids, cancer therapy drugs, blood pressure meds, oral contraceptives.  Some medications have side affects that reduce saliva, making the mouth dry and plaque easier to adhere to the teeth and gums.
• Pregnancy, oral contraceptives, and puberty – Can cause changes in hormone levels, causing gum tissue to become more sensitive to bacteria toxins.
• Systemic diseases – Diabetes, blood cell disorders, HIV / AIDS, etc.
• Genetics may play role – Some patients may be predisposed to a more aggressive type of periodontitis.  Patients with a family history of tooth loss should pay particular attention to their gums.

Signs and Symptoms of Periodontal Disease

• Red and puffy gums – Gums should never be red or swollen.
• Bleeding gums – Gums should never bleed, even when you brush vigorously or use dental floss.
• Persistent bad breath – Caused by bacteria in the mouth.
• New spacing between teeth – Caused by bone loss.
• Loose teeth – Also caused by bone loss or weakened periodontal fibers (fibers that support the tooth to the bone).
• Pus around the teeth and gums – Sign that there is an infection present.
• Receding gums – Loss of gum around a tooth.
• Tenderness or Discomfort – Plaque, calculus, and bacteria irritate the gums and teeth.

Good oral hygiene, a balanced diet, and regular dental visits can help reduce your risk of developing periodontal disease.

Signs of Gum Disease include:

• Red, puffy, or bleeding gums
• Persistent bad breath
• New gaps or spacing between teeth
• Loose teeth
• Pus around gums
• Receding gums
• Gum tenderness or discomfort

Risk factors include smoking, crowded teeth, defective dental work, certain medications, hormonal changes (pregnancy, puberty), systemic diseases (diabetes, HIV), and genetics. If any of these signs or factors apply, it’s important to see your dentist for an evaluation.