Gum Disease

Gum disease is a broad term that's used to describe many different diseases. It comes in many varieties and affects most adults. The problem is most of the time it's painless so it goes undetected but continues to do damage. I'm going to break it down a little bit here.

Let's first talk about gingivitis. This is an inflammation in the gum tissue. Instead of pink gum tissue the gums will look red and swollen. The gums bleed easily and you may notice this when brushing or flossing. At this stage the bone surrounding the teeth is not affected. Certain conditions can induce gingivitis such as puberty, menstrual cycle, pregnancy, some medications, malnutrition, some viral and fungal infections, and allergic reactions. Most times though, gingivitis is caused by bacteria in plaque. The good news is at this point it's reversible.

Periodontitis is a different animal altogether. Periodontitis not only affects the gums but also the bone support around the teeth. The bacteria here live deep in spaces between the gums and teeth that we call "pockets". Deep pockets in this case is not a good thing. Deep pockets indicate that more bone has been lost which will not come back. Deep pockets also mean that a greater number of disease causing bacteria can live there. Eventually the bone loss can be so severe that the teeth are not well supported and become loose. Gum infections can also occur. Periodontitis (periodontal disease) is one of the leading causes for tooth loss. Some risk factors include diabetes, and smoking. There's no cure for periodontal disease. Once you have it you will always have it, but there's treatment. Reducing the depth of the pockets and the number of bacteria will allow us to control the disease. Everyone is susceptible to this disease to different degrees. Therefore, there's no single treatment regimen that will fit everyone.

There's growing evidence that there's a link between gum disease and overall health. Since the bacteria and their toxins involved in gum disease can enter the blood stream easily. It's no surprise that research shows a higher incidence of heart attacks, strokes, preterm births, as well as other health problems in patients with gum disease.

It's important that your level of risk for this disease is assessed by your dentist and treatment should be aimed at reducing the risk for future problems.

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Tooth Erosion

Erosion is the process of tooth structure loss that affects the enamel and dentin due to chemical and physical factors and not due to decay. Acid plays a major role in this type of tooth structure loss. Acids can be found in certain types of food and beverages or in our stomach contents.

The signs of erosion are easily identified by your dentist which include wear of the enamel and dentin in a specific pattern that looks different than wear or attrition of the teeth due to clenching and grinding alone. Lack of salivary flow (xerostomia) which is caused by certain health conditions or certain medications will make the problem worse. Modifying your diet or seeking medical treatment maybe necessary depending on what's causing the erosion.

GERD (Gastroesophageal Reflux Disease) is a condition where the lower esophageal sphincter (LES) opens spontaneously, for varying periods of time, or does not close properly and stomach contents rise up into the esophagus. When acid reflux occurs, food or fluid can be tasted in the back of the mouth. When refluxed stomach acid touches the lining of the esophagus it may cause a burning sensation in the chest or throat called heartburn or acid indigestion. This can also occur at night while you sleep and you maybe totally unaware of it. Anorexia and Bulimia Nervosa can also cause the contents of the stomach to enter the oral cavity on a regular basis and cause tooth erosion.

Some examples of foods and drinks that are high in acid (low PH) are grapefruit juice, apple juice, orange juice, carbonated sodas (even diet ones), oranges and lemons. The importants thing to remember is to reduce the amount of time that the teeth are exposed to such foods and drinks. It's better to drink a glass of orange juice or a soda for example over a short period of time than to sip on it over a longer period of time. Brushing right after helps clear the acids.

It's important to identify this condition early before significant tooth damage has occured and restoring the teeth if significant amounts of dentin have been exposed. It's also important to address other issue such as clenching or grinding (bruxism) that can further breakdown tooth structure.