Gum disease progresses in stages-pyorrhea-Plaque

Gum disease progresses in stages

 It starts with gingivitis, in which the gums become inflamed, swollen, and tender. Left uncontrolled, the inflammation advances and the gums begin to stand away from the teeth so that pockets are formed which harbor bacteria and pus. 

This ispyorrhea. As pyorrhea progresses, fibers holding the teeth in their sockets weaken and gradually the bone supporting the teeth is destroyed, and the teeth become loose and are lost. What starts the process?.There is now evidence-thanks to the brilliant work of many investigators, notably Dr. Sumter Arnim of the University of Texas, Houston- that, just as in tooth decay, bacteria are involved.

Clinging to the teeth and working on food particles to produce acid, bacteria also produce a material-a film called plaque-that covers them over, allowing them to work undisturbed. Plaque not only furthers decay; it triggers the formation of tartar, or calculus. 

And it is calculus that, spreading down below the gum line, irritates the gums, starts up inflammation and gingivitis, and opens the way for pyorrhea and gum disease progression. "Calculus cannot form unless plaque is present," says Dr. Irving Glick- man, Chairman of the Department of Periodontology at Tufts University School of Dental Medicine. "It's important for a dentist to remove calculus once formed; but it's also vital for the individual to minimize formation. In no other field of medicine can the patient so effectively assist in preventing and reducing the severity of disease.

Other factors may enter into decay and gum disease. In some caries- rampant individuals-those with far more even than the bad-enough average of decay-poor nutrition or faulty saliva flow may play a role; dentists can correct both. Faulty bite may help foster gum trouble; this can be corrected. But it is now clear that against both decay and periodontal disease, effective home care to prevent plaque formation is a prime weapon of prevention.

And more and more dentists are taking time to educate patients in proper home care methods. Recently, one of us spent two and a half months visiting such men in and around more than a dozen cities and in small communities. It was gratifying to see them lift bits of plaque from patients' teeth and place them under special microscopes so the patients could see for themselves the teeming colonies of bacteria in the plaque. 

Plaque on the teeth is invisible, but these dentists reveal it to patients graphically with a simple tool, a disclosing wafer. It's a small tablet containing a harmless vegetable dye. Chewed up, it stains the teeth temporarily, but only where the plaque is.