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.
