Periodontal disease: what it is and how to avoid it

Periodontal disease is an infection of the tissues that support your teeth.

There is a very slight gap (called a sulcus) between the tooth and the gum.

Periodontal diseases attack this gap and cause a breakdown in the attachment of the tooth and its supporting tissues.

When the tissues are damaged, the sulcus develops into a pocket and, as the disease gets more severe, the pocket usually gets deeper.

The two major stages of periodontal disease are gingivitis and periodontitis.

Gingivitis is a milder and reversible form of periodontal disease that only affects the gums. Gingivitis may lead to periodontitis, which is a more serious, destructive form of periodontal disease.

There are several factors that have been shown to increase the risk of developing periodontal disease:
– Systemic diseases such as diabetes
– Some types of medication
– Crooked teeth
– Bridges that no longer fit properly
– Fillings that have become defective
– Smoking
– Pregnancy

And there are a number of warning signs that can suggest a possible problem:
– Gums that bleed easily
– Red, swollen, tender gums
– Gums that have pulled away from the teeth
– Persistent bad breath or taste
– Permanent teeth that are loose or separating
– Any change in the way your teeth fit together when you bite
– Any change in the fit of partial dentures

However, it’s also possible to have periodontal disease with no warning signs.

It’s therefore important to have regular dental checkups and periodontal examinations.

If you have developed periodontal disease, the treatment will depend on how far it has progressed.

You can take steps to prevent periodontal disease from becoming more serious or recurring.

Good dental hygiene practices such as brushing twice a day, cleaning between your teeth, eating a healthy diet and having regular visits to the dentist will make a huge difference.

How older adults can handle dry mouth and taste problems

Reduced saliva flow that results in a dry mouth is a common problem among older adults.

It is caused by certain medical disorders and is often a side effect of medications such as antihistamines, decongestants, pain killers and diuretics.

Some of the common problems associated with dry mouth include:
– Constant sore throat
– Burning sensation
– Problems speaking
– Difficulty swallowing
– Hoarseness or dry nasal passages

Left untreated, dry mouth can damage your teeth. Without adequate saliva to lubricate your mouth, wash away food, and neutralize the acids produced by plaque, extensive cavities can form.

Your dentist can recommend various methods to restore moisture. For example, sugar-free candy or gum stimulates saliva flow, and moisture can be replaced by using artificial saliva and oral rinses.

Another issue that can affect older adults is a loss of appetite due to a change in your sense of taste. Besides an age-related decrease in the sense of taste and smell, certain diseases, medications and dentures can contribute to a decrease in your sense of taste.

Whether you are suffering from dry mouth or problems with your sense of taste, your dentist will be able to make suggestions to help.

Different types of dentist and how they help your oral care

While many people see dentists as the single group of people who look after the health of your teeth and mouth, there are various specialist categories that help you in different ways.

The categorization of a dentist will depend on their education, training and experience.

Here are some of the main specialist areas of dentistry:

Endodontics: Concerned with the dental pulp – the part in the center of a tooth made up of living soft tissue and cells and root canal therapy

Oral and Maxillofacial Pathology: This deals with the identification, and management of diseases affecting the oral and maxillofacial regions

Oral and Maxillofacial Radiology: Deals with the production and interpretation of images and data produced by radiant energy that are used for the diagnosis and management of diseases, disorders and conditions of the oral and maxillofacial region

Oral and Maxillofacial Surgery: Diagnosis and surgical treatment of diseases, injuries and defects of the tissues including extractions, facial surgery and implants

Orthodontics and Dentofacial Orthopedics: Mainly deals with diagnosis, prevention and treatment of misaligned teeth and modification of midface and mandibular growth

Pediatric Dentistry: Provides preventive and therapeutic oral health care for infants and children through adolescence.

Periodontics: Prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth and the maintenance of the health, function and esthetics of these structures and tissues. Most periodontist place implants

Prosthodontics: Diagnosis, treatment planning, rehabilitation and maintenance associated with missing or deficient teeth and/or oral and maxillofacial tissues. Includes dentures, bridges and the restoration of implants.

Plus, of course, general dentists provide everyday care and many specialist services to maintain your oral health.

What will it be like living with dentures?

People who are new to wearing dentures naturally have many questions about how their life will change.

New dentures may feel awkward for a few weeks until you become accustomed to them. The dentures may feel loose while the muscles of your cheek and tongue learn to keep them in place.

During this time, it’s not unusual to experience minor irritation or soreness. You may find that saliva flow temporarily increases.

As your mouth becomes accustomed to the dentures, these problems should diminish.

Dentures can be made to closely resemble your natural teeth so that little change in appearance will be noticeable. Dentures may even improve the look of your smile and help fill out the appearance of your face and profile.

Eating will take a little practice. Start with soft foods cut into small pieces. Chew slowly using both sides of your mouth at the same time to prevent the dentures from tipping. As you become accustomed to chewing, add other foods until you return to your normal diet.

Continue to chew food using both sides of the mouth at the same time. Be cautious with hot or hard foods and sharp-edged bones or shells.

Initially you may also find that wearing dentures changes how you speak. Pronouncing certain words may require practice. Reading out loud and repeating troublesome words will help. If your dentures “click” while you’re talking, speak more slowly.

You may find that your dentures occasionally slip when you laugh, cough or smile.

After your dentures are fitted, you’ll have a few follow-up appointments with your dentist to take care of any initial issues and to answer any questions you have.

Your options if you have many missing or damaged teeth

People who have not followed adequate dental care for some years may have already lost most of their teeth and feel a little hopeless.

Sometimes they ask a dentist to remove the remaining teeth as they are often broken and have deep cavities.

It’s true that, sometimes, removal of the remaining teeth and replacing them with full dentures is the only option.

But more often there are other options available.

Some or all of the remaining teeth could be repaired and used in conjunction with a partial denture. While a full denture replaces all of the teeth on the upper or lower jaw, a partial denture replaces some of the teeth.

If only a few weak teeth remain on the upper jaw, it might be preferable to have them extracted and a full upper denture made. Full upper dentures can be more secure than lower ones as the upper denture gets added stability from the palate and is not easily dislodged by the tongue.

If only a few teeth remain on the lower jaw, however, the dentist will usually aim to save them and use a partial denture if necessary.

Ideally, all teeth that can be saved should be saved but this is not always possible – often due to finances.

In such cases, having teeth removed and dentures may be the only option.

You might have gum disease without even knowing it

Gum disease – also known as periodontal disease – is an infection of the tissues surrounding and supporting the teeth and it’s a major cause of tooth loss in adults.

But it’s usually painless so you may not even know you have it.

It’s caused by plaque – a sticky film of bacteria that constantly forms on the teeth. These bacteria create toxins that can damage the gums.

The early stage of gum disease is called gingivitis. In this stage, the gums can become red, swollen and bleed easily. At this stage, you can usually still reverse the disease by daily brushing and flossing.

The more advanced stage of gum disease is known as periodontitis. At this stage, the gums and bone that support the teeth can become seriously damaged. The teeth may then become loose, fall out or have to be removed by a dentist.

It’s therefore very important to look out for any signs of gum disease. These signs include:

– Gums that bleed when you brush your teeth
– Red, swollen or tender gums
– Gums that have pulled away from the teeth
– Bad breath that doesn’t go away
– Pus between your teeth and gums
– Loose teeth
– Change in the way your teeth fit together when you bite
– Change in the fit of partial dentures

If you notice any of these signs, contact you dentist quickly and they’ll help you take action to make improvements.

Taking care of your dentures

Your dentures are designed to last a very long time so it’s important that you take care of them as you would take care of your own teeth.

They are very delicate and may break easily if dropped even a few inches. So it’s a good idea to stand over a folded towel or a basin of water when handling dentures.

When you are not wearing your dentures, store them away from children and pets.

Like natural teeth, dentures must be brushed daily to remove food deposits and plaque.

Brushing helps prevent dentures from becoming permanently stained and helps your mouth stay healthy.

There are special brushes designed for cleaning dentures but a toothbrush with soft bristles can also be used. Avoid using hard-bristled brushes as these can damage your dentures.

Some denture wearers also use hand soap or mild dishwashing liquid for cleaning and that’s fine. But avoid using powdered household cleansers, which may be too abrasive. Also, avoid using bleach, as this may whiten the pink portion of the denture.

The first step in cleaning dentures is to rinse away loose food particles thoroughly. Moisten the brush and apply denture cleanser. Brush every surface, scrubbing gently to avoid damage.

Dentures may lose their shape if they are allowed to dry out. When they are not worn, dentures should be placed in a denture cleanser soaking solution or in water. Never place dentures in hot water, which could cause them to warp.

Ultrasonic cleaners are also used to care for dentures. However, using an ultrasonic cleaner does not replace a thorough daily brushing.

You can seriously damage your dentures by trying to adjust or repair them yourself. So see your dentist if your dentures break, crack, chip or if one of the teeth becomes loose.

Over time, dentures will need to be relined, rebased, or remade due to normal wear. They may also need to be replaced if they become loose and the teeth show signs of significant wear.

You need to make regular visits to your dentist to make sure the dentures are working as well as possible for you and to check for more serious problems in your mouth such as oral cancer.