Diabetes and Periodontal Disease
How Does Periodontal Disease Develop?
Gingivitis. Poor brushing and flossing habits allow dental plaque --
a sticky film of germs -- to build up on teeth. Some of these germs cause gum
disease. The gums can become red and swollen and may bleed during toothbrushing
or flossing. This is called gingivitis, the first stage of periodontal
Gingivitis can usually be reversed with daily brushing and flossing and
regular cleanings by the dentist. If it is not stopped, gingivitis could lead
to a more serious type of gum disease called periodontitis.
Periodontitis. Periodontitis is an infection of the tissues that hold
the teeth in place. In periodontitis, plaque builds and hardens under the gums.
The gums pull away from the teeth, forming "pockets" of infection. The
infection leads to loss of the bone that holds the tooth in its socket and
might lead to tooth loss.
There are often no warning signs of early periodontitis. Pain, abscess, and
loosening of the teeth do not occur until the disease is advanced. Since
periodontitis affects more than just the gums, it cannot be controlled with
regular brushing and flossing. Periodontitis should be treated by a
periodontist (a gum disease specialist) or by a general dentist who has special
training in treating gum diseases.
How Is Periodontal Disease Treated?
Plaque Removal. Treatment of periodontitis depends on how much damage
the disease has caused. In the early stages, the dentist or periodontist will
use deep cleaning to remove hardened plaque and infected tissue under the gum
and smooth the damaged root surfaces of teeth. This allows the gum to re-attach
to the teeth. A special mouthrinse or an antibiotic might also be prescribed to
help control the infection.
Deep cleaning is successful only if the patient regularly brushes and
flosses to keep the plaque from building up again.
Periodontal Surgery. Gum surgery is needed when periodontitis is very
advanced and tissues that hold a tooth in place are destroyed. The dentist or
periodontist will clean out the infected area under the gum, then reshape or
replace the damaged tooth-supporting tissues. These treatments increase the
chances of saving the tooth.