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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 disease.

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.

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