Periodontal diseases are ongoing infections that can destroy the support of your natural teeth. Bacteria form colonies within a sticky layer called plaque or biofilm. Bacterial biofilms are generally resistant to antibiotics and other chemical agents. A large variety of bacteria form an ecosystem that is very adherent and very resistant to removal from tooth surfaces, especially those on teeth within the gap between our teeth and our gums. Their presence and metabolic processes cause our defensive mechanisms to react, which for some proves protective. For those persons susceptible to periodontal disease the immune/inflammatory cascade is excessive, particularly when the biofilm is left undisturbed for a number of hours. The integrity of the skin, which ideally is protecting the gum tissues on the inside of the gap or crevice between the gum and the tooth, is disrupted so that is no longer an effective barrier and may bleed with little disturbance. The tiny blood vessels are affected by the mediators of inflammation and become fragile and are no longer selective with what passes out of them and into them.
Periodontitis is basically an inflammatory disease that damages bone, not the somewhat innocent sounding "gum problems, often used to describe it. The nearly constant presence of the bacterial biofilm confronts the host, the patient susceptible to periodontitis, whose inflammatory response leads to damage to their own bone. Essentially the bone recedes from the neck of the tooth. As the bone is lost a deeper gap may develop between the tooth and the adjacent gum tissue. When the deepened gap persists it is often called a pocket, which actually protects the biofilm and reduces the patient's access for removing it. Gum recession is another way the bone loss is experienced. Gum tissue is only securely attached to bone, so if the bone recedes the gum adapts to the new level of the bone. When a person's genetics allows the bone to be thin enough to readily recede when challenged, bone anatomy is a predisposing factor to gum recession. If the gum over the thin bone is too weak to form an effective seal, the bone is poorly protected. The character and strength of the seal or barrier the gum ideally provides is also a function of genetics, so fragile gum tissue may only provide a weak seal, which additionally may be undermined by inflammation.
Though genetics is the major determinant of susceptibility to bone loss from periodontitis, there are other factors which can predispose or amplify the bone loss a patient experiences. Certain medical conditions, like diabetes, and specific medications may negatively influence the course of one's disease. Stress alters our immune/inflammatory responses such that they might not be as protective. Smoking seems to work through multiple mechanisms to magnify the bone loss experienced and compromising any healing potential, while often further masking the relatively subtle symptoms of infection. Our bites can be in harmony with the supporting bone for our teeth, but they can also be the source of physical stress on the bone, amplifying ongoing bone loss in specific sites. Each of us is most often so accustomed to our bite, our occlusion, that we are unaware of any disharmony. Physical trauma to the gum from harsh personal care measures may damage the gum tissues and create inflammation incompatible with bone health.
These are some of the major modifying determinants that may affect or may have already affected your experience. One of our major responsibilities is to be a source of understanding for you. The list of factors that may negatively influence the health and stability of the supporting bone for our teeth is growing constantly as new science emerges. Drs. McDevitt, Jacquot, and Izarra find that their constant reading of professional journals and their frequent attendance at continuing education courses is an essential part of your successful therapy. The complexity of comprehensive diagnosis requires a thorough analysis of all the identifiable factors that may affect your meeting your health goals.
home | patient information | periodontal disease | services | referring doctors | meet us | contact us | sitemap | disclaimer
Atlanta Address: 3580 Piedmont Road, NE, Suite 120 • Atlanta, GA 30305 • Phone: 404-231-1080
Peachtree City Address: 402 Stevens Entry, Parkside Office Park • Peachtree City, GA 30269 • Phone: 404-231-1080
Periodontics Website Designby PBHS 2010©