Posts for tag: periodontal disease

By Drs. Wu & Kennedy
January 02, 2017
Category: Oral Health
SeekImmediateTreatmentforthisAdvancedFormofGingivitis

It takes only a short time neglecting your oral hygiene before you begin to notice some unpleasant things with your gums: swelling, redness or even bleeding. These are all signs of gingivitis, a periodontal (gum) disease that arises from bacterial plaque, a thin biofilm that builds up on tooth surfaces when a person doesn't brush or floss.

Fortunately, early stages of gingivitis can be treated effectively with comprehensive plaque removal during one or more office visits. If, however, it's not dealt with early, it can develop into something much more serious: acute necrotizing ulcerative gingivitis (ANUG). This form does more than leave you with unattractive teeth and gums and terrible breath — it could eventually cause you to lose your teeth.

ANUG is also known as trench mouth, a common ailment among front line World War I soldiers without access to proper dental care and hygiene. It's most prevalent today among individuals who are under a great deal of stress, not sleeping or eating well and haven't cleaned or properly cared for their teeth for an extended period of time. Tobacco smokers also seem more susceptible than non-smokers to the disease, perhaps because smoke dries the mouth and changes the bacterial environment.

Unlike common gingivitis, ANUG can be quite painful. In effect, the gum tissues begin to die (necrotize), especially the triangular peaks between teeth known as papillae. Besides the other symptoms of gingivitis, the tissues may become yellowish.

ANUG can be treated effectively. The first step is to relieve the symptoms of pain and inflammation through medication. The focus then shifts to treating the underlying cause, bacterial plaque. Besides plaque removal common in any treatment for gum disease, we may also need to initiate antibiotic therapy. Metronidazole is a common antibiotic that's been demonstrated effective against the specific bacterial strain associated with ANUG. We might also combine this with an antibacterial mouth rinse containing chlorhexidine.

The final step belongs to you: to keep ANUG or any other gum disease from reoccurring, it's important for you to adopt a daily regimen of brushing and flossing, along with regular dental visits for thorough teeth cleaning and checkups. Taking this proactive approach will help ensure you won't suffer from this painful and unattractive form of gingivitis again.

If you would like more information on acute gingivitis, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Painful Gums in Teens & Adults.”

YourCaseofGingivitisCouldDevelopintoSomethingMoreHarmful

That bit of gum bleeding after you brush, along with redness and swelling, are strong signs you have gingivitis, a form of periodontal (gum) disease. Without treatment, though, your gingivitis could turn into something much more painful and unsightly — a condition commonly known as “trench mouth.”

Properly known as Acute Necrotizing Ulcerative Gingivitis (ANUG), the more colorful name arose from its frequent occurrence among soldiers during World War I. Although not contagious, many soldiers contracted it due to a lack of means to properly clean their teeth and gums and the anxiety associated with war. Inadequate hygiene and high stress still contribute to its occurrence today, along with smoking, medications that dry the mouth and reduced disease resistance — all of which create a perfect environment for bacterial growth.

ANUG can arise suddenly and be very painful. The cells in the gum tissue begin to die (“necrotizing”) and become swollen (“ulcerative”), especially the small triangle of gum tissue between the teeth called the papillae, which can appear yellowish. Patients also encounter a characteristic foul breath and taste. Untreated, ANUG can damage tissue and contribute to future tooth loss.

Fortunately, antibiotics and other treatments are quite effective in eradicating bacteria that cause the disease, so if caught early it’s completely reversible. We start with a complete examination to confirm the diagnosis and rule out other possible causes. We then attempt to relieve the pain and inflammation with non-steroidal, anti-inflammatory drugs like aspirin or ibuprofen and begin antibiotic treatment, most notably Metronidazole or amoxicillin. We may also prescribe a mouthrinse containing chlorhexidine and mild salt water rinses to further reduce the symptoms.

We must also treat any underlying gingivitis that gave rise to the more acute disease. Our goal here is remove any bacterial plaque and calculus (hardened plaque deposits) that have built up on tooth surfaces, particularly below the gums. Only then can we fully bring the disease under control.

It’s also important you become more consistent and effective with daily brushing and flossing, quit smoking, reduce undue stress, and get better rest and nutrition. Establishing these new habits and lifestyle changes will help ensure you’ll never have to experience trench mouth again.

If you would like more information on ANUG and other periodontal gum conditions, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Painful Gums in Teens & Adults.”

By Drs. Wu & Kennedy
August 14, 2014
Category: Oral Health
OurArsenalofWeaponsintheWarAgainstGumDisease

Advanced periodontal (gum) disease is a chronic, progressive condition characterized by bacterial infection and inflammation. Without proactive treatment, gum disease can cause extensive damage to the various tissues that hold teeth in place, and lead eventually to tooth loss.

As every war has its tactics, so the war against advanced gum disease is no different. Here’s a few of the approaches and treatments we use to stop the disease and promote healing to damaged tissues.

A Change in Behavior. Regardless of other risk factors, a film of bacterial plaque on tooth surfaces caused by a neglect of proper oral hygiene is the main culprit behind progressive gum disease. Your first step is to form new hygiene habits — brushing and flossing — that will need to be performed daily to be effective. It’s also time to end some old habits like smoking that are contributing to your gum disease.

Total Plaque Removal. Although your renewed efforts at oral hygiene are essential, it’s just as important for us to use our expertise to remove the hard deposits of plaque (known as calculus) you can’t reach with brushing and flossing. Clinging stubbornly below the gum line, these deposits will continue to be sources of infection until they’re removed. Using techniques known as scaling or root planing, we employ ultrasonic or manual instruments to access and remove as much of the offending deposits as possible. This essential step may require more than one visit to give time for inflammation to subside, and may be followed with antibiotic therapy as well.

Surgical Treatments. Although quite effective in most cases of gum disease, scaling or root planing may not be adequate in more severe cases. We still have other weapons in our arsenal, though — there are a number of surgical procedures we can use to eliminate hidden pockets of infection, or repair and regenerate damaged tissues and bone. These procedures not only help restore you to better oral health and function, but also establish a more conducive environment for maintaining future care.

Using these and other techniques, we can reduce the infection and inflammation associated with gum disease. This sets the stage for healing and renewed health, both for your mouth and your entire body.

If you would like more information on treatment for periodontal gum disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Understanding Periodontal Disease.”