Gingivitis is the mildest form of periodontal disease. It causes the gums to become red, swollen, and bleed easily. There is usually little or no discomfort at this stage. Gingivitis is often caused by inadequate oral hygiene. Gingivitis is reversible with professional treatment and good oral home care.

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Untreated gingivitis can advance to periodontitis. With time, plaque can spread and grow below the gum line. Toxins produced by the bacteria in plaque irritate the gums. The toxins stimulate a chronic inflammatory response in which the body in essence turns on itself, and the tissues and bone that support the teeth are broken down and destroyed. Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. Often, this destructive process has very mild symptoms. Eventually, teeth can become loose and may have to be removed.

There are many forms of periodontitis. The most common ones include the following.

Aggressive periodontitis occurs in patients who are otherwise clinically healthy. Common features include rapid attachment loss and bone destruction and familial aggregation.

Chronic periodontitis results in inflammation within the supporting tissues of the teeth, progressive attachment and bone loss. This is the most frequently occurring form of periodontitis and is characterized by pocket formation and/or recession of the gingiva. It is prevalent in adults, but can occur at any age. Progression of attachment loss usually occurs slowly, but periods of rapid progression can occur.

Periodontitis as a manifestation of systemic diseases often begins at a young age. Systemic conditions such as heart disease, respiratory disease, and diabetes are associated with this form of periodontitis.

Necrotizing periodontal disease is an infection characterized by necrosis of gingival tissues, periodontal ligament and alveolar bone. These lesions are most commonly observed in individuals with systemic conditions such as HIV infection, malnutrition and immunosuppression.

The best way to prevent gum disease is effective daily brushing and flossing as well as regular professional examinations and cleanings. Unfortunately, even with the most diligent home dental care, people still can develop some form of periodontal disease. Once this disease starts, professional intervention is necessary to prevent its progress.

Worse still, more and more research points to the grave systemic consequences of allowing this chronic bacterial infection to persist in your body. Numerous medical researchers have reported links between active periodontal disease and numerous systemic illnesses. Heart valve damage and blood vessel narrowing (arteriosclerosis & clot formation), low birth weight babies and premature delivery, elevated blood sugar in diabetics, increased incidence of respiratory infections and other less serious effects are associated with bacterial contamination and bacterial toxins from diseased gums. Clearly periodontal disease is not the sole cause of these problems but it clearly plays a role for many people. As one well-respected physician said - "What other part of your body would you permit to be chronically infected and expect no consequence on your overall health?"

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As you probably already know, tobacco use is linked with many serious illnesses such as cancer, lung disease and heart disease, as well as numerous other health problems. What you may not know is tobacco users also are at increased risk for periodontal disease.

In fact, recent studies have shown that tobacco use may be one of the most significant risk factors in the development and progression of periodontal disease.

How Tobacco Use Affects Your Oral Health
Whether you smoke, dip or chew tobacco, you are more likely to have periodontal disease - and to have it more severely - than those who do not use any form of tobacco.

Smokers-
As a smoker, you are more likely than nonsmokers to have calculus form on your teeth, have deeper pockets between your teeth and gums, and lose more of the bone and tissue that support your teeth.

If the calculus is not removed during a professional cleaning, and it remains below your gum line, the bacteria in the calculus can destroy your gum tissue and cause your gums to pull away from your teeth. When this happens, periodontal pockets form and fill with disease-causing bacteria. If left untreated, periodontal disease will progress. The pockets between your teeth and gums can grow deeper, allowing in more bacteria that destroy tissue and supporting bone. As a result, the gums may shrink away from the teeth making them look longer. Without support, your teeth may become loose, painful and even fall out. Research shows that smokers lose more teeth than nonsmokers.

Smokeless Tobacco Users-
As a user of smokeless tobacco, your gums are more likely to recede, and you have a greater chance of losing the bone and fibers that hold your teeth in your mouth. If your gums recede to the point where the tooth roots are exposed, your teeth may become susceptible to root cavities or sensitive to cold and touch (not to mention the fact that your chances of developing oral cancer increase with smokeless tobacco use).

These problems, associated with tobacco use of any kind, are caused by the many chemicals, such as nicotine and tar, in tobacco. These chemicals have harmful effects on the periodontal tissues. They cause an increase in the accumulation of plaque and calculus (or tartar) that can irritate your gums and lead to infection. Following periodontal treatment or any type of oral surgery, the chemicals in tobacco can also slow down the healing process and make the treatment results less predictable.

Research Shows...
Researchers also are finding that many of the following problems occur more often in patients who use tobacco:
- Oral cancer
- Bad breath
- Stained teeth
- Tooth loss
- Bone loss
- Loss of taste and smell
- Less success with periodontal treatment
- Less success with dental implants
- Gum recession
- Mouth sores

Why Quitting Makes Sense
Tobacco use is addictive, yet every year millions of Americans quit. The benefits include reduced chances of developing cancer, lung disease and heart disease, as well as less expensive health care. When you quit using tobacco, you also reduce your chances of getting oral and gum disease. Gums that are free of disease are essential to help you keep your teeth for a lifetime.

Quitting takes commitment - and it's usually easier if you have help. To begin a tobacco-cessation program, talk to you periodontist or physician. They are prepared to help you.

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It's possible that if you have periodontal disease, you may be at risk for cardiovascular disease...

For a long time we've known that bacteria may affect the heart.
Now evidence is mounting that suggests people with periodontal disease - a bacterial infection, may be more at risk of having a fatal heart attack, than patients without periodontal disease.

While more research is needed to confirm how periodontal bacteria may affect your heart, one possibility is that periodontal bacteria enter the blood through inflamed gums and cause small blood clots that contribute to clogged arteries.
Another possibility is that the inflammation caused by periodontal disease contributes to the buildup of fatty deposits inside heart arteries.

One out of every 5 Americans has one or more types of heart disease. If you are one of these Americans, or if you are at risk for periodontal disease, see a periodontist for a periodontal evaluation - because healthy gums may lead to a healthier body.

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The two-way relationship between periodontal disease and diabetes...

For years we've known that people with diabetes are more likely to have periodontal disease than people without diabetes.

Recently, research has emerged suggesting that the relationship goes both ways - periodontal disease may make it more difficult for people who have diabetes to control their blood sugar.

More research is needed to confirm how periodontal disease can make it more difficult to control blood sugar. What we do know is that severe periodontal disease can increase blood sugar, contributing to increase periods of time when you body functions with a high blood sugar. And, as a diabetic, you know that this puts you at increased risk for diabetic complications.

In other words, controlling your periodontal disease may help you control your diabetes. If you are among the nearly 16 million Americans in the U.S. who live with diabetes, or are at risk for periodontal disease, see a periodontist for a periodontal evaluation - because healthy gums may lead to a healthy body.

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It's possible that if you have periodontal disease and are pregnant, you may be at risk for having a premature, low birthweight baby.

For a long time we've known that many risk factors contribute to mothers having babies that are born prematurely at a low birthweight - smoking, alcohol use, drug use and infections.

Now evidence is mounting that suggests a new risk factor- periodontal disease. Pregnant women who have periodontal disease may be seven times more likely to have a baby that is born too early and too small.

More research is needed to confirm how periodontal disease may effect pregnancy outcomes. What we do know is that periodontal disease is an infection and all infections are cause for concern among pregnant women because they pose a risk to the health of the baby.

If you are planning to become pregnant or are at risk for periodontal disease , be sure to include a periodontal evaluation with a periodontist as part of your prenatal care? because healthy gums may lead to a healthier body and healthy baby.

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The inside of the mouth is normally lined with a special type of skin (mucosa) that is smooth and coral pink in color. Any alteration in this appearance could be a warning sign for a pathological process. The most serious of these is oral cancer. The following can be signs of the beginning of a pathologic process or cancerous growth:

- Reddish patches (erythroplasia) or whitish patches (leukoplakia) in the mouth
- A sore that fails to heal and bleeds easily
- A lump or thickening on the skin lining the inside of the mouth
- Chronic sore throat or hoarseness
- Difficulty in chewing or swallowing

These changes can be detected on the lips, cheeks, palate, gum tissue around the teeth, tongue, face, and/or neck. Pain is not always necessary to define a pathology and, curiously, is not often associated with oral cancer. However, any patient with facial and/or oral pain without an obvious cause or reason may also be at risk for oral cancer. If you feel that you or someone you know, have any of the symptoms that have been discussed or if you have any questions and/or concerns, please do not hesitate to contact our office so we may be of some assistance to you.

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