Gum Disease Prevalence Surpasses Diabetes with Nearly 65 Million Affected

With one in every two adults age 30 and older suffering from periodontal disease (commonly referred to as gum disease), the American Academy of Periodontology (AAP) and its 8,300 members are calling for Americans to Love the Gums They’re With. Periodontal disease can lead to receding gums, bone damage, loss of teeth, and can increase the risk of other health problems such as heart disease and diabetes. Despite its prevalence, periodontal disease is hardly ever discussed, resulting in a lack of urgency for people to properly care for their gums. Simple steps like brushing twice a day, flossing daily, and receiving an annual comprehensive periodontal evaluation from a periodontist can help detect and prevent gum disease.

Periodontal disease is an inflammatory condition that, if left untreated, may cause damage to the tissues and bone surrounding the teeth,eventually leading to tooth loss. According to the Centers for Disease Control and Prevention, 64.7 million Americans are affected by periodontal disease. In addition to diabetes, periodontal disease has been linked to other chronic diseases, including cardiovascular disease, rheumatoid arthritis, Alzheimer’s disease, and even cancer.

The serious risks of periodontal disease upon an individual’s oral and physical well-being is a very serious – but often overlooked – health issue, which affects the patient's overall health.” said Miguel A. González Ascar, DMD MS. “With more Americans suffering from this disease than diabetes, the AAP created ‘Love the Gums You’re With’ to educate the public on the importance of prevention and early diagnosis of periodontal disease.”

Periodontal disease typically does not cause pain until it’s in an advanced stage, at which point much of the damage has been done and tooth support destroyed. To raise awareness and to help health consumers better understand periodontal disease, the AAP is teaming up with TV personality Chris Harrison to launch the Love the Gums You’re With educational effort. As host of ABC’s “The Bachelor,” Harrison knows that first impressions are important in successful relationships.. Just as personal relationships thrive on daily attention and care, so does the relationship with your gums.

What Puerto Rico Patients Can Do

To aid in the prevention of periodontal disease, establishing good oral hygiene habits including brushing at least twice a day, flossing daily, and discussing gum health with a dental professional is highly recommended. To learn more, patients can take a brief quiz on perio.org to evaluate the current state of their gum health, learn the signs and symptoms of periodontal disease, and receive tips on how to properly care for their gums. Each patient is unique, and a dental professional can make a referral to a periodontist — a dentist who specializes in the prevention, diagnosis and treatment of periodontal disease — for a comprehensive periodontal evaluation and specialized periodontal treatment plan to help support a life-long commitment to healthy gums. You can find a Puerto Rico periodontist on perio.org, or contact Periodoncia e Implantes Dr. Miguel A. González Ascar.

About Periodontal Disease

Periodontal disease is caused by bacteria in the mouth that form plaque below the gum line. There are more than 500 bacterial species that can be found in plaque, and brushing alone does not remove the bacteria that live below the gum line. Poor oral hygiene is one cause of periodontal disease, but smoking is also a significant risk factor in the development and progression of the disease. While periodontal disease is mostly preventable and treatable, the early warning signs can be painless, making it necessary for individuals to establish strong oral hygiene habits and to discuss their periodontal health with a dental professional. With an appropriate diagnosis, the damage from periodontal disease is reversible in many cases.

About the American Academy of Periodontology

The American Academy of Periodontology (AAP) is the professional organization for periodontists – specialists in the prevention, diagnosis, and treatment of diseases affecting the gums and supporting structures of the teeth, and in the placement of dental implants. Periodontists are also dentistry’s experts in the treatment of oral inflammation. They receive three additional years of specialized training following dental school, and periodontics is one of the nine dental specialties recognized by the American Dental Association. The AAP has 8,300 members worldwide. For more information, visit perio.org.

Tipos de enfermedades periodontales

GINGIVITIS

La Gingivitis es el tipo de enfermedad periodontal más leve.  Ocasiona que las encías se pongan rojas e inflamadas, y a su vez hay sangrado fácil.  Por lo general durante esta etapa no hay molestia.  La causa principal es higiene oral inadecuada, y la misma es reversible con tratamiento profesional y buena práctica de higiene oral en su hogar.

Otros factores que pueden contribuir a la gingivitis incluyen: diabetes, cigarrillos (u otros productos de tabaco), edad, predisposición genética, nutrición inadecuada, pubertad, fluctuaciones hormonales, embarazo, medicamentos para condiciones cardiacas, entre otras.

PERIODONTITIS

Si la gingivitis no es tratada, la misma puede progresar y convertirse en periodontitis.  En esta etapa, la placa bacteriana se acumula debajo de las encías, causando mayor irritación y comenzando a ocasionar pérdida ósea.  Al perder hueso, y la encía separarse del diente, aumenta la movilidad de ellos, al igual que la acumulación de bacterias ocasiona un mal aliento constante (halitosis).

La periodontitis se divide de la siguiente manera:

  • Aggressiva- ocurre en pacientes que estan clinicamente saludables y son jóvenes.  Se presenta con destrucción rápida de tejidos oseos y encías.
  • Crónica- Resulta en inflamación dentro de los tejidos de soporte, la pérdida de estos tejidos es progresiva.  Es la más común, afectando a sobre 1/3 parte de la población.
  • Periodontitis como manifestación de enfermedades sistémicas- Condiciones tales como enfermedades cardiacas, respiratorias, y diabetes se han asociado con esta forma de periodontitis.  La periodontitis NO causa estas condiciones, sin embargo las personas que padecen de estas enfermedades tienen una mayor predisposición para padecer de periodontitis.  En especial los pacientes diabéticos.
  • Periodontitis Necrosante- Se caracteriza por necrosis y dolor en los tejidos gingivales, ligamento periodontal y hueso alveolar.  Se observa mayormente en pacientes severamente desnutridos e immunosuprimidos.

La mejor forma de prevenir esta condición es con buena práctica de higiene oral en su hogar.  Su periodoncista puede educarlo y asegurarse que su cuidado oral sea óptimo.  Recuerde visitar a su dentista cada 6 meses.  Pacientes con condiciones de las encías deben visitar a su periodoncista cada 3 meses para arrestar la condición y evitar la pérdida de dientes.

Tu evaluación periodontal comprensiva anual (CPE)

Muchos ya saben que el visitar a su dentista regularmente para un examen y limpieza es esencial para mantener tu salud e higiene oral en óptimas condiciones.  Sin embargo, estas visitas no siempre estan enfocadas en las señales de enfermedad periodontal.  Síntomas de enfermedad periodontal en ciertos pacientes pueden pasar por desapercibidas. La Academia Americana de Periodoncia (AAP por sus siglas en inglés) recomienda una evaluación periodontal comprensiva (CPE) anualmente para determinar si usted tiene o está a riesgo de enfermedad periodontal.

Al examinar su salud periodontal, y determinar los riesgos temprano, usted y su periodoncista sabrán el estado actual de su salud oral (inflamación de encía, pérdida de hueso, recesión de encía, mobilidad de los dientes) y si tratamiento adicional será necesario.  La CPE puede hacerse en su chequeo anual por un miembro de su equipo dental, incluyendo su dentista generalista, higienista, ó periodoncista.

Típicamente, durante un CPE, su periodoncista asesorará estas seis áreas:

  1. Sus Dientes:  Se examina en detalle sus dientes, implantes, restauraciones, dentaduras, y coronas.  La posición de los dientes y calidad e integridad de restauraciones  es muy importante para mantener un tejido periodontal sano.
  2. Placa Dental: Se le evalúa la cantidad de placa bacteriana entre sus dientes y sus hábitos de higiene oral.
  3. Encías: Utilizando una sonda periodontal, se mide la profundidad de los "bolsillos" periodontales para determinar la pérdida de hueso, adhesión de las encías al diente, sangrado, e inflamación.
  4. Mordida y Oclusión: Se examina cómo están alineados los dientes, ya que una oclusión pobre puede afectar la salud periodontal.
  5. Estructura Osea: Utilizando radiografías, el hueso alrededor del diente se examina para determinar su nivel y calidad.  Dependiendo de estas cualidades, se puede determinar varios tipos de tratamiento, ya sea regenerativo o resectivo.
  6. Factores de Riesgo: Factores como edad, fumar, diabetes, enfermedades cardiovasculares, y auto imunes como la artritis, pueden tener un efecto detrimental en la salud periodontal.

Una vez haya concluído el CPE, su periodoncista discutirá su situación y determinará un plan de tratamiento para su situación.  Durante este momento es ideal el hacerle cualquier pregunta a su médico para aclarar cualquier duda.

Recuerde que además del cepillado dental, uso del hilo dental, y visitas regulares a su dentista, un examen periodontal es una parte esencial para su rutina de salud oral.

Para más informacion, puede visitar la página de la Academia Americana de la Periodoncia (www.perio.org).  Esta información es para su uso personal y no se debe de utilizar como sustituto del cuido y manejo de su dentista.  Todo paciente es único y los tratamientos varían de acuerdo a cada caso por individual.

Periodontal Disease, What you need to know: American Academy of Perio (AAP)

This is taken from the AAP Patient Brochure, in order to provide a more simple and complete definition of what constitutes periodontal disease and what we as specialists deal with. For more information, visit THE AMERICAN ACADEMY OF PERIODONTOLOGY website at www.perio.org.

PERIODONTAL DISEASES-

The image of grandparents’ “teeth” in a drinking glass is a common memory associated with many people’s youth. It was believed that as a person got older, tooth loss was inevitable. With the aid of new research and better oral care, members of today’s generation are more likely to keep their teeth in their mouths for life.

Research shows that nearly one in three U.S. adults aged 30 to 54 has some form of periodontitis, also known as gum disease. This high incidence may not only be related to age but also to other risk factors, suggesting that tooth loss is not an inevitable aspect of aging…Read on to discover how you can keep a healthy smile for a lifetime!

keeping a healthy smile

What are periodontal diseases?

The word “periodontal” literally means “around the tooth.” Periodontal diseases are bacterial gum infections that destroy the gums and supporting bone that hold your teeth in your mouth. Periodontal diseases can affect one tooth or many teeth. The main cause of periodontal diseases is bacterial plaque, a sticky, colorless film that constantly forms on your teeth. If the plaque is not removed, it can turn into a hard substance called calculus or tartar in less than two days. Tartar is so hard it can only be removed by an oral health professional, such as a dentist or dental hygienist. The bacteria in plaque infect the

gums, and release poisons that cause redness and inflammation (irritation). The inflammation and the poisons themselves cause destruction of the tissues that support the teeth, including the bone. When this happens, the gums separate microscopically from the teeth, forming pockets that fill with even more plaque causing even more infection.

Periodontal diseases are multi-factorial. This means that there is not just one cause of periodontal diseases but rather multiple factors that can affect the health of your gums.

  • TOBACCO use significantly increases the risk of developing periodontal diseases and can negatively affect treatment.
  • HORMONAL CHANGES during pregnancy, puberty and menopause can cause the gums to become red, tender and bleed easily.
  • GENETICS and family history of periodontal diseases indicate a greater likelihood of developing these diseases.
  • STRESS can make it more difficult for the body to fight off infection, including periodontal diseases.
  • Some MEDICATIONS such as oral contraceptives, antidepressants and certain heart medicine, can affect oral health.
  • DESTRUCTIVE HABITS such as improper oral hygiene technique, oral piercing, drug or alcohol abuse can affect periodontal health.
  • POOR NUTRITION can make it harder for the body to fight off infection.
  • SYSTEMIC DISEASES that interfere with the body’s immune system may worsen the condition of the gums and supporting bone.

Are all forms of periodontal diseases the same?

There are many types of periodontal diseases. The following is an overview of the most common:

Gingivitis

As the mildest form of the periodontal diseases, gingivitis causes the gums to become red, swollen, and bleed easily. There is usually no discomfort at this stage.

Chronic Periodontitis 

Chronic periodontitis is a condition resulting in inflammation within the soft tissues surrounding the teeth causing progressive attachment and bone loss (see Figures 1.0 and 2.0). It is diagnosed by bone loss on a dental X-ray, the formation of gum pockets and/or receding gums. It is most common in adults, but can occur at any age.

Dotted line indicates healthy bone level

Aggressive Periodontitis

This form occurs in patients who are otherwise in good health. Common features include rapid attachment loss and bone destruction. There are two forms of aggressive periodontitis:

LOCALIZED AGGRESSIVE PERIODONTITIS – Most often occurs near puberty and usually involves attachment loss around first molars and/or front teeth but may involve one or two additional teeth.

GENERALIZED AGGRESSIVE PERIODONTITIS – Usually, but not always affects people under 30 years of age. It involves attachment loss on at least three permanent teeth in addition to first molars and incisors.

Periodontitis as a Manifestation of Systemic Disease

As the name indicates, this form is associated with one of several systemic diseases that are related to periodontitis, such as diabetes.

Necrotizing Periodontal Diseases

These types of periodontal diseases cause ulcers in the gums between the teeth and are most commonly observed in individuals with certain conditions including, but not limited to, HIV infection, malnutrition and immunosuppression. Stress, smoking, and poor oral hygiene sometimes can contribute to this problem.

What are the signs of periodontal diseases?

Periodontal diseases are often silent, meaning that symptoms may not materialize until significant bone loss has occurred. Some people may have periodontitis and not experience any symptoms and be unaware that they have disease. Common symptoms and signs of periodontal diseases include:

  • RED, SWOLLEN OR TENDER GUMS
  • BLEEDING WHILE BRUSHING OR FLOSSING
  • GUMS PULLING AWAY FROM THE TEETH MAKING TEETH APPEAR LONGER
  • LOOSE OR SEPARATING TEETH
  • PUS BETWEEN THE GUM AND TOOTH
  • PERSISTENT BAD BREATH
  • A CHANGE IN THE WAY YOUR TEETH FIT TOGETHER WHEN YOU BITE
  • A CHANGE IN THE FIT OF PARTIAL DENTURES

If you notice any of these symptoms, you should see a periodontist for a complete periodontal examination. A periodontist is a dentist who specializes in the prevention, diagnosis and treatment of tissues surrounding the teeth. In addition, periodontists are experts in the placement and maintenance of dental implants.

During a periodontal examination, the periodontist will gently place a small measuring instrument called a periodontal probe in the pocket between the teeth and gums to measure pocket depths and help make a diagnosis. Probing depths measuring 1-3mm are usually considered healthy. Four to 5mm may indicate mild periodontitis, 5-6mm suggest moderate periodontitis, and 7mm or greater may indicate severe periodontitis. In addition to probing depth measurements, X-rays may be taken to evaluate the health of the bone supporting the teeth.

How are periodontal diseases treated?

Once your periodontal health has been evaluated, your periodontist will work with you to determine the best treatment options to control your disease and bring you back to health.

Treatment can vary depending on how far the disease has progressed. If diagnosed and treated in the early stages, simple non-surgical periodontal therapy may be sufficient. If periodontitis has advanced to the point where the periodontal pockets are deep and significant amounts of bone are lost, surgical therapy may be necessary.

Once periodontitis has been controlled, patients will require ongoing periodontal maintenance procedures to sustain health. This ongoing phase of treatment will allow your periodontist to assess your periodontal health and make sure that your infection stays under control or remains eliminated. During these re-evaluation appointments, your mouth will be examined, new calculus and plaque will be removed and, if necessary, your teeth will be polished and your bite will be checked.

Periodontal diseases are chronic diseases, just like diabetes. Without careful, ongoing treatment, periodontal diseases can and often do recur.

How can the periodontal diseases be prevented?

Good oral hygiene and professional care are the keys to keeping your teeth for a lifetime. The best way to prevent periodontal diseases and tooth decay is to remove the bacterial plaque by thorough brushing and flossing every day. Good oral hygiene habits will help keep the formation of dental tartar to a minimum.

Regular dental visits that include a periodontal examination are also important to detect any changes in periodontal health and, if necessary, to remove hardened tartar in places that your toothbrush and floss may have missed. A professional cleaning (often called a prophylaxis) at least twice a year is recommended for patients with good periodontal health. If you have had any form of the periodontal diseases, you may need professional maintenance more frequently.

Congratulations on taking the first step to achieving periodontal health! Preventing and/or controlling periodontal diseases is a worthwhile commitment that will keep you smiling for life.

Cómo reducir la inflamación oral

La enfermedad periodontal es una enfermedad inflamatoria crónica la cual afecta los tejidos que dan soporte al diente.  Estos son las encías, hueso, y ligamentos periodontales.  La inflamación es la forma en la cual el cuerpo reacciona para remover toxinas que son productos de bacterias que habitan en su boca, las cuales se exacerban ante la presencia de placa bacteriana.   Cuando la inflamación es crónica (entiéndase que esta presente constantemente) puede comenzar a causar daños irreversibles en el hueso y encías, y a tal efecto, en los dientes, causando que estos se aflojen y eventualmente, se pierdan. Desafortunadamente, la inflamación no ocurre únicamente en la boca.  Otras condiciones sistémicas, entre ellas enfermedades cardiovasculares, diabetes y artritis, también están causadas por inflamación crónica.  Varios estudios han encontrado enlaces entre estas condiciones y la enfermedad periodontal.

Un periodoncista lo puede ayudar a usted a controlar la enfermedad periodontal como resultado de inflamación oral.  Los tratamientos dependerán de la severidad de la condición y pueden ser tanto invasivos (cirugía localizada) como no-invasivos (alisados radiculares o limpiezas profundas).  Además de visitar a su periodoncista, es importante mantener un buen régimen de higiene oral y buena dieta en su hogar.  Esto lo podrá ayudar a controlar la inflamación oral y sistémica.

  • Mantener una Dieta Saludable - Comidas ricas en omega-3 (salmón, atún, sardinas, o nueces) y anti-oxidantes (té, frutas, vegetales) han demostrado ayudar a reducir la inflamación y reducir el riesgo para enfermedades periodontales.
  • Ejercicio - El mantener un peso saludable y hacer ejercicio hasta moderadamente ha demostrado una incidencia mas baja en condiciones inflamatorias que aquellos que no se ejercitan.
  • Cepillarse los Dientes e Hilo Dental - El cepillado de dientes de 2-3 veces al día y uso de hilo dental una vez al día es la mejor manera para interrumpir las actividades bacterianas en la boca que pueden causar enfermedad periodontal.  Los estudios indican que mientras mejor sea el cepillado, y mas frecuente, menos la incidencia de condiciones periodontales.
  • Visite a su periodoncista - 2 visitas para limpieza al año es recomendado para una sonrisa saludable.  Pero a pacientes con enfermedad periodontal, diabetes, u otras condiciones que afectan más la salud oral, se les recomienda limpiezas cada 3-4 meses.

Si no ha visitado a su dentista, llámenos y permitanos orientarle sobre su salud oral.