We used to believe that gum disease came in two basic forms that were closely related: a minor form called gingivitis and a major form called periodontitis. Controlling gingivitis prevented a person from developing periodontitis, while a neglect of gingivitis would increase the risk of developing periodontitis.
But as we’ve increased our understanding of gum disease, we have come to know that the connection between them isn’t as simple as that. Many people have gingivitis for years with minimal treatment and minimal problems. Other people, despite good preventive care, progress rapidly from gingivitis to periodontitis, suffering major damage to their teeth and gums.
New research points to a different understanding of the relationship between these varieties of gum disease, and that maybe they’re not as connected as we thought.
Know Your Gum Disease: Gingivitis vs. Periodontitis
Gingivitis is still considered a minor form of gum disease. People with gingivitis experience many symptoms, in their gums, such as swelling, tenderness, redness, and bleeding. Although gingivitis can lead to receding gums, it isn’t associated with tooth loss.
Periodontitis, on the other hand, is a much more serious condition. In this condition, oral bacteria have deeply infected the spaces around your teeth. The gums may recede dramatically. Bone can be lost around your teeth. The teeth can become loose, and in some cases they are even lost.
Unfortunately, it’s hard for you to tell the difference between the two conditions until you start to experience tooth loss.
Completely Different Ecologies
So what makes the difference between periodontitis and gingivitis? A multinational team of researchers thinks they may have discovered part of the answer while examining patients in Malawi. They looked at nearly 1000 Malawian women, giving them detailed dental exams and analyzing the population of oral bacteria in their mouths.
They discovered that people with gingivitis and periodontitis didn’t differ in the amount of bacterial plaque they had, but genetic sequencing revealed that the plaque was nonetheless very different. Certain bacteria were found in people who developed periodontitis, but not in people who just had gingivitis. Therefore, they proposed that the primary difference between periodontitis and gingivitis is the population of oral bacteria.
With the presence of different oral bacteria, different networks were formed that allowed the disease to progress differently. Thus, it wasn’t just the presence of these other types of bacteria, but the way these other bacteria created partnerships within the oral bacteria population.
Using this information can certainly help, because it can give us ways to help determine your risk of periodontitis by testing the genes of the oral bacteria in your mouth. But it’s only part of our increased understanding of the complexities of gum disease.
Multifactorial Gum Disease
However, controlling gum disease is not as simple as just trying to eliminate the “bad” bacteria. Instead, we have to look at the ways that these “bad” bacteria can form partnerships with otherwise harmless bacteria, and may even cause them to start acting in harmful ways. We have to understand how these symbiotic relationships develop, and what causes “good” bacteria to turn bad.
Understand the body’s immune response is also key, because it plays at least as big a role in gum disease as that of the bacteria themselves. We have to understand why some people’s bodies are more likely to become self-destructive, and potentially cause as much or more damage than the bacteria themselves. Delving into this might also reveal how and why gum disease can trigger autoimmune disorders such as rheumatoid arthritis.
Because gum disease is so complicated a condition, it is best approached with a comprehensive program to attempt to keep it under control. This can include the usual preventive care, such as brushing, flossing, and regular dental visits.
However, we might also propose additional approaches. Genetic testing can help us identify the oral bacteria that you have and whether this can increase your risk of developing periodontitis.
Also important is your diet. An anti-inflammatory diet can help reduce your gum disease, but it’s also important to understand when certain foods are going to trigger an immune response–i.e. an inflammatory response–because of food allergies. To help with that, we offer ALCAT testing, which can help you identify even minor food allergies.
With this comprehensive strategy, we cannot only help you preserve your teeth, we can help you preserve your health. To learn more about our comprehensive approach to gum disease treatment, please call (201) 343-4044 today for an appointment with a dentist at River Edge Dental.
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