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ADVANCED GINGIVITIS

Is a serious infection of the gums caused by plaque buildup at the gumline.

  PERIODONTAL DISEASE IS USUALLY A PAINLESS PROGRESSIVE INFECTIOUS DISEASE

      Gingivitis is inflammation of your gum tissue and is the beginning stage of periodontal or gum disease. Gingivitis is one of the most common untreated infections. After 35, approximately three out of four adults develop some form of gum disease. Plaque-induced gingivitis is defined as inflammation of the gingiva in the absence of clinical attachment loss.*

  Gingivitis damages your gums and reduces their ability to protect vulnerable areas. 

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     Gingivitis, and its progression to periodontitis, starts with the plaque that forms mostly at the gumline at the base of the visible part of your teeth. 

     This plaque is caused by food debris and bacteria that grow in this area. This group of harmful bacteria begins to recolonize and dominate in only 24 hours after you brush.  Their levels of toxins continue to increase causing an infection that can damage your gums and affect your immune system.  

You may not know you have this infection because it is painless

If this plaque is not removed daily it will harden to form calculus (tartar) around the necks of your teeth.

     This calculus will often result in a mechanical irritation that damages your gums. Additionally, calculus provides an area on which more bacteria easily grow, plaque and calculus will, if not removed, continue to grow and form deep pockets at the base of your teeth that will sooner or later fill with pus, infect the bone and cause tooth loss.  

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     Blood on your toothbrush or dental floss is one of the earliest and most common signs of advanced gingivitis. Other signs of advance gingivitis are:

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irritated gum tissue  

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changes in contour and consistency of gum tissue                          

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swollen gums due to bacterial infection

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sore gums due to toxins                                

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gum tissue that bleeds easily which is a good indicator that you have ACTIVE disease 

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6 or more bleeding points

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gums that are puffy and soft        

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red instead of pink gum tissue

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bad breath                                 

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pocket depths of 4mm because in pockets over 4mm is where 85% of the "Red Zone" bacteria (P.
 gingivalis, B.forsythus, T. denticola) are found.

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no bone loss

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presence of plaque

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gingival recession with soft tissue defects or frenum pulls

   

Your gums should never bleed while brushing or flossing.  

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     If your oral hygiene habits are poor, gingivitis may progress to periodontitis.  This disease attacks your gums, bones and supporting structures of your teeth leading to tooth loss

     You can never completely get rid of all the bacteria in your mouth but brushing and flossing make sure the number of bacteria you do have is in a safe range. A common mistake most people make is to brush but not floss. This allows bacteria to build up to dangerous levels between your teeth where brushing alone cannot reach. When any one group or family of bacteria begin to dominate their levels of toxins increase to a point where they cause an infection.  

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     The good news is that in advance gingivitis:

  No bone structure around the teeth has yet been lost.

  It is preventable.

  Easier to treat in a non-surgical manner.

  Less costly to treat in its early stages.  

   Reattached gum tissue to a spotlessly clean root surface

Scaling and root planing are non-surgery treatments that control infection and allow for natural healing

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  And it is reversible through:

1.  Professional treatments-to remove this harmful bacterial growth from you teeth and gums. You will be placed in the green program which includes two sessions:

A. Session 1:
 1.   Full mouth debridement to remove
        contamination above gum line 
 2.   One quadrant of Root Planing 
        and Scaling consisting
        of nine or less teeth to remove
        contamination above and 
        below the gum line
 3.   Irrigation with medications
 4.   Perio bag including home care 
       items
 5.   Oral Hygiene Instructions

B. Session 2:   

     1.   Remeasuring and updating 
        perio charting
2.   Cleaning with ultrasonic scaler and medication placement.

 

2.  Three month perio maintenance visit to remove the tartar, which harbors and nurtures the growth of undesirable bacteria. You need to be seen every 3-4 months because that's about how long it takes for the biofilm to re-establish causing bacteria infection.

3.  Good brushing for a minimum of twice a day and after meals (if possible) using your soft bristled perio instrument (Rota-dent) for at least two minutes.

4.   Daily flossing Start cleaning BETWEEN your teeth.  Periodontal disease begins between the teeth.  The area between the teeth are more prone to infection than facial or tongue gum tissue surfaces simply by anatomy.  This tissue is not keratinized like tissue found on the facial and tongue surfaces.  Non-keratinized tissue is more susceptible to breakdown.  It is also a very protected area, NOT reached by brushing or rinsing. 

     Since the disease starts between the teeth, it makes sense to start cleaning in between the teeth and than brush.  You can clean this area with interdental brushes, picks, sticks, oral irrigation, and automatic flossers.  remember this disease needs to be treated both in the office and at home.++

5.   Use of Periogard, an antimicrobial medicated mouthrinse.

6.   Daily fluoride treatments.

7.   Do not smoke or use alcoholic beverages while your gums are inflamed.

8.  Good dietary habits.  Cut back on foods and beverages that contain sugar.

9.  On going education about your dental health.

    To insure successful results following periodontal treatments, patient cooperation in maintaining  excellent oral hygiene is essential.

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    Remember: If left untreated, advance gingivitis will develop into periodontitis which will lead to:

bulletInfection that can affect your overall health
bulletSore bleeding gums
bulletDiscomfort
bulletBone loss
bulletTooth loss
bulletChanges affecting your appearance
bulletPoor nutrition
bulletPossible surgery
bulletCostly treatments  

Delaying treatment is a risky decision because gum disease never goes away on its own. It is an ongoing destructive bacterial infections of gums and bone that can have systemic effects.

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Case Type II Early Periodontitis- Diagnosis Code 4600- Progression of the gingival inflammation in the deeper periodontal structures with evidence of some attachment and bone loss Probing depth is generalized 4mm with isolated 5mm pockets possible.
 

*AAP Parameters of Care

February 06, 2008

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