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Your Teeth are Fine but What About Your Gums?

September 2003
Your Teeth are Fine but What About Your Gums?

When you were a child, you probably remember someone telling you all about the importance of brushing your teeth after every meal. "Look mom, no cavities," was the expression of the day, and the success of a trip to your dentist's office hinged on how few cavities you had.

Now that you're older, the issues surrounding your oral health aren't as clear cut. While tooth decay could still be a problem, adults have the added concerns of gum disease, which often isn't accompanied by noticeable pain or discomfort as is a lost filling or even a cavity.

"We call periodontal disease "the silent disease" because most times you don't even know you have it," said Lou Graham, DDS section chief of the Zoller Dental Clinic at the University of Chicago. Dr. Graham maintains an adult private practice in Chicago and lectures both nationally and internationally on dental issues. "If people don't have a toothache, they don't think there's anything wrong and they often won't seek treatment. Unfortunately, this often results in patients requiring more invasive treatments when, if they had been diagnosed earlier, they could have been treated much easier with superior outcomes."

According to the American Dental Association, 50 million American have some form of gum disease, ranging from mild and highly reversible gingivitis to the chronic and more severe periodontitis, which has been linked to heart disease, diabetes, and pre-term low birth weight. Both gingivitis and periodontitis are caused from the bacteria that live inside plaque.

"There's a lot more to plaque than most people realize, "Dr. Graham said. "It's full of bacteria and other harmful byproducts. It can cause real problems when it gets into the gums."

Gingivitis is caused when bacteria from plaque sit atop the gum line. Your gums are often red, puffy, may bleed upon brushing and you might have bad breath. Fortunately, a few simple treatments with a hygienist can halt the process and return the patient to smiling health.

"Prevention and early diagnosis are the keys to sound, oral health, which is why we recommend routine checkups every three to six months," Dr. Graham said, pointing out that ADA warns that only one-fifth of all Americans with periodontal disease actually seek treatment.

Advanced gum disease, or peridontitis, occurs when the bacteria sitting atop your gums start seeping into the underlying pockets that surround your teeth. Normally these pockets are shallow, but as the bacteria accumulate they release toxic substances that create inflammation along with tissue and bone loss, deepening the pockets. Early on, your gums may not hurt or bleed, but left unchecked, these symptoms become evident and significant treatment is often required.

The first line of defense in combating periodontitis is a deep cleaning of the teeth and gums called scaling and planing. While this might require multiple visits (each case is different) recent studies have shown that the scaling becomes more effective when it is combined with the use of localized antimicrobials, a treatment that is applied directly and painlessly to the gums following a scaling and root planing.

"Even when a patient comes in for a routine checkup, if an early problem is found we simply clean the area and place a small amount of the localized antibiotic into the pocket to eradicate the remaining bacteria, it's so simple and the patients couldn't be happier because it's quick and painless," Dr. Graham said.

One such treatment is an FDA-approved therapy called Arestin, a powder that contains a low dose of the antibiotic minocycline. The dentist places the powder directly into the pocket, and it develops instantly into a gel-like substance that adheres to the tooth for up to three weeks. During this time, the antibiotic is released into the pocket to destroy the remaining bacteria not removed by the scaling and root planing.

Dr. Graham is quick to remind his patients that treatments like Arestin are no substitute for good dental hygiene.

"Patients must maintain excellent oral hygiene or the problems can return, but again early diagnosis and treatment can turn early negative situations around," he says.

For more information about locally administered antibiotics and Arestin, please log on to www.arestin.com or call (866) ARESTIN.

-Courtesy of ARA Content

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