Dental Problems

Periodontal Disease

Periodontal disease is the number one cause of tooth loss in this country and afflicts more than 75% of the population. The early signs are so subtle that many people do not even realise they have it - until it's too late. This page explains how to recognise periodontal disease, what causes it, and what can be done about it.

Pickpockets are subtle thieves. It may be hours before you even realise that you were robbed. You reach into your pocket - and your wallet is gone! Periodontal disease is also subtle. Since it is invisible and initially painless, it may be years before you realise you have it. However, ultimately at it can rob you of your teeth.

What is Periodontal Disease?
Periodontal disease attacks the soft tissues (gums) and bone supporting the teeth. Unlike tooth decay, which directly attacks the teeth, periodontal disease undermines them. It can destroy the supporting structure of a tooth so that it either falls out or has to be pulled. Though most tooth loss from periodontal disease occurs after the age of 35, the disease often begins during the teenage years. It begins by affecting the gums and then affects the bone.

Early symptoms include:
- Bleeding of gums when brushing or flossing
- Persistent bad breath
- Soft, swollen or tender gums
- Loose teeth
- Gum shrinking away from the teeth
- Sensitive teeth where the root surfaces are exposed

Plaque Attack
What causes periodontal disease? Bacteria is the culprit for the most common form of the disease. The soft, sticky film of bacteria which constantly form on your teeth is called plaque. If not removed by careful daily cleaning, plaque will thicken. It will combine with a hard deposit called calculus (tartar). The calculus provides a rough surface to which more plaque can attach. As the plaque and calculus accumulate, the gums become inflamed and slowly detach from the teeth, leaving deep pockets that become filled with bacteria and pus. In its latest stages, the connective tissue fibres which fasten the teeth to the bone are destroyed and the bone socket gradually disintegrates.

Contributing Factors
All mouths are filled with bacteria. Why does periodontal disease strike some people and not everyone?

One important factor is diet. Sugar-rich foods are especially harmful and should be avoided since plaque feeds on sugar. Lack of dietary calcium and the B and C vitamins will also increase the likelihood of periodontal disease. Other factors which aggravate this disease include:

- Medical conditions
- Pregnancy
- Cigarette smoking
- Worn out fillings on crowns

A Bad Bite Will Worsen the Condition
Your bite is another, more subtle, aggravating factor. When your upper and lower teeth do not come together properly, they place excessive stress on the teeth.

The powerful muscles which control your jaw exert tremendous forces on the teeth. The force your teeth exert against each other can be as much as 300 lbs pounds per square inch!

Teeth were designed to withstand this force if it is directed straight down. When hammering you must hit the nail straight on or the nail will bend. Its weakest point is where the nail is embedded in the board. Similarly misdirected forces of the upper and lower teeth against each other will weaken a tooth. The tooth is forced to rotate in its socket. Like the nail, the part of the tooth which is most affected by the misdirected forces is the part which is embedded in the bone near the gum line. This puts pressure on certain parts of the bone in the socket so that the bone begins to disintegrate. The muscular forces generated by a bad bite aid the bacteria in its breakdown process by weakening the bone's support.

Prevention is the Key
What can be done? Good oral hygiene and nutrition are important preventative measures which you can practice. These include daily brushing and flossing, and regular professional cleaning by your dentist or hygienist. You can also pay attention to early warning signs, such as bleeding gums, and loose or chipped teeth. Once bone and gum tissue are lost they are lost forever.

If you are experiencing any of the symptoms of periodontal disease, consult your dentist. Through careful diagnosis, the dentist can determine if your bite is contributing to the disease. If so, the bite must be corrected so that the forces of the tooth against each other are properly directed.

Where to find us
Based in Argyll, on the West Coast of Scotland, Stewart Wright currently practices two days per week in Oban.