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Periodontal Disease: The Silent Disease

Most of us have heard “periodontal disease” before, but don’t know what it is or what its implications are. It is one of the most widespread diseases in adult Americans who are frequently unaware of its presence.  The AAP and CDC both describe periodontal disease as a public health concern. A whopping 47.2%, or 64.7 million, American adults have mild, moderate, or severe periodontal disease. If it’s considered a public health concern and affects almost half of the US adult population, why aren’t more people aware of it and its severity?

So, what is periodontal disease?

It is the inflammation of the periodontium caused by bacterial infection.

Okay, so what is the periodontium?

The periodontium is made up of all of the tooth supporting structures of your mouth. These structures include your gums, alveolar bone (the bone that your teeth sit in), periodontal ligaments (fibers that attach your teeth to your bone), and cementum (the outer layer along the tooth root that the periodontal ligaments attach to).

Now, there are two types of periodontal disease. The first is gingivitis; it is reversible and only involves your gums. The second is periodontitis; it is irreversible and involves all four of the structures that make up the periodontium. Periodontitis results in the loss of the structures that support your teeth and once they are gone, there is not getting them back. Ultimately, if left untreated, periodontitis leads to tooth loss.

It is estimated that by age 60-69, less than half of all adults in the US will have 21 or more natural teeth. You’re supposed to have 32; 28 without wisdom teeth.

How do you know if you have it?

Gingivitis is characterized by either 1) swollen, red gums and bleeding with brushing or flossing or 2) enlarged, light pink, leathery gums & bleeding with brushing or flossing. Gingivitis can take just 4-14 days to develop and show clinical signs.

Periodontitis takes a much longer time to develop. Untreated gingivitis can lead to periodontitis in some cases, but not all. It is characterized by either a bluish, purplish-red color, and a smooth, shiny appearance or a light pink and puffy, leathery appearance. Recession may be evident, exposing the more yellow colored root surface of the tooth, and bleeding with brushing or flossing is apparent. In more severe cases, there will be pus beneath the gums from bacterial infection.

There is typically no pain associated with either of these unless the periodontitis has progressed far enough along that there is tooth mobility. Ultimately, you will need to see a dental professional to get a clear diagnosis and treatment plan if you think you may have periodontal disease.

Don’t think you have it, but want to know if you are at risk?

There are a few risk factors associated with periodontal disease. Those who are 65 and older have an increased risk 70.1%. Men are 18% more likely to get it than women. Smokers, those below federal poverty level, those having less than a high school education, those having poor oral care practices, and those among the black and Mexican populations are at higher risk as well.  If you fall under any of the categories, there is a possibility that you either already have or will later develop periodontal disease.

How is it treated?

Gingivitis can typically be resolved quickly by improving self oral hygiene methods.

Periodontitis requires diagnosis and specified treatment planning from a dentist and occasionally, if the severity goes beyond the scope of a general dentist, a periodontist who specializes in the periodontium is required.

Always make sure to practice good oral hygiene and see your dentist for regular check-ups and radiographs. Good oral hygiene can range anywhere from brushing twice a day and flossing once a day to brushing and flossing after every meal and using a waterpik regularly. Do whatever works best for you and that you are more likely to do regularly!

Post #2, How cavities work (acid)

Dental thoughts for the great people of Robertson Co and Springfield:

Cavities are an acid erosion process.  My poor assistant Gracie has heard this a zillion times.

The generic cavity process is:

  1. mouth bacteria + sugars = acid.
  2. strong enough acid = enamel (hard, white outside of your teeth) mineral breaks down
  3. bacteria and acid reaches inside (dentin) of your teeth = active cavity.  This will grow on it’s own, without sugar.

My goal is stopping the cavity process with my patients; therefore, acid erosion is the prime problem.

So, preventing the generic cavity is:

  1. decreasing mouth bacteria (brushing and flossing)
  2. strengthening enamel (this is fluoride’s job).
  3. eliminating as many acid sources as possible.

OK, that’s the basic stuff.  You PROBABLY have been told to brush and floss, but even then, some poor souls get stupid cavities.  Here’s what they might not know:

  • Acid from ANY source can contribute to erosion:
    • please don’t drink energy drinks.
    • ACID REFLUX.  (The dental effects of chronic heartburn are disastrous.)
    • don’t smoke meth.
  • Some people’s enamel is more prone to acid destruction than others; usually this is due to chemical variations in the enamel (classic variant is fluoride concentrations).
  • Some people’s particular strains of bacteria make acid more effectively than other’s.  This can change over time.
  • Saliva buffers acid and rebuilds etched enamel.
    • Some people make less saliva than others (post cancer-therapy. blood pressure medications.)

Got it?  These factors are modifiable.  In fact, I believe a major benefit of regular dental visits is your dentist identifying and helping you to CHANGE your acid erosion risk factors.

If you, or someone you know is frustrated by constant new cavities, please call me.  I can help you identify WHY, and I can help the CAVITIES STOP.

-Dr Adam Veitschegger

615-384-2558

First post.

I want the people of Springfield and of Robertson County to have a great understanding of dentistry, and high expectations for their own oral health.

Many of my patients have heard me say this, and I repeat it both for them to understand, and for me to hear again and again.  I have made this goal of dental education and increased understanding in order to clarify my work; I am working to eradicate disease and to improve the quality of life of the people around me, and this can only happen if I educate, educate, educate.

I’ve come to find that many professionals, including dentists, suffer from tunnel vision, focusing on the immediate problems while losing vision of the overall goal.  This is simply human nature, and I certainly do the same.  I am focusing on the crown or filling margin.  I am focusing on the extraction or implant.  I must always keep the end goal in mind: stop dental problems from occurring.

Stopping oral health problems is more than restoration, it is MOSTLY identifying AT-HOME and existing risk factors, and limiting or eliminating them.  This requires understanding cavities, gum disease, bite problems, oral cancer, etc.

Therefore, I AM AVAILABLE TO TALK.

If you have dental concerns, questions about health or oral health, you have fear about dentistry, or if you have questions about your family’s dental health PLEASE CALL DR. V or COME BY THE OFFICE.

I’ll talk to anyone.  I want to help.  I want to educate.

I want our town to be known for good teeth and big, healthy smiles.

615-384-2558

-Dr. Veitschegger