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Gum disease is also called periodontal disease. It is defined as the inflammation of the structures that surround and support the teeth. If left untreated, gum disease may progress to the point where there is destruction of the jawbone. It is one of the most common causes of tooth loss. Periodontal disease is also a risk factor for coronary heart disease and preterm low birth weight.
Gingivitis is the earliest stage of a gum infection. It may recur or even become chronic. If gingivitis is not treated properly, it may progress to periodontitis, an inflammation of the periodontal ligament that helps hold the teeth in the bone. Periodontitis is sometimes called pyorrhea, which means a pus discharge. Severe cases of periodontitis may affect the jawbone. A severe case of gum disease that comes on suddenly is a disease known as trench mouth. Trench mouth, or necrotizing ulcerative gingivitis, is also known as Vincent's infection. It is caused by an infection of both spirochetes and fusiform bacilli. It was once a major problem for soldiers during World War I. Currently, trench mouth is particularly common among teenagers and young adults under stress, often at examination time. Inflammation from trench mouth can also spread to nearby tissues of the face and neck.
By far, the most common cause of gum disease is poor dental hygiene. Regular daily brushing and flossing of the teeth generally clears away food and bacteria
buildup in the mouth. If the teeth are neglected, bacteria collect, and plaque forms on the teeth and gums. If the plaque is not removed, it mixes with saliva and hardens into tartar. Tartar irritates the gums and causes them to shrink away from the teeth, opening up spaces where more bacteria and plaque can collect. This cycle encourages increasingly severe inflammation and infection.
The mechanisms by which bacteria cause tissue destruction in advanced gum disease are not fully understood. Several bacterial products that diffuse through tissue are thought to play a role in gum disease. Toxins produced by some bacteria can kill cells. Studies show that the amount of endotoxin present correlates with the severity of periodontal disease. Other bacterial products include proteolytic enzymes, which are molecules that digest protein found in cells, thereby causing cell destruction. The human immune response has also been implicated in tissue destruction. As part of a normal immune response, white blood cells enter regions of inflammation to destroy bacteria. In the process of destroying bacteria, periodontal tissue is also destroyed.
Other factors can contribute to the development of gum disease. Smokers are more than two times as likely as nonsmokers to develop gum disease. Hormone levels contribute to the development of bacteria in the mouth. Thus pregnancy, puberty, menopause, and the use of
oral or injectable contraceptives may create a climate that favors the development of gum disease. Additional factors include diabetes mellitus, scurvy, pellagra, allergies, leukemia, Crohn's disease, AIDS, chemotherapy, nutritional deficiencies, hydrochloric acid deficiency, poorly fitted fillings, radiation treatments, and exposure to heavy metals (mercury, lead, arsenic, and nickel). Medications that may contribute to the development of gum disease include phenytoin for controlling seizures; cyclosporine, which is taken by people who have had organ transplants; and the calcium channel blockers used to control blood pressure and heartbeat.
The main symptoms of gingivitis are dark red swollen gums that are mushy and bleed easily. Pain is usually minimal. People with periodontitis have the same symptoms. In addition they may also have pain, loose teeth, and bad breath. Abscesses and pus may develop. The symptoms of trench mouth include sudden onset of illness accompanied by pain, bleeding gums, bad breath, and a grayish mucus that covers the gums.
Author Info: Patience Paradox, Teresa G. Odle, The Gale Group Inc., Gale, Detroit, Gale Encyclopedia of Alternative Medicine, 2005
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