1. What is the gum?
It is part of the support system of the tooth to the jaw. If the gum is healthy, the teeth are
firmly attached, ensuring properly fulfill its mission and isolating masticatory organ-
mechanism of attacks coming from the external environment through the mouth.
The gum is a constituent of the periodontium by the alveolar bone and periodontal ligament. The
periodontal ligament and alveolar bone to insert the tooth and gum body is a barrier which
protects the right of physical attacks, chemical and bacterial coming from abroad.
Two. How healthy gums?
Healthy gingiva fits scalloped shaped teeth. Its color is light pink and do not bleed.
Three. Why diseased gum?
The most frequent cause that leads to gum disease is bacteria. In the mouth there are more than
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 the teeth and in the sulcus,
forming plaque.
When bacteria grow surpassing a certain level, are capable of producing tissue damage
periodontal. The severity of the lesions produced by bacteria in the periodontal depends on the
Individual susceptibility which is a genetically determined trait.
April. 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, it takes the presence of bacteria.
Often people with periodontitis, especially the more severe forms,
are affected by their parents or siblings, which speaks of family character-hereditary. The fact
being so frequent, often takes weight to this element to be considered as match-
Family ence due to the high incidence.
Genetic predisposition BACTERIA + = PERIODONTITIS
Genetic predisposition BACTERIA + = GINGIVITIS
Genetic predisposition BACTERIA + = HEALTH
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
May. Does diet influence the health of the gums?
Unlike dental caries, the type of power seems to play an important role in health
gum, although probably consume foods to facilitate self oral hygiene as fruits
and vegetables have a beneficial effect.
June. What is the relationship between poorly positioned teeth with periodontal disease?
In people who have a great care of your mouth, malposition not carry a higher risk of
developing periodontitis, but in people less attentive to his mouth, teeth can favorable misplaced
harden the onset of gum problems, gingivitis and periodontitis both because hygiene is diffi-
cultured in these cases and bacteria grow best.
It is often recommended that patients treated periodontally Cured undergo a tra-
ment to properly position your teeth, because thereby improve long-term prognosis
besides the aesthetic benefit accordingly.
July. How does the gum snuff?
Although snuff is not able to produce gum disease directly, if that aggravates the evo-
solution of the same and reduces the efficacy of treatment.
The mechanisms by which the snuff aggravate the development of periodontitis are a reduction in
blood supply to the tissues of the gum with declining defense capacity of these
against bacteria. This effect is independent of swallowing smoke or not related to the
number of cigarettes smoked, the effect being maximum over a pack a day and quite
least below 10. 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.
August. What medications can affect my gums?
Three types of drugs have an effect on the gum, which is characterized by increased volume
and inflammation:
· Some used after organ transplantation such as cyclosporin
· 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 for
to recommend the attitude to take.
Oral contraceptives also can have an effect of increased redness and bleeding
gum. Yes 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
called gingivitis and only affect the gingiva, 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
manifested by blisters, ulcers and color changes. Some of them may be reflective 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
gingivitis shown that affects almost all of the population both children and adults. Although
periodontitis just affect children, one in two adults aged 35 years are found-
tra afflicted by them.
children
adults
Healthy 4%
periodontitis 50%
gingivitis 67%
gingivitis 46%
Manifestations of gum disease
11. At what age can begin to appear gum disease?
Rarely occurs in children, but if they do they are threatening severe forms of
very seriously to teething, and sometimes, to the child's health.
The most frequent forms appear in adults, beginning early manifestations to youth ages
tions around 30 years. The younger the person at the time to appear, more severe-
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, producing
cen transient alterations in the gum that need special care.
Manifestations of gum disease
13. What consequences have periodontal disease?
If untreated can lead to loss of teeth in a variable period of time. The
edentulism is a priority health problem because it produces large functional consequences, be-
tics and psychological impact on those who suffer.
In Spain the percentage of partially edentulous is 52% at 40 years of age and edentulous
Total is 41% at 60 years of age. The economic cost of tooth replacement
lost is difficult to assume a cost of state health and many economies particle-
res, which causes a major problem of accessibility to a right as fundamental as the
health.
Recently been shown a number of important consequences for overall health, which tra-
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
bad breath, redness, retraction, change in position of the teeth, thermal sensitivity, pain
and even mobility.
Definitive diagnosis can only dentist so if you have some of
these circumstances should consult him to assess the situation and advise you how to act.
Indented
Redness and
inflammation
Retraction
and separating teeth
Manifestations of gum disease
15. Is it normal for blood gum?
The most early sign warns us that there is spontaneous bleeding problems or
brushing. A gum that bleeds can make an 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 we'll see later.
not normal for a healthy gum blood
16. Is it normal for teeth to move?
Normally the teeth do not move. Only in special circumstances may appear a certain
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 it appears terminal reflects a situation more complex treatments
complexes and worse treatment outcome.
Mobility reflects around the tooth has been lost or anchor bracket 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
ing with an intensity and inadequate direction, but in these cases you need a different treatment
You.
Manifestations of gum disease
17. Is 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. Having teeth mobility 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, producing
of volatile compounds that are eliminated by the breath. Such gases typically contain amounts 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 feels full or partial disappearance of this symptom
after treatment. In case of persistence will have to ask 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 gum disease?
The best way to prevent gum disease is to maintain proper oral hygiene, but people
predisposed despite oral hygiene disease tends to occur.
Therefore, oral hygiene is an important pillar preventing periodontitis but not the sole, and
periodic review must accompany the dentist or periodontist for the early diagnosis
in case of.
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
intermediate hardness to not damage the gums. If you keep your toothbrush for too long in
use bristles deteriorate and 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 use dental floss correctly 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.
Yes after applying silk smells, check off an odor that reflects what the
bacteria and the alteration produced in your gum. This odor will be worse the more time has passed
not apply in the 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, 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 action if they break it.
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 food does not act as favoring them.
There are reasons to believe that a diet rich in fruits promotes natural tooth hygiene and
gums, contributing to an elimination of bacteria and indirectly, contributing to health
gum.
25. Periodontal care Can help prevent tooth decay?
In patients undergoing periodontal care program which includes proper oral hygiene and
scheduled visits to the dentist or periodontist, significantly reduces the appearance of new
cavities. This is because the bacterial plaque control is also effective in preventing
cavities, and if it appears, is detected when the size is small and simple treatment.
CARING FOR YOUR GUM IS ALSO A
GUARANTEE PREVENTION OF DECAY
26. Are they contagious gum disease?
Periodontal disease is an infection caused by bacteria and as such can get.
Recent 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 do not recommend changing any habit of regarding even-
if you have this disease should encourage family members to do a simple review
with the dentist to rule out the involvement.
infection has not been demonstrated between casual partners,
other between the coexisting for years ...
27. What I care not to infect my relatives if I have disease
periodontal?
None in particular. The best way to avoid infection is proper disease control
get rid of the bacteria producing it and not make it contagious.
28. I can know if my children will have periodontal disease in the future?
There are tests that can be performed in healthy individuals and indicate whether we are at greater risk of
have 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 who have 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 greater chance of
Early detection of problems.
Analysis are rather expensive, available from very early dates but it will allow you, yes you pade-
ce periodontal disease, detect their children's predisposition to suffer, to thereby apply
car 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 to have the
disease, if they have a genetic predisposition to it, teach from small to maintain habits
proper oral hygiene, brushing your teeth and gums after meals and let them review
periodically by the dentist.
30. How do you treat gum disease?
Treatment is aimed at eliminating the disease-producing bacteria, correct the factors that
make you more susceptible to them as snuff and certain dental alterations like malpo-
positions finally create the conditions necessary for the disease can be maintained with-
Long-term controlled.
In case of gingivitis is enough improved oral hygiene and prophylaxis are periodontal
preventive actions fast, simple and nothing annoying.
In periodontitis, first performed a thorough periodontal clinical and radiological study,
to assess the situation at the time of start. Is sometimes necessary to use
tests.
The basic phase of treatment is aimed at removing 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 deeper areas of the bag
periodontal and correct anatomical defects arising as a result of the disease. In
Sometimes it is possible to recover the lost bone by applying regenerative techniques.
Other surgical procedures are known as mucogingival surgery that can correct
alterations in the quantity or quality of the gum at certain locations, especially prior to
improve the prognosis of some teeth, or for cosmetic reasons.
32. Can you recover lost bone by periodontal disease?
On several occasions the defects produced in the jawbone by periodontal disease
meet specific characteristics that enable regeneration. Regenerative procedures
are applied in different ways in the form of filler material, regeneration systems
guided tissue as membranes or organic substances derived from proteins that stimulate
bone growth.
These procedures require high qualifications and are not listed more than on occasion,
therefore be applied after a careful study of each case by a highly professional
qualified as a dentist or periodontist.
33. Does it improve the aesthetics oral periodontal treatment?
There is no worse image than that of a mouth with red gums and bleeding. The health of the gums
ensures a pink color and image and look healthy mouth. Periodontal disease often
makes teeth appear longer due to gum recession. Sometimes after the is-
periodontal treatment, teeth are slightly longer disappear because inflammation
the 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.
At other times are localized gum recession in some teeth, which can
treated successfully by simple procedures.
The inflamed gingiva loses
height to heal after treatment.
34. What is periodontal cosmetic surgery?
They are a series 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.
They are an aid to the dentist in performing many prosthetic type treatments
long term also preserve the health of the gums.
35. What is periodontal maintenance?
It is a fundamental stage of periodontal treatment and
periodontitis long term. Surgical basic phases
and achieve periodontal health, but those tend to
Oral and yes reservoirs do not act properly
We months.
In each maintenance visit the dentist or hygienist will perform some actions its protocol-
das consisting of: verifying the clinical situation tooth for tooth, your oral health assessment
and removal of calculus and bacteria individually according to the situation of the different areas
mouth. Importantly, periodontal maintenance is cleaning his mouth but a
medical intervention individualized to each patient's situation in each particular time.
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 testing and analysis?
To treat periodontitis most do not need to perform any analysis, but in certain
tas aggressive forms, which appear in young or general ill
like diabetes, you may want to identify the 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 treated if respond worse
than others. In these cases this alteration can be detected to implement preventative protocols and
more comprehensive individualized therapeutic.
The evidence cited are taken from the periodontal pocket or saliva without invasive methods let you
more effective treatment of complex cases.
37. Can you treat periodontal disease with antibiotics?
Antibiotics are substances capable of removing or inactivating bacteria, therefore, the disease
ing periodontal an infection, it can be treated with antibiotics. Due to the chronic nature of
periodontitis is not recommended to use them continuously for prolonged use produces resis-
tencies bacteria and undesirable side effects on the organism.
It is currently recommended to treat with antibiotics certain aggressive periodontitis by
persistence of bacteria after the usual, with the aid of 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 can
treat the condition.
39. Who should treat my gum problems?
Your dentist is trained to diagnose and treat gum problems as well as counseled-
jarle on preventive measures to help keep gums healthy yourself and your
family.
Sometimes the dentist may delegate certain parts of the dental hygienist treatment, such as
scaling and oral hygiene instruction. Also sometimes the dentist can apply
collaboration periodontist to treat the 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 tinge of
we can not forget to perform regular maintenance visits, according to the protocol estab-
established by our dentist or periodontist. Otherwise again reactivated disease.
Sometimes this result is not achieved complete control and in this case although the disease progresses
that more slowly than without treatment. These cases are:
· Very aggressive forms such as occur in children or very young adults.
· Smoking more than a pack a day.
· Patients with severe systemic diseases such as diabetes or certain medications.
41. Is periodontal treatment painful?
Is generally slightly annoying including surgery, if necessary. Your dentist
or periodontist valued in each case the need for anesthesia and type.
Sometimes after treatment is a sensitivity to cold 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 periodontal treatment with other treatments of the mouth?
When the disease has been controlled it is necessary to make other treatments of your mouth
help to achieve long-term control of it. If periodontal treatment need
had been necessary to postpone fillings or fillings at the end this is the time to rea-
lizarlos.
It is generally necessary, replace missing teeth, since losses are not replaced
factor favoring the development of periodontal diseases.
Similarly, in many cases orthodontic treatment to correctly position the teeth
ing improves the overall prognosis for long-term mouth. In each case your dentist must inform
marle on these aspects that give a fair assessment 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 partially or totally lost their teeth as a result thereof. In this case
is convenient to replace missing teeth and tooth loss that can not favorable responses
harden the development of periodontitis and decrease the effectiveness of treatment.
The best way to restore your teeth is fixed prosthesis supported on their own teeth, if
they can bear, or implants. The removable dentures usually hurt the gum
and the remaining teeth, so it should be placed if there is the possibility of fixed prosthesis.
The decision indicated the type of prosthesis should take it if your dentist and bears some
complexity, so we recommend that you ensure you decide well before and never trust
who does not have the proper qualifications.
only the dentist has the skills to Give you the prosthesis
44. I can place myself? Implants if I have periodontal disease?
Si.
Implants placed in the mouth are subject to the same risks of infection from the teeth.
Never be placed implants without adequate control of periodontitis, but once achieved
it, behave as in a patient affected by the disease.
The best way to ensure good long-term outcome of treatment with implants is
ensure that there is no periodontal disease or should be affected, treated earlier.
45. What risks are a pregnant woman with periodontal disease?
There is clear evidence that periodontal disease uncontrolled increases the risk of having a
immature newborn. Preterm birth is a major health problem because, although the
perinatal mortality has decreased dramatically in developed countries such as Spain, is among
premature infants who are concentrated in the few deaths that still exist. Besides the cost
economics of hospital care for 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 low birth weight. The influence of this factor
could even be compared to smoking or alcohol intake. The
percentage of preterm births due to this cause could be in
around 18%.
46. Can the menopause affect diseases affecting the gums?
It has recently been shown that there may be a relationship between alterations in the metabolism of
consecutive bone menopause and periodontitis. At menopause there is a decrease
marked certain estrogen hormones called trigger reaching osteoporosis states.
Although periodontal disease is not a metabolic bone disease but infectious, there is
possibility of 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 healthy teeth and chewing
normally have less degree of osteoporosis than toothless. Yes we believe that the most
frequent tooth loss in adults is periodontal disease, achieve good health
periodontal is for women that guarantee to get
menopause will not see a reduction in quality of life for the oste-
porosis.
47. Does it affect periodontal health on quality of life of older people?
Studies in the Nordic countries found that older people with more teeth are
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.
Caring young gum keep more teeth makes more and have 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 come to know 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
presence of chronic infection and inflammation and CVD. No doubt more chronic infections
frequent caries and periodontal disease, 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 classical risk factors such as cholesterol.
Has been linked to the presence in the blood of certain substances in inflammation
(Cytokines), with the onset of CVD. Bacteria present in the untreated periodontal pockets
das, run frequently to the blood as a result of acts like the same chewing; these
would lead to overproduction of cytokines that could cause effects on distant organs such as
the 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
certainly an additional guarantee for 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 some
elevated blood glucose (blood sugar) with implications in different organs such as the kidney,
eyes, heart, blood vessels and organs with small caliber. Treating the aforementioned diseases
tion is aimed at achieving blood glucose levels stabilize within normal limits, which is
external input made with insulin or other substances of similar effect.
The presence of periodontal disease may increase the difficulty to control blood sugar
increasing the risk of vascular complications, both of
circumstances related to the severity of periodontitis. It
parallel seen that control of the periodontitis-mediate
you correct treatment can improve the patient's situation
you have diabetes, reducing him even the need for insulin.
Thus, in the diabetic patient, the health maintenance
guarantees gum improved their situation and gain quality
life.
50. A diseased gums can harm athletes?
Yes Traditionally it was recommended by the trainers of the athletes who will perform a
oral exam when they had some type of muscle or joint injury cause unclear, although not
knew why.
Recent studies in Japan have allowed to relate the presence of periodontal disease
with decreased muscle performance, flexibility and responsiveness physics. In this line
will in the future continue to investigate, but there are substantial grounds for believing that a healthy gingiva is
the best guarantee of a good physical performance.
