1. What is the gum?
It is part of the support system of the tooth to the jaw. If the gums are healthy, teeth are
firmly attached, ensuring properly fulfill its mission and isolating masticatory organ-
nism of attacks coming from the external environment through the mouth.
The gum is a constituent of the periodontium and alveolar bone adjacent to the periodontal ligament. The
periodontal ligament and alveolar bone to insert the tooth gum body and the barrier is
protects the right of physical attacks, chemical and bacterial coming from abroad.
2. How healthy gums?
Healthy gingiva fits scalloped shaped teeth. Its color is light pink and do not bleed.
3. Why diseased gum?
The most frequent cause that leads to gum disease are bacteria. In the mouth, there are over
300 different types of bacteria, many of which are potentially harmful to the periodontium. The
bacteria in the mouth are deposited on the surface of teeth and in the gingival sulcus,
forming plaque.
When bacteria grow exceeding a certain level, can produce tissue damage
periodontal. The severity of the lesions produced by bacteria in the periodontal depends on the
individual susceptibility is genetically determined trait.
4. Is periodontal disease hereditary?
The key element for developing periodontal disease is individual predisposition and this comes
genetically conditioned. It is a misconception that genetic predisposition is only sufficient to
developing periodontitis, requires the presence of bacteria.
Often people with periodontitis, especially the more severe forms,
are affected by their parents or siblings, which speaks of family-hereditary character. The fact
being so frequent, often takes the weight off this, to be considered as match-
lence due to the high incidence.
BACTERIA + = PERIODONTITIS genetic predisposition
BACTERIA + = GINGIVITIS genetic predisposition
BACTERIA + = HEALTH genetic predisposition
Therefore, and considering that today can do little to alter the genetic predisposition
ca, how to prevent and treat periodontitis is the bacterial plaque control.
Causes of gum disease
5. Does diet influence on the health of the gum?
Unlike dental caries, the feed rate may not play an important role in the health
gum, although probably consume foods which facilitate self oral hygiene as fruits
and vegetables have a beneficial effect.
6. What is the relationship between dental malpositions with periodontal disease?
In people who have a great care of your mouth, malpositions not carry an increased risk of
developing periodontitis, but people less attentive to his mouth, teeth may be favorable misplaced
Recer the onset of gum problems, gingivitis and periodontitis both because hygiene is diffi-
cultured in these cases and the bacteria grow best.
It is often recommended that patients treated periodontally once cured undergo a tra-
ment to properly position your teeth, as it will improve their long-term prognosis
addition consequent aesthetic benefit.
7. How does the gum snuff?
Although snuff is not capable of producing gum disease directly, if it aggravates the evo-
solution of the same and reduces the efficacy of treatment.
The mechanisms by which the snuff aggravates the evolution of periodontitis are a reduction
blood supply to the tissues of the gum with diminished capacity defense thereof
against bacteria. This effect is independent of swallowing or smoke and is related to the
number of cigarettes smoked, the effect being maximum over a pack a day and quite
least 10 below. In patients who quit after a few months, the gum
acquires several characteristics that make it similar to that of a person who has never smoked, so that the
elimination of smoking is a health guarantee for the gum and treatment efficacy in
If you suffer from periodontitis.
8. What medications can affect my gums?
Three types of drugs have an effect on the gingiva, which is characterized by increased volume
and inflammation:
· Some used after organ transplants as cyclosporine
· Antihypertensives such as nifedipine
· Difenilhidantohina Anticonvulsants as used in epileptic patients
If you are taking any of these medicines, check with your doctor and your dentist to
can recommend the steps to follow.
Oral contraceptives also can have an effect of increased redness and bleeding
gum. If you are in this situation, talk to your doctor or gynecologist.
Manifestations of gum disease
9. What are periodontal diseases?
The most common are certainly known as periodontal disease. Mild forms are
called gingivitis and affects only the gums, severe periodontitis is where there is a
deep tissue destruction such as periodontal ligament and alveolar bone.
There are many diseases that can affect the periodontium as certain skin conditions
that are manifested by blisters, ulcers and color changes. Some of them may be a reflection of
serious conditions such as cancer.
Periodontitis with periodontal pocket formation
Periodontitis with gingival recession
10. Are very common gum disease?
They are among the most common of the human race. Research studies have demonstrated
shown that gingivitis affects almost the entire population of both child and adult. Although
periodontitis only affect children, one in two adults aged 35 years It is found
tra afflicted by them.
children
Adult
Healthy 4%
periodontitis 50%
gingivitis 67%
gingivitis 46%
Manifestations of gum disease
11. At what age can begin to appear gum disease?
Rarely appear in children, although if it is very severe forms of threatening
very seriously to teething, and even sometimes to the child's health.
The most frequent forms appear in adults, beginning its first manifestations young ages
tions around 30 years. The younger the person at the time of appearing more seve-
ra will probably need more care and periodontitis.
12. Do women have increased risk of periodontal disease?
No. It is often thought so, but has not been demonstrated. What happens is that certain stages of
the lives of women, related to hormonal changes such as pregnancy and menopause, produced
cen temporary alterations in the gum that need special care.
Manifestations of gum disease
13. What consequences have periodontal disease?
In the absence of treatment leading to tooth loss in a variable period of time. The
edentulism is a priority health problem because it produces large functional consequences, be-
cies and psychological impact on those who suffer.
In Spain the percentage of partially edentulous is 52% at 40 years of age and of edentulous
Total is 41% at 60 years of age. The economic cost of the replacement of teeth
lost is difficult to assume a cost of state health and economies of many-particle
res, causing a major problem of accessibility to a right as fundamental as the
health.
Recently been shown a number of important implications for overall health, they work
taremos later.
14. How to know if my gum is sick?
Symptoms are spontaneous bleeding or brushing, the appearance of pus in the gums, bad taste or
mouth odor, redness, shrinkage, change of position of the teeth, thermal sensitivity, pain
and even mobility.
Definitive diagnosis can only dentist so if you have some
these circumstances should consult him to assess the situation and advise you how to act.
Indented
Redness and
inflammation
Retraction
and separation of teeth
Manifestations of gum disease
15. Is it normal for blood gum?
The more early sign warns us that there is spontaneous bleeding problems or
brushing. A bleeding gums may have gingivitis (mild problem) or periodontitis (problem
severe), the difference between the two situations requires an assessment by the dentist.
Sometimes appears an increased tendency to bleeding gum and at certain times of the
woman's life that we will see later.
is not normal for a healthy gum blood
16. Is it normal for the teeth to move?
Normally the teeth do not move. Only under special circumstances may appear some
considered normal mobility and subsequently disappears, as in orthodontic treatments.
Periodontal disease is not the only cause of tooth mobility, but the most frequent. In this
case is a very late sign and when a situation appears terminal reflects more complex treatments
complexes and worse treatment outcomes.
Mobility reflects around the tooth is lost support or anchor to the jawbone and is therefore
greater the extent of the disease.
Other circumstances that mobility increases associated with the forces exerted on the teeth
tients with inadequate intensity and direction, but in these cases you need a different treatment
you.
Manifestations of gum disease
17. Is it reversible tooth mobility caused by periodontitis?
Mobility tends to persist despite treatment for periodontal bone level does not recover
after treatment in most cases, what you get is indefinite maintenance
bone support. The mobility presenting teeth at diagnosis usually lost to
medium to long term despite treatment and this is one reason for the need for a
Early diagnosis and treatment of periodontitis.
18. Can periodontal disease cause bad breath or halitosis?
Certain bacteria produce periodontitis producing protein metabolism with production
volatile compounds that are eliminated by the breath. Such gases typically contain quantities of sulfur
which gives the characteristic odor. Also a result of the inflammatory process which occurs in
diseased periodontium is the pus that accumulates in the periodontal pocket that produces bad feeling
patient taste and bad breath that others perceive.
In the majority of cases the patient notices a partial or complete disappearance of this symptom
after treatment. In case of persistence of the same should consult the specialist unit
respiratory tract or on the subject.
Manifestations of gum disease
19. What should I do if my gum is sick?
Consult your dentist. He clinically assess if periodontitis or gingivitis only and both
situations will advise on the most appropriate treatment for you.
20. Can a good oral hygiene to prevent periodontal disease?
The best way to prevent gum disease is to maintain proper oral hygiene, but people
predisposed despite correct oral hygiene disease tends to occur.
Therefore, oral hygiene is an important pillar of prevention of periodontitis but not the only, and
revisions must accompany regular dentist or periodontist for the early diagnosis
if present.
21. What type of toothbrush should I use and when should I change it?
A good toothbrush should be small to reach all areas of the mouth and have nylon bristles
of intermediate hardness to not damage the gums. If you keep your toothbrush for too long in
use, the bristles and deteriorate its cleaning efficiency decreases.
To decide which is the best toothbrush for your mouth, seek advice from your dentist or periodontist and remember
pharmacist will also advise you as an expert.
22. Is it enough brushing to prevent gum disease?
No. The brush does not reach interdental spaces and to keep these areas free of bacteria
need to use silk or floss. While learning to properly use dental floss is something
complex at first, with a little patience will get reach a sufficient skill and apply
correctly throughout the mouth, in just a few minutes.
If after applying the smells silk, verify that gives off an odor which reflects the
bacteria and the alteration produced in their gumline. This odor will be worse the more time has passed
without applying area.
23. How often should I clean my teeth to prevent gum disease?
Although dental caries prevention is necessary to clean the teeth and gums before or after each
food, in adult patients where dental caries tends to decrease, it may be sufficient twice
day, morning and evening.
Remember that although you may find a good oral hygiene and make your gums are healthy, you need carried
Tsar regular reviews with your dentist or periodontist to check the health status and
take measures in case it breaks.
24. Do you keep gum disease related to food?
Unlike tooth decay that sugar intake is an important predisposing factor,
in gum disease the type of power does not act as favoring them.
There are reasons to believe that a diet rich in fruits promotes natural hygiene and teeth
gums, contributing to elimination of bacteria and indirectly, working in health
gum.
25. Can periodontal care help prevent cavities?
In patients undergoing periodontal care program that includes proper oral hygiene and
scheduled visits to the dentist or periodontist, significantly reduces the appearance of new
cavities. This is because control plaque is also effective in preventing
caries, and if found, it detects when the size is small and simple treatment.
CARING FOR YOUR GUM is also a
GUARANTEE caries prevention
26. Are they contagious gum disease?
Periodontal disease is an infection caused by bacteria and as such can get.
Research studies have shown that people living for years with a
periodontal patients are more likely to develop the disease. Relatives more sus-
fuels would be the children and life partners and saliva transmission vehicle.
The mode of transmission is the input kiss but not recommended to change any habit-even ratio
if you have this disease should encourage family members to do a simple review
with the dentist to rule out involvement.
contagion has not been demonstrated between casual partners,
yes between living for years ...
27. What I care not to spread it to my relatives if I have disease
periodontal?
None in particular. The best way to avoid infection is proper management of the disease
get rid of the bacteria that produce it and make it not contagious.
28. ? I can tell if my children will have periodontal disease in the future?
There are tests that can be performed in healthy individuals and indicate if they have a higher risk of
developing periodontal disease in the future.
These tests are based on detection of genetic alteration of a substance called interleukin
and are performed on blood or saliva. People with this disorder, are predisposed
greater to have periodontal disease in the future than those without. It is possible that the
coming years they appear more similar systems that provide increasingly more likely to
Early detection of problems.
Analysis are rather expensive, available from very early dates but it will allow you, yes you suf-
ce periodontal disease in their children detect predisposition to suffer, to thereby apply
car in preventive protocols them very early.
29. ? I can keep my kids suffer from gum problems if I suffer?
In addition to the discussion in the previous question, the best way to prevent your children suffer the
disease, if they have a genetic predisposition to it, is taught from a young age to keep habits
adequate oral hygiene, brushing your teeth and gums after meals and revise them
periodically by the dentist.
30. How do you treat gum disease?
Treatment is aimed at eliminating the disease-producing bacteria, eliminate the factors that
make you more susceptible to them as snuff and certain dental alterations like malpo-
sions, finally you need to create the conditions for disease can be maintained with-
Long-term controlled.
In case of gingivitis is sufficiently improved oral hygiene and periodontal prophylaxis are
preventive actions fast, simple and nothing annoying.
In periodontitis, first performed a detailed study periodontal clinical and radiological
to assess the situation at the time of start. Occasionally it becomes necessary to use
tests.
The basic phase of treatment is intended to remove bacteria from the periodontal pocket and is known as
scraping. When deep periodontal pocket is usually not achieved good control of the
infection so it is necessary periodontal surgery.
When the disease is controlled periodontal maintenance starts at issue in the
Question 35
31. What is periodontal surgery?
It is a stage that eliminates bacteria from the deepest parts of the bag
periodontal defects and anatomical correct produced as a result of the disease. In
Sometimes it is possible to recover lost bone by applying regenerative techniques.
Other surgical procedures are known as mucogingival surgery that can correct
alterations of the quantity or quality of the gum in certain locations, especially prior to
improve the prognosis of some teeth or for aesthetic reasons.
32. Can you recover the bone lost to periodontal disease?
On many occasions the defects produced in the jawbone by periodontal disease
meet specific characteristics that allow the regeneration. Regenerative procedures
applied in various ways either as filling material, feedback systems
as guided tissue membranes or proteins derived from organic substances that stimulate
bone growth.
These procedures require a highly skilled and are not indicated further that in some instances,
therefore be applied after a thorough study of each case by a highly professional
qualified as a dentist or periodontist.
33. Does it improve the aesthetics mouth periodontal treatment?
No worse than the image of a mouth with red and bleeding gums. The health of the gum
ensures pink and image and look healthy mouth. Periodontal disease often
makes teeth appear longer due to gum recession. Sometimes, after the treatment
periodontal treatment, teeth are a little longer because the disappearance of inflammation,
gum loses some volume.
The best way to avoid this negative effect is early diagnosis so that action is taken
before is lost bone and gum around the tooth.
On other occasions are located gum recession in some teeth, which can
treated successfully by simple procedures.
Inflamed gingiva loses
height to cure after treatment.
34. What is periodontal cosmetic surgery?
They are a set of procedures that help maintain the harmony of the smile or return to the
defects normally produced as a result of periodontitis or other causes.
Are an aid to the dentist in achieving many treatments and prosthetic type
long term also help preserve the health of the gums.
35. What is periodontal maintenance?
It is a fundamental stage of periodontal treatment and
Long term periodontitis. The basic stages and surgical
and achieve periodontal health, but those tend to
Oral and reservoirs Failure to act appropriately
We months.
Each maintenance visit the dentist or hygienist will perform some actions its protocol-
das consisting of: verifying the clinical tooth for tooth, your oral health assessment
and bacteria elimination and calculation individually according to the situation of different areas
mouth. Importantly periodontal maintenance is cleaning mouth but a
medical intervention individualized to each patient's situation at any particular moment.
The frequency of maintenance is defined for each particular case but usually ranges between visits
every 3-6 months depending on each case.
the only way to get control of the
are highly effective in controlling bacteria
periodontal pocket recolonization from other
the disease tends to recur after some
36. Do you need additional analysis and testing?
To treat most periodontitis no analysis is required, but in certain
tas aggressive forms, which appear in young or general ill
like diabetes, you may want to identify bacteria by micro-procedures
biology to verify that they have been eradicated.
It has recently been shown that people with a genetic alteration in a molecule associated with the res-
inflammatory response is more likely to have periodontitis and respond if treated worse
than others. In these cases you can detect this change to apply preventive protocols and
more comprehensive and individualized therapeutic.
The evidence cited are taken from the periodontal pocket or saliva without invasive methods do allow
more effective treatment of complex cases.
37. Can you treat periodontal disease with antibiotics?
Antibiotics are substances able to eliminate or inactivate bacteria, therefore, the disease
Dad is a periodontal infection can be treated with antibiotics. Due to the chronic nature of
periodontitis is not advisable to use them continuously for prolonged use produces resis-
tencias bacteria and undesirable side effects on the organism.
At present antibiotics recommended treat certain more aggressive periodontitis, by
persistence of bacteria after the usual treatment with the aid of a bacterial analysis
and sensitivity to select the most effective antibiotic in each case.
38. Do you serve the mouthwash to treat periodontitis?
In pharmacies and supermarkets can be found many substances that help prevent
periodontitis. In the treatment of these diseases have limited effectiveness because not
penetrate periodontal pockets and in this case only the intervention of the dentist or periodontist may
treat box.
39. Who should treat my gum problems?
Your dentist is trained to diagnose and treat gum problems as well as advis-
Jarle on preventive measures to help keep the gums healthy yourself and your
family.
Sometimes the dentist may delegate certain parts of the treatment in the dental hygienist, as are the
scaling and oral hygiene instruction. Also sometimes the dentist can apply
collaboration periodontist to treat cases it deems appropriate, especially the more complex
and advanced.
40. Is there a cure periodontal disease?
Treating periodontal disease gets stopped indefinitely with consequent
maintenance of the teeth. In practice this can be understood as a cure, with the hue of
we can not forget to perform regular maintenance visits, according to the protocol estab-
established by our dentist or periodontist. Otherwise the disease reactivated again.
Sometimes this result is not achieved complete control and in this case, although the disease progresses
more slowly than that without treatment. These cases are:
· Forms very aggressive as those in very young children or adults.
· Smoking more than a pack a day.
· Patients with severe systemic diseases such as diabetes or certain medications.
41. Is periodontal treatment painful?
Usually some annoying including surgery, if necessary. Your dentist
or periodontist assessed in each case the need for anesthesia and type.
Occasionally remaining after the sensitivity to cold treatment that may be more or less
accused. In the majority of cases disappears after a few days or weeks form
spontaneous, if not, see your dentist and he will recommend the use of some
products to solve the problem.
42. What relationship does periodontal treatment with other treatments of the mouth?
When the disease has been controlled is required other treatments your mouth
help achieve long-term control of the same. If periodontal treatment need
had been necessary to postpone fillings or fillings, at the end it is the time to rea-
lizarlos.
It is generally necessary, replace missing teeth, as losses are not replaced
factor favoring the development of periodontal diseases.
Also, in many cases orthodontic treatment to correctly position the teeth
ing, improves the overall outlook of the mouth long term. In each case your dentist will inform
marle on these issues that present a review of some complexity.
43. What if I lose my teeth due to periodontal disease?
If you came late or if your periodontitis treatment failed to adequately control is
may be completely or partially lost their teeth as a result thereof. In this case
is convenient to replace missing teeth and tooth loss that can not favorable responses
Recer the development of periodontitis and decrease the effectiveness of treatment.
The best way to restore your teeth is supported fixed prosthesis on his own teeth, if
they can bear, or implants. Dentures usually harm the gum
and the remaining teeth, so it should be placed if there is the possibility of fixed prostheses.
The decision on the type of prosthesis indicated if your dentist should take it and bears some
complexity, so we recommend that latches itself before deciding and never trust
who does not possess the appropriate qualifications.
only the dentist has the qualification to Give you the prosthesis
44. I can Stand? Implants if I have periodontal disease?
If.
Implants placed in the mouth are subject to the same risks of infection from the teeth.
Never implants placed without adequate control of periodontitis, but once achieved
it, behave like a patient affected by the disease.
The best way to ensure good long-term outcome of implant treatment is
ensure that there is no periodontal disease or in case of being affected, treated earlier.
45. What risks are a pregnant woman with periodontal disease?
There is clear evidence that periodontal disease of uncontrolled increases the risk of a
immature newborn. Preterm birth is a major health problem, for although the
perinatal mortality has decreased dramatically in developed countries like Spain, is among
premature infants who are concentrated in the few deaths that still exist. Besides the cost
Economic hospital attention to these children is very high and the suffering of the parents of
neonate immense.
The research studies show that periodontal disease in pregnant women can
be a significant risk factor for preterm birth, low weight. The influence of this factor
could even be compared to smoking or alcohol intake. The
preterm birth rate due to this cause may be in
around 18%.
46. Does menopause influence diseases affecting the gums?
It has recently been shown that there may be a relationship between alterations in metabolism
consecutive bone menopause and periodontitis. At menopause there is a decrease
marked certain estrogen hormones called trigger reaching osteoporosis states.
Although periodontal disease is a metabolic bone disease infectious but there the
possibility that a bone "quality" reduced more susceptible to destruction by the
bacteria and thus in menopause predisposition to that disease is accentuated.
Moreover, it has been shown that postmenopausal women with teeth and chewing
normally have less degree of osteoporosis than toothless. If we consider that the most
frequent tooth loss in adults is periodontal disease, achieving good health
for women periodontal guarantee that upon arrival
menopause will not see a reduction in quality of life for the oste-
oporosis.
47. Does it affect periodontal health in the quality of life of older people?
Studies in the Nordic countries found that older people with more teeth usually
be more active than those who have less and spend more time on leisure activities. Women
with more teeth were more physical strength, flexural capacity and faster reaction.
Taking care of young gum makes keeping more and more teeth for better quality of life
48. What relationship does the health of the gum with myocardial infarction?
CVD Cardiovascular disease is the leading cause of death in Spain.
Traditionally it has been knowing the role of high cholesterol, obesity, smoking and life
sedentary in the development of CVD. However, these risk factors do not explain all
Clinical and epidemiological aspects of this disease. Evidence has been accumulating links between
chronic infection and inflammation and CVD. Definitely more chronic infections
frequent caries and periodontal diseases, the latter in adulthood, when with
more often suffer from CVD.
Studies conducted in 1989 indicated a relationship between dental disease and accidents
acute cardiovascular. Initially regarded with caution the possibility of establishing a relationship
tion of causality between the two circumstances, but any subsequent more detailed studies,
established the relationship between dental infections and coronary atherosclerosis was the same
magnitude than that reported for traditional risk factors such as cholesterol.
Has been associated with blood presence of certain substances in inflammation
(Cytokines), with the occurrence of CVD. Bacteria present in the untreated periodontal pockets
das, run frequently to the blood as a result of the same acts as chewing, they
would lead to overproduction of cytokines that could cause effects on distant organs as
coronary arteries.
Maintaining proper oral health based on oral hygiene and regular reviews to
dentist to diagnose, prevent and treat dental caries and periodontal diseases are
more surely guarantee the prevention of cardiovascular diseases.
49. What is the relationship between diabetes and periodontal disease?
Diabetes mellitus is a metabolic disorder characterized by the presence of a
elevated levels of blood sugar (glucose) which impacts on different organs such as kidney,
eyes, heart, blood vessels and organs with small caliber. The treatment of the aforementioned diseases
tion is directed to achieve stabilization of blood glucose levels within normal limits, which
External contributions made with insulin or other substances of similar effect.
The presence of periodontal disease may increase the difficulty in controlling glycaemia
increasing the risk of vascular complications, both of
circumstances related to the severity of periodontitis. It
parallel seen that control of the periodontitis-mediate
proper treatment you can improve the situation of the patient
you have diabetes, reducing him even the need for insulin.
Therefore, in the diabetic patient, the health maintenance
guarantees gum improved their situation and gain quality
life.
50. A diseased gums can hurt athletes?
Yes Traditionally was recommended by the trainers of the athletes who will perform a
oral revision when an injury suffered muscle or joint cause unclear, although no
knew why.
Recent studies in Japan have allowed to relate the presence of periodontal disease
with reduced muscle capacity, flexibility and rapid physical response. In this line
should investigate further in the future, but there are reasons to believe that a healthy gum is
the best guarantee of a good physical performance.
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