THE MAIN CAUSE OF TOOTH LOSS IN ADULTS IS PERIODONTAL DISEASE (commonly known as gum disease).

However, most patients think that the main cause of tooth loss is cavities (caries).

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.

Not only Periodontal Disease is the number one reason for tooth loss, research suggests that there may be a link between periodontal disease and other diseases such as, stroke, bacterial pneumonia, diabetes, cardiovascular disease, and increased risk during pregnancy.  Researchers are determining if inflammation and bacteria associated with periodontal disease affects these systemic diseases and conditions.  Smoking also increases the risk of periodontal disease.

Since periodontal disease is painless, very few patients know about it and very few dentists speak about it.

In very few countries in the world, dentists get punished for not informing their patients about the importance of periodontal disease. In those countries, not informing a patient of a disease or a condition is considered as a SUPERVISED NEGLECT in Dentistry. Unfortunately, in most of the European countries, the vast majority of patients having the painless periodontal disease totally ignore the fact that they are gradually losing their teeth even though they go to their dentists for a checkup or cleaning once or several times a year

Periodontal disease can refer to any condition that affects the gums, supporting bone and other structures supporting your teeth. However, bacteria cause the most common forms of periodontal disease. These bacteria grow in a film called BACTERIAL Plaque that sticks on the tooth surfaces next to the gums. The bacteria can cause inflammation and infection.

Indeed, periodontal disease begins when the toxins found in plaque start to attack the soft or gingival tissue surrounding the teeth. This bacterium embeds itself in the gum and rapidly breeds, causing a bacterial infection. As the infection progresses, it starts to burrow deeper into the tissue causing inflammation or irritation between the teeth and gums. The response of the body is to destroy the infected tissue, which is why the gums appear to recede. The resulting pockets between the teeth deepen and, if no treatment is sought, the tissue which makes up the jawbone also recedes causing unstable teeth and tooth loss.

A simple cleaning by a general dentist once or twice a year is NOT the appropriate definitive treatment to prevent periodontal disease and tooth loss!

It only takes twenty four hours for plaque that is not removed from your teeth to turn into calculus (tartar)!  

When plaque and calculus are not removed, they begin to destroy the gums and bone. 

The word periodontal means “around the tooth”. 

The mildest form of infection is gingivitis. It affects only the gums. More severe disease damages the other structures that support the tooth such as the bone. This can lead to tooth loss.

There are several types of periodontal disease:

 Gingivitis

 -Gingivitis is the mildest form of periodontal disease. It is caused by bacteria in plaque, which produce substances that can harm the gums. Gingivitis is quite common. Almost 3 out of every 4 adults over age 35 have some evidence of this condition.

Some groups of people are at increased risk:

Gingivitis doesn't usually cause discomfort. However, gingivitis can get worse. It can lead to a more serious form of periodontal disease, called periodontitis.

Gingivitis can be reversed with a combination of professional and home care. You will need a thorough cleaning in your dentist's office either by a general dentist or a specialist dentist (periodontist), including removal of plaque below the gum line. Then you must practice good oral care at home.

 -Chronic Periodontitis

 Periodontitis is a more advanced disease than gingivitis. Periodontitis involves all of the tissues that support the teeth. This includes both the gums and the bone.

Chronic periodontitis is the most common form of periodontitis. The older you are, the more likely you are to show signs of periodontitis but many patients already have periodontitis before the age of 30.

If you have periodontitis, your gums become detached from your teeth. Spaces form between the teeth and gums. These spaces are called periodontal pockets. Bacterial plaque builds up in the pockets. Eventually, this destroys the bone that supports the teeth. In more severe cases, teeth can become loose and even fall out.

Periodontitis usually is not painful. Some people notice that their gums are bleeding. The gums may recede (move back away from the teeth). People also may have bad breath or a bad taste in the mouth. However, periodontitis may not cause any symptoms that you would notice. Your specialized dentist can diagnose it during an examination, however. The condition usually gets worse quite slowly, over several years.

Unlike gingivitis, periodontitis can't be completely reversed. That is because the lost supporting tissues usually can't be rebuilt. However, treatment and proper brushing and flossing can improve your oral health. This can stop periodontitis from getting worse. Stopping the disease in this way can help prevent tooth loss and other serious problems.

Treatment for periodontitis typically includes a thorough cleaning called scaling and root planing. In certain cases, you may need other steps, such as antimicrobial therapy and/or periodontal surgery.

 

-Aggressive periodontitis

Aggressive periodontitis gets worse faster than chronic periodontitis. Aggressive periodontitis tends to run in families. Recent research suggests that people can inherit an increased risk of this disease. It also is more common in smokers.

Aggressive periodontitis used to be considered a young person's disease, but it is no longer classified this way. However, it is more common in younger people than in older people. Bacteria found in dental plaque also cause this form of periodontitis.

The treatment generally is the same as treatment for chronic periodontitis. However, antibiotics and periodontal surgery are needed more often. In certain situations, aggressive periodontitis can be difficult to treat. These patients do not get better with treatment.

 

-Periodontitis Caused by Conditions of the Body

Periodontitis can be a symptom of diseases that involve the whole body. These include certain types of leukemias, neutropenias and genetic disorders. This type of periodontitis can vary, depending on the medical condition. However, it sometimes looks and acts like aggressive periodontitis. These patients often are young and do not have large amounts of dental plaque.

Treatment involves controlling the medical problem first. This is followed by treatment similar to that for chronic or aggressive periodontitis.

 -Other medical conditions can make all forms of periodontitis worse. Examples include diabetes and HIV infection. People with these conditions usually have a fair amount of dental plaque and/or calculus (tartar) on their teeth. They are more prone to developing severe periodontitis.

How to detect the periodontal bone loss?

Only a precise radiographic survey of the bone supporting the roots of your teeth through a series of digital radiographs (up to 14 radiographs) and a precise periodontal examination could detect the periodontal bone loss before it leads to advanced bone loss.

Are dental x-rays safe?

·         We are all exposed to natural radiation in our environment.   At the Dental Treatment Center in Brussels, we only use digitalized long-cone radiographs to detect the early periodontal bone loss. Digital x-rays produce a significantly lower level of radiation compared to traditional dental x-rays.  Not only are digital x-rays better for the health and safety of the patient, they are faster and more comfortable to take, which reduces your time in the dental office.  Also, since the digital image is captured electronically, there is no need to develop the x-rays, thus eliminating the disposal of harmful waste and chemicals into the environment.

Even though digital x-rays produce a low level of radiation and are considered very safe, dentists still take necessary precautions to limit the patient’s exposure to radiation.  These precautions include only taking those x-rays that are necessary, and using lead apron shields to protect the body.

Using digital radiographs helps us reduce by more than 90 percent the dose of radiation, thus not only protecting the dentists but also the patients.

If requested, the digital radiographs are sent by email to patients without any additional charges. 

How are X-rays Used?

X-ray images, also called dental radiographs, are among the most valuable tools a dentist has for keeping your mouth and teeth healthy. By understanding what the structures of the mouth look like normally on an X-ray film, dentists can diagnose problems in the teeth and jaws. For adults, radiographs can:

• Show areas of periodontal bone loss, commonly known as gum disease, which is the main cause of tooth loss in adults
• Show areas of decay that your dentist may not be able to see with just a visual examination, such as tiny pits of decay that might occur between teeth
• Find decay that is developing underneath an existing filling
• Find cracks or other damage in an existing filling
• Reveal problems in the root canal, such as infection or death of the nerve
• Help your dentist plan, prepare and place tooth implants, orthodontic treatments, dentures or other dental work
• Reveal other abnormalities such as cysts, cancer and changes associated with metabolic and systemic diseases (such as Paget's disease and lymphoma)

 

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