Periodontitis is the most serious of the periodontal diseases, commonly referred to as gum diseases. It is remarkably common in adults over the age of 35, with some sources estimating that up to one third of American adults (more than 50 million people) suffer from some form of periodontitis. Periodontitis is the number one cause of tooth loss in adults, and is particularly prevalent in smokers and those with complicating diseases such as diabetes and osteoporosis. There are also some individuals who are genetically predisposed to developing this disease.
What Causes Periodontitis?
Periodontitis is the end result of a complex interaction between the bacteria (or plaque) that accumulates on tooth surfaces and your own body’s efforts to fight this bacterial infection. Everyone has bacteria in their mouth; if you follow normal oral hygiene procedures (brushing and flossing) and see your dentist regularly, under most circumstances these bacteria live in balance with your body’s defense mechanisms. However, if the bacteria build up on the tooth near the gums, and particularly if your body’s defense mechanisms are compromised, then an imbalance can arise and your gums will become red and inflamed. This inflammation, if left untreated, eventually results in damage to the ligaments and bone which hold your teeth in place, and in the worst cases can cause the teeth to become loose or to be lost.
From Gingivitis to Periodontitis:
The Progression of Gum Disease
In its earliest stages, gum disease is referred to as gingivitis inflammation of the gums. Every day a clear sticky film called plaque builds up on the surface of the tooth. Plaque is made up of bacteria and their secretions, and it is easily removed by proper brushing and flossing. However, if plaque is allowed to build up, then eventually the gum tissue in contact with the plaque becomes red and inflamed. You may have observed that sometimes your gums bleed when you brush your teeth. This is because of the inflammation, and is often the first sign that you have the earliest stages of periodontal disease. In most cases, a thorough professional cleaning from your dental professional, and more attention to brushing and flossing can reverse the inflammation and bleeding associated with gingivitis.
If the plaque is not removed, it hardens into deposits called tartar, which cannot be removed by just brushing and flossing. These deposits and their associated bacteria can cause a more severe form of inflammation as your body tries to fight the infection. One of the most important tools your body has to fight infection are white blood cells, which are loaded with substances designed to help the white cell get out of the bloodstream and pass through the gum tissue to then kill the bacteria. Some of these substances, known as enzymes, have an unfortunate side effect they can attack your body’s own tissues.
In the case of gum disease, the long-term, chronic nature of the infection means that these tissue-destroying enzymes build up. Eventually they start to eat at the ligaments and bone which support your teeth. First, a small “pocket” forms between the tooth and the gum where food can be lodged and bacteria can live. If left undisturbed, the bacteria will continue to cause inflammation and tissue destruction, and they will gradually move down the tooth surface. This results in tooth pockets that get deeper and deeper. The depth of the pocket is a good measure of the severity of your disease, and your dentist will use a probing device to measure how deep your tooth pockets are. Your dentist will also take radiographs (X-rays) which show the extent of the loss of the supporting bone. If pockets are deep and bone loss is evident, this stage of gum disease is known as periodontitis.
Eventually, if left untreated, the disease progresses to the point where the bone loss is so severe that the tooth becomes loose, and in the worst case, is lost. However, don’t despair. If your condition is treated early and aggressively by your dental professional, it is possible to slow the progression of the disease.
A Risk to Oral and General Health
If you suffer from periodontitis, there might be more at risk than just your oral health. Obviously, loose or missing teeth have an impact on your appearance and your self-confidence, and may affect the types of food you can eat. Restoration of your teeth can be costly and time-consuming.
Recent research has suggested that the effect of an untreated infection such as periodontal disease may be far more wide-reaching than just your mouth. For example, researchers have identified a link between periodontitis and the risk for a fatal heart attack or stroke. Indeed, untreated periodontitis may be as significant a risk factor for heart disease as elevated cholesterol!
In other studies, pregnant women with untreated periodontal disease were much more likely to have preterm babies with low-birth-weights than were a control group of pregnant women without the disease. Some very exciting preliminary findings have suggested that this risk can be reduced if the periodontal disease is treated. Other studies have suggested that treating periodontal disease can have a positive impact on the ability of those with diabetes to maintain proper blood sugar levels.
As stated in the 2000 U.S. Surgeon General’s Report on Oral Health, all of these findings suggest that, in order to maintain optimum general health, you should also maintain optimum health of your teeth and gums.
Most treatments for adult periodontitis focus primarily on reducing the number of bacteria on the surface of your teeth. For example, your dental professional is likely to perform SRP (scaling and root planing). This is an important part of your treatment because periodontal disease begins with a bacterial infection on the tooth surface, and by reducing the number of bacteria, the symptoms of periodontitis such as bleeding can be reduced.
Recent research has shown that it is also important to suppress your body’s overproduction of gum- and tissue-destroying enzymes. That’s where Periostat® comes in. It is the first and only medication that works by reducing the activity of the enzymes that destroy tooth and gum tissue. Periostat® is available only by prescription from your dentist or periodontist and should be taken in conjunction with SRP delivered by your dental professional to reduce pocket depths and improve clinical attachment levels.
In clinical trials, adverse reactions to Periostat® were similar to taking a placebo. Don’t take Periostat® if you are pregnant, nursing, or if you’re hypersensitive to tetracyclines. For more information, please refer to the Periostat® full prescribing information.
Periostat® Dosage and Duration of Treatment
Periostat® is available as a capsule to be taken twice daily, about an hour before meals. Periostat® should be taken with plenty of fluids. If you forget to take a dose, just take the normal dose of 1 capsule at the next scheduled dose. Do not double up to make up for the missed capsule.
In clinical studies, Periostat® was proven to be safe when taken for as long as 12 months. Typically, the drug is taken for periods of no less than three months. Your dentist or periodontist will tell you how long you should take Periostat®.
Periostat® is a unique dosage of a drug called doxycycline. The dosage of Periostat® differs from that of doxycycline used to treat infections. Exceeding the recommended dosage may result in an increased incidence of side effects including development of resistant microorganisms.
Plan for Better Oral Health
At all times, follow instructions given to you by your dentist or periodontist. Make sure you keep appointments for treatment and checkups. Between visits, follow good dental hygiene as recommended by your dental professional. If Periostat® has been prescribed for you, make sure you take it as directed, for the full length of time recommended by your dentist or periodontist.