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  Periodontal disease

Periodontal diseases range from simple gum inflammation to serious diseases that result in major damage to the soft tissue and bone that support the teeth. In the worst cases, teeth are lost. This condition may begin as “plaque” on teeth, a sticky colorless material surrounding the teeth along with bacteria, mucus and other particles. Brushing and flossing can help in getting rid of the plaque.

Periodontal disease Mouth diseases
Periodontal disease

However, if not removed, it can harden and form bacteria-harboring “tartar” that brushing does not clean. Tartar formation may need professional cleaning by a dentist or dental hygienist. The longer the tartar and plaque are on teeth, the more harmful they become and may lead to condition known as gingivitis (inflammation of the gums). Gingivitis is described as gums that become red, swollen, and can easily bleed. This form of mild gum disease does not include any loss of bone and tissue that hold the teeth in place and can be reversed with daily brushing, flossing and regular cleaning by a dentist or dental hygienist. The problem lies if gingivitis is not treated because it can advance to a more serious problem known as “periodontitis” (inflammation around the tooth). Periodontitis is described as gums that pull away from the teeth and forming “pockets” that are infected. Untoward complications are destruction of the bones, gums and connective tissue that support the teeth. Eventually, the teeth become loose and have to be removed.

Smoking is one of the most significant risk factors associated with the development of periodontitis. Other risk factors are: hormonal changes in girls/women, diabetes mellitus, medications like antidepressants and some heart medicines (lessen the flow of saliva which ahs a protective effects on teeth and gums), stress, chronic illnesses (e.g. AIDS) and genetic susceptibility. Men are more likely to have periodontal disease than women.

Here are some things you can do to prevent periodontal diseases: Brushing the teeth twice a day (with a fluoride toothpaste), flossing daily, regularly visit the dentist for professional cleaning, eating a well balanced diet and avoidance of smoking.

Symptoms are often not noticeable until the disease is advanced which include:

Bad breath that won't go away
Red or swollen gums
Tender or bleeding gums
Painful chewing
Loose teeth
Sensitive teeth

Research is still inconclusive but there are ongoing studies to determine whether there is a cause-and-effect relationship between periodontal disease and:

an increased risk of heart attack or stroke,
an increased risk of delivering preterm, low birth weight babies,
Difficulty controlling blood sugar levels in people with diabetes.

The main goal of treatment of periodontal diseases is to control the infection. The type of treatment varies on the extent of the gum problem. Patient must also adhere with good daily care at home and needs to modify behaviors that will improve treatment outcome. The dentist, periodontist or dental hygienist performs a deep cleaning method called scaling and root planning. This is actually scraping off the tartar from above and below the gum and getting rid of rough spots on the tooth root where the germs gather to help remove the bacteria. Some of the current medications are: antimicrobial mouth rinse, antiseptic “chip” (a tiny piece of gelatin filled with chlorhexidine), antibiotic gel, antibiotic micro-spheres (tiny round particles containing the antibiotic minocycline) and enzyme suppressant (a low dose of doxycycline). Depending on the severity of the disease, if medications failed to resolve the problem then surgical treatment may be suggested by the dentist or periodontist.

Surgery is only indicated if the inflammation is severe and deep pockets remain even following deep cleaning treatment in combination with the medications. The common surgical procedures are: flap surgery (to remove tartar deposits in deep pockets) and bone and tissue grafting (to replace and encourage new bone growth).

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