Periodontics is a specialty of dentistry concerned with the health of the tissues that surround and support
teeth, such as the gums,
periodontal membrane, alveolar bone, and jaw. Periodontal disease is caused by
plaque, a gummy film that coats the surface of teeth. If not removed every 24 to 36 hours, the bacteria produce toxins that cause inflamed, swollen gums that bleed easily. This early
stage of
gum disease is called gingivitis, and experts estimate that at least 4 out of 5 Americans have this problem by the age of 15. Generally, this stage of the disease is painless and often progresses to a more serious stage unnoticed. Plaque that is not removed migrates below the gum line, causing
advanced gum disease called periodontitis, or pyorrhea. This disease, which is the major cause of tooth loss in adults, causes gums to pull away from teeth;
pockets to form that fill with pus and cell debris; and jaw-bone degeneration.
A variety of factors influence the progression of periodontal disease. While fibrous foods, such as carrots and celery, have a natural cleansing action, frequent consumption of sugary foods fosters plaque formation. Plaque bacteria utilize sucrose from the diet to produce dextran, a substance that helps plaque stick to teeth. A vitamin C deficiency can promote gum degeneration, and certain conditions, such as pregnancy, diabetes, and thyroid disorders, may foster periodontal disease. In addition, chronic injury to periodontal structures frequently results from malocclusion (crooked teeth). Stresses caused by malocclusion weaken the tissues and allow the inflammatory process to progress more rapidly.
Early stages of the disease can be effectively treated with regular oral hygiene. A dental specialist, the periodontist, treats more advanced periodontal diseases with a variety of methods: thorough cleaning to remove plaque from teeth above the gum line and within pockets below the gum line; antibiotics that kill specific disease-causing bacteria; and surgery to remove infected tissues and to reshape pockets that have developed so that they are no longer bacterial havens. A prescription drug called Periostat, which slows or stops the breakdown of gum in advanced periodontal disease, was approved for use by the U.S. Food and Drug Administration in 1998. Researchers are working to develop a method that will regenerate bone tissue lost to gum disease.
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