American Medical Association Family Medical Guide - American Medical Association [800]
To clear up gum inflammation caused by a fungus, your dentist may prescribe an antifungal medication and teach you how to take better care of your gums and dentures to avoid future problems. Some people have problems coping with dentures and never fully adjust to them. And as some people who wear dentures get older, they find it difficult to adjust to a new set of dentures when their old dentures are replaced.
Periodontal Disease
Gingivitis is an early stage of periodontal (gum) disease. It is caused by plaque, a sticky deposit of bacteria, mucus, and food particles that forms at the base of the teeth. Plaque irritates the gums, causing inflammation and swelling. Gingivitis also may result from a vitamin deficiency, some medications, and some glandular disorders and blood diseases. Gingivitis can be treated easily and reversed. However, if it is not treated, gingivitis can progress to a more severe form of periodontal disease called periodontitis, which is the leading cause of tooth loss in adults in the United States.
About 75 percent of American adults over age 35 have some form of periodontal disease. Pregnant women and people who have diabetes are particularly susceptible to developing gingivitis because changing hormone levels can affect the condition of the gums. Smoking and chewing tobacco are major causes of periodontal disease and tooth loss.
However, periodontal disease may not affect only the teeth and gums—it may also be a risk factor for heart disease. The bacteria that cause periodontitis have been found in the bloodstream of some people with periodontal disease. These bacteria can cause blood platelets to accumulate and stick together in arteries, setting the stage for heart attack and stroke.
Preventing gingivitis When plaque builds up, bacteria in its deeper layers die and mineralize and harden to form a material called calculus, which can lead to gum inflammation and swelling, or gingivitis. Proper brushing and flossing and regular dental checkups and cleanings help prevent the formation of calculus.
Symptoms
Healthy gums are firm, pink, and have natural variations in shade. When a person has gingivitis, his or her gums become red, soft, shiny, and swollen. The gums bleed easily, even from gentle brushing or flossing. If you have any of these symptoms, see your dentist as soon as possible.
Periodontitis develops if gingivitis is not treated. In periodontitis, the gums begin to pull away from the teeth, and pockets form between the teeth and gums. The pockets trap more plaque, the gums become more swollen, and the pockets deepen. The pockets between the teeth and gums gradually deepen, and the bacteria in the plaque inside the pockets cause a persistent, unpleasant taste in the mouth and bad breath. As the disease progresses, the teeth begin to loosen in their sockets. Eventually, more and more cementum (the sensitive, bonelike material that covers the roots of a tooth) is exposed, and the tooth aches when you eat very hot, very cold, or sweet or sour food. Sometimes a tooth abscess (see page 1104) forms deep inside a pocket and damages the jawbone.
Diagnosis
To diagnose periodontal disease, your dentist will check the gums for bleeding, measure the depth of any gum pockets, assess the looseness of the affected teeth, and take X-rays to determine the condition of the underlying bone. These factors are important for determining treatment.
Treatment
You can help prevent periodontal disease by keeping your teeth and gums healthy (see page 1102). If you already have gingivitis, try to brush and floss your teeth more carefully and thoroughly.
For more severe cases of gingivitis, the dentist removes any plaque and calculus from the base of the teeth. During a procedure called scaling, the dentist uses a handheld instrument called a scaler to remove plaque and calculus above and beneath