Periodontal disease is often silent, meaning symptoms may not appear until an advanced stage of the disease. However, warning signs of periodontal disease include the following:
o    Red, swollen or tender gums or other pain in your mouth
o    Bleeding while brushing, flossing, or eating hard food
o    Gums that are receding or pulling away from the teeth, causing the teeth to look longer than before
o    Loose or separating teeth
o    Pus between your gums and teeth
o    Sores in your mouth
o    Persistent bad breath
o    A change in the way your teeth fit together when you bite
o    A change in the fit of partial dentures

Periodontal (gum) diseases, including gingivitis and periodontitis, are serious infections that, left untreated, can lead to tooth loss. Periodontal disease can affect one tooth or many teeth. The main cause of periodontal disease is bacterial plaque, a sticky, colorless film that constantly forms on your teeth. However, factors like the following also affect the health of your gums. 

Smoking/Tobacco Use
As you probably already know, tobacco use is linked with many serious illnesses such as cancer, lung disease and heart disease, as well as numerous other health problems. What you may not know is that tobacco users also are at increased risk for periodontal disease. In fact, recent studies have shown that tobacco use may be one of the most significant risk factors in the development and progression of periodontal disease.

Research proves that up to 30% of the population may be genetically susceptible to gum disease. Despite aggressive oral care habits, these people may be six times more likely to develop periodontal disease. Identifying these people with a genetic test before they even show signs of the disease and getting them into early interventive treatment may help them keep their teeth for a lifetime.

Puberty, Pregnancy and Menopause in Women
A woman's health needs are unique. Though brushing and flossing daily, a healthy diet, and regular exercise are important for oral health throughout life, there are certain times in a woman's life when extra care is needed-times when you mature and change such as puberty or menopause, and times when you have special health needs, such as menstruation or pregnancy. During these particular times, a woman's body experiences hormonal changes that can affect many of the tissues in your body, including the gums. Your gums can become sensitive, and at times react strongly to the hormonal fluctuations. This may make you more susceptible to gum disease. Additionally, recent studies suggest that pregnant women with gum disease may be more likely to deliver preterm, low birthweight babies.

As you probably already know, stress is linked to many serious conditions such as hypertension, cancer, and numerous other health problems. What you may not know is that stress also is a risk factor for periodontal disease. Research demonstrates that stress can make it more difficult for the body to fight off infection, including periodontal diseases.

Some drugs, such as oral contraceptives, anti-depressants, and certain heart medicines, can affect your oral health. Just as you notify your pharmacist and other health care providers of all medicines you are taking and any changes in your overall health, you should also inform your dental care provider.

Clenching or Grinding Your Teeth
Has anyone ever told you that you grind your teeth at night? Is your jaw sore from clenching your teeth when you're taking a test or solving a problem at work? Clenching or grinding your teeth can put excess force on the supporting tissues of the teeth and could speed up the rate at which these periodontal tissues are destroyed.

Diabetes is a disease that causes altered levels of sugar in the blood. Diabetes develops from either a deficiency in insulin production (a hormone that is the key component in the body's ability to use blood sugars) or the body's inability to use insulin correctly. According to the American Diabetes Association, approximately 16 million Americans have diabetes; however, more than half have not been diagnosed with this disease. If you are diabetic, you are at higher risk for developing infections, including periodontal diseases. These infections can impair the ability to process and/or utilize insulin, which may cause your diabetes to be more difficult to control and your infection to be more severe than a non-diabetic.

Other Systemic Diseases
Diseases that interfere with the body's immune system may worsen the condition of the gums.

Poor Nutrition and Obesity
As you may already know, a diet low in important nutrients can compromise the body's immune system and make it harder for the body to fight off infection. Because periodontal disease is a serious infection, poor nutrition can worsen the condition of your gums.

periodontal-diseaseNon-Surgical Treatments
Current treatment guidelines stress that periodontal health should be achieved in the least invasive and most cost-effective manner. This is often accomplished through non-surgical periodontal treatment, including scaling and root planing (a careful cleaning of the root surfaces to remove plaque and calculus [tartar] from deep periodontal pockets and to smooth the tooth root to remove bacterial toxins), followed by adjunctive therapy such as local delivery antimicrobials and host modulation, as needed on a case-by-case basis.

Most dental professionals would agree that after scaling and root planing, many patients do not require any further active treatment, including surgical therapy. However, the majority of patients will require ongoing maintenance therapy to sustain health. Non-surgical therapy does have its limitations, however, and when it does not achieve periodontal health, surgery may be indicated to restore periodontal anatomy damaged by periodontal diseases and to facilitate oral hygiene practices.

Heart Disease
Several theories exist to explain the link between periodontal disease and heart disease. One theory is that oral bacteria can affect the heart when they enter the blood stream, attaching to fatty plaques in the coronary arteries (heart blood vessels) and contributing to clot formation. Coronary artery disease is characterized by a thickening of the walls of the coronary arteries due to the buildup of fatty proteins. Blood clots can obstruct normal blood flow, restricting the amount of nutrients and oxygen required for the heart to function properly. This may lead to heart attacks.

Another possibility is that the inflammation caused by periodontal disease increases plaque build up, which may contribute to swelling of the arteries. Researchers have found that people with periodontal disease are almost twice as likely to suffer from coronary artery disease as those without periodontal disease. Periodontal disease can also exacerbate existing heart conditions. Patients at risk for infective endocarditis may require antibiotics prior to dental procedures. Dr. Proto and your cardiologist will be able to determine if your heart condition requires use of antibiotics prior to dental procedures.

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