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 Gingivitis and Periodontitis
NC Charlotte Dentist

 Gingivitis Periodontist Dentist Charlotte NC North Carolina Holistic Biological Biocompatible 


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I cannot emphasize enough to my Charlotte NC area patient how important it is to maintain healthy gum and bone tissue around the teeth. Traditionally, dentists educated patient about the local damage that occurs in the mouth from periodontal disease. A dentist treating patients holistically and biologically will educate their patients about the harmful effects periodontal disease on the entire body.



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Note:

Periodontal disease is discussed below. However, you must understand that their are several things that contribute greatly to periodontal disease (besides inadequate home care). These include:

1) An unbalanced bite 
2) Smoking (see bottom of this page) 
3) Diabetes (see bottom of this page) 

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Gingivitis ("inflammation of the gum tissue") is a term used to describe non-destructive periodontal disease. The most common form of gingivitis is in response to bacterial biofilms (also called plaque) adherent to tooth surfaces, termed plaque-induced gingivitis, and is the most common form of periodontal disease. In the absence of treatment, gingivitis may progress to periodontitis, which is a destructive form of periodontal disease. While in some sites or individuals, gingivitis never progresses to periodontitis, data indicate that periodontitis is always preceded by gingivitis. 

Periodontitis is a set of inflammatory diseases affecting the periodontium, i.e., the tissues that surround and support the teeth. Periodontitis involves progressive loss of the alveolar bone around the teeth, and if left untreated, can lead to the loosening and subsequent loss of teeth. Periodontitis is caused by microorganisms that adhere to and grow on the tooth's surfaces, along with an overly aggressive immune response against these microorganisms. {gingivitis and periodontitis} 

Gum tissue, bone and periodontal ligament tissue
can all be damaged from periodontal disease.
Gingivitis and periodontitis




The combined acute and chronic inflammation seen in gingivitis and periodontitis is destructive to bacteria. It also causes damage to the connective tissue of gingival and the periodontal tissues.


The first bacteria that from a biofilm on cleaned tooth surfaces are streptococci species (Gram positive cocci).


Within two days Gram negative bacteria also appear in the subgingival biofilm and gingival inflammation begins.


Subgingival bacterial biofilm (plaque) initiates gingival inflammation (Gingivitis).


Radiograph of advance Periodontitis with evidence of interproximal bone loss .


Same case with gum tissue pulled away from teeth and bone shows extensive bone loss due to periodontitis. 

Periodontitis will be more destructive if the bite is unbalanced. 



Gingival Sulcus:

The normal sulcular depth is three millimeters or less. Through much investigation and research, it has been determined that sulcular depths of three millimeters or less are readily self-cleansable with a properly used toothbrush or the supplemental use of other oral hygiene aids. When the sulcular depth is chronically in excess of three millimeters, regular home care is unable to properly cleanse the full depth of the sulcus, allowing food debris and microbes to accumulate. This poses a danger to the periodontal ligament (PDL) fibers that attach the gingiva to the tooth. If accumulated microbes remain undisturbed in a sulcus for an extended period of time, they will penetrate and ultimately destroy the delicate soft tissue and periodontal attachment fibers. If left untreated, this process may lead to a deepening of the sulcus, recession, destruction of the periodontium, and tooth loss. 

Health



Gingival Pocket:

A gingival pocket presents when the marginal gingiva experiences an edematous reaction, whether due to localized irritation and subsequent inflammation, systemic issues, or drug induced gingival hyperplasia. Regardless of the etiology, when gingival hyperplasia occurs, greater than normal (the measurement in a pre-pathological state) periodontal probing measurements can be read, creating the illusion that periodontal pockets have developed. This phenomena is also referred to as a false pocket or "pseudopocket". The epithelial attachment does not migrate, it simply remains at the same attachment level found in health. The only anatomical landmark experiencing migration is the gingival margin in a coronal direction. 

In a gingival pocket, no destruction of the connective tissue fibers (gingival fibers) or alveolar bone occurs. This early sign of disease in the mouth is completely reversible when the etiology of the edematous reaction is eliminated and frequently occurs without dental surgical therapy. However, in certain situations, a gingivectomy is necessary to reduce the gingival pocket depths to a healthy 1-3 mm. 


Periodontal Pocket:

As the original sulcular depth increases and the apical migration of the junctional epithelium has simultaneously taken place, pathosis has occurred. To have a true periodontal pocket, a probing measurement of 4 mm or more must be clinically evidenced. In this state, much of the gingival fibers that initially attached the gingival tissue to the tooth have been irreversibly destroyed. 


Click on the following link and the video below it for information on periodontal disease and smoking:

Smoking 


Click on the following video for information on periodontal disease and smoking:


Periodontal (gum) disease and smoking.


Click on the following video for information on periodontal disease and diabetes:


Periodontal (gum) disease and diabetes