Do You Know Your Numbers?

Do you know your periodontal pocket depth numbers? Do you need to care? You read the articles in the health section of the paper or in the popular women’s magazines, or maybe catch a clip on the “Health Watch” edition of the evening news on the effects of gum disease. Most people disregard the information, because they brush regularly, see their dentist, and may have nice looking teeth.
But the fact is that 3 out of 4 people have some form of gum disease ranging from mild to severe. Gum disease is mostly painless, but can be dangerous at any stage. Its destructive power on the jaw bones and other related oral cavity structures has been well-documented. Over the last several years, studies looking at the effects of gum diseases on the vital organs of our body have begun to surface.
The systemic implications are more dramatic than just the risk of losing your teeth.

Your mouth is not a separate entity from the rest of your body.

The same blood and bacteria that circulate through your mouth and gums also makes its way to your heart and all the other major organs. Research shows that there is an association between gum disease and many chronic inflammatory conditions such as diabetes, cardiovascular disease, stroke, respiratory disease, and pre-term, low-birth weight babies.

Pregnant women with gum disease are seven times more likely to have a baby that is born too early and too small. This is due to a labor-inducing chemical that is found in oral bacteria called prostaglandin. People with gum disease are twice as likely to suffer from coronary heart disease and/or exacerbate an existing condition. Diabetic patients are more likely to get gum disease due to their inability to fight infections. Furthermore, gum disease can actually increase blood sugar, increasing their risks for complications. As you can see, gum disease is not something one would want to have a wait and watch attitude, because the repercussions
could be severe.

It is also important to understand the risk factors. 

You are more likely to get gum disease if you:

• Do not clean your teeth well

• Smoke or chew tobacco

• Have a family history of gum disease

• Are taking medications that affect your mouth by making it dry

• Are experiencing hormonal changes for girls/women

• Have a condition that makes it harder for you to fight infections such as:

* Uncontrolled diabetes, AIDS, or cancers

*  High levels of stress

*  Poor diet that is low in nutrients

The mouth is a playground for bacteria.

Some good, but mostly bad. They hide under our gum line, between the teeth, and in the crevices of the tongue. The longer plaque and tartar remain on the teeth, the more harmful they become. Bacteria cause the gums to become inflamed, red, swollen and bleed easily. These symptoms describe a condition known as gingivitis. Gingivitis is the beginning stages of gum disease. It is very important to realize that it is also the reversible stage. Gingivitis can be easily “knocked out” with diligent home care that includes brushing, flossing and/or Water Pick^® use and regular visits to your hygienist. Unfortunately most people think that bleeding gums are totally normal, and ignore this first warning sign of gum disease.

As gum disease progresses the gums pull away from the tooth’s root, causing “pockets” that are in fact infected. Deep within these pockets, the bacterial toxins set up their home and literally destroy the supportive bone and connective tissue that hold the teeth in place. Over time, and without proper treatment, the teeth will eventually become loose and need to be removed. As a diagnostic tool, once a year your hygienist should be taking measurements (in millimeters) of the pockets around each tooth. This is a simple and usually painless screening for possible gum problems. The ideal numbers range between 1 and 3 mm. We use this as a guideline of health because each person is able to clean below their gum line up to 3 mm with the normal use of brushing and flossing. But at pocket depths of 4mm and above, it is impossible to reach to the bottom of the pocket and remove those bacteria that are setting up for destruction. This is why it is so important to “know your numbers.”

So, what should you do if you hear your hygienist say numbers that are 4mm and above?  Treatment is necessary if you wish to keep your teeth and maintain your overall health.

Before considering the painful option of gum surgery to reduce pockets, there are several non-surgical treatment options to try. The recommendation may include more frequent visits where the hygienist will use an ultrasonic scaler- the most effective tool in breaking up bacteria and flushing it out of the pocket. An increase in the frequency of removing the bacteria and letting the body heal itself will bring the pocket depths to a maintainable depth. If needed, a localized antibiotic can be inserted into a troublesome pocket area to help boost the destruction of bacteria. These options have been proven to be very effective along with the therapy the hygienist can provide.

These days we are made aware of so many ways to protect our health and prevent disease. We spend so much money on vitamins, health and beauty products and use our time exercising and reading up on ways to better our health. While all of these are important, we overlook three of the simplest tools; your toothbrush, floss and the diligence in committing to regular dental care.

We urge you to “know your numbers,” and take control of your dental health and overall well-being!

Dr. Lewis Yu earned his dental degree from the University of Pennsylvania School of Dentistry in 1996. He received two years of advanced post-graduate oral surgery training in both the New York City Hospital System and the Hospital of the University of Pennsylvania. He continues his education through extensive hands-on training at the prestigious Las Vegas Institute for Advanced Studies and the Pankey Institute. The Las Vegas Institute has provided Dr. Yu with advanced training in Neuromuscular Dentistry and Comprehensive Aesthetic Restorations. He had practiced in Philadelphia and Newark, DE before joining All About Smiles, P.A. He is a member of the Delaware State Dental Society, American Dental Association, and  the Academy of

General Dentistry.

Dr. Grace Liu has been practicing dentistry since 1996, having earned her degree from the New York University School of Dentistry. She continued her education through post-graduate studies at Columbia University, the Las Vegas Institute for Advanced Studies in Nevada and the Academy of Dentistry. She is also a member of the Delaware State Dental Society, American Dental Association, and the Academy of General Dentistry.