10 Most Common Misconceptions About Gum Disease

It is a fact that the general public knows a lot more than they used to about gum disease. All one has to do is flick on the television to be treated to a commercial for mouthwash that throws around terms like biofilm and gingivitis.

Unfortunately, a 30-second time slot in between your favorite situation comedy is not thorough enough to describe the whole issue. I've been a La Mesa dentist for over thirty years and have can say with certainty that there is still a lot of confusion surrounding gum disease. Hopefully, this list helps to clear the air.

1. Gum disease is periodontal disease is bone loss.

These terms are interchangeable, but equally serious. The best descriptor is bone loss. When swelling of the gum tissue (gingivitis) is left unattended to for years, the jaw bone becomes involved. It slowly starts to deteriorate and your teeth are afforded less and less structural support. Once this process has begun, it can be halted but never cured and requires a great deal of attention to keep it in a dormant phase.

2. Brushing and flossing are NOT created equal.

Dentists always tell people to brush and floss every day, but most people hear brush or floss every day. This must be based on a false assumption that flossing just does more of what brushing does. This misconception is why 90% of Americans have some degree of gum disease. Brushing is awesome. It controls plaque that cause cavities. It is, however, topical. Flossing is the only dental therapy that goes underneath the gum tissue where the bone-destroying bacteria live. You need both to keep your teeth cavity free and physically present in old age.

3. It's all in the numbers.

A typical dental visit includes a bout of gum poking wherein numbers are called off and recorded. It is known as periodontal probing. Most people do not understand the significance of these numbers. They are measurements in millimeters, not a rating on a scale of one to ten. They measure the swelling in the gum tissue combined with the amount of supportive jaw bone already lost. One two and three are considered healthy numbers. Four millimeters indicates the swelling associated with gingivitis. Five and up suggests some dissolution of the jaw bone. These numbers are important to track because the disease process happens in slow motion. It can be very insidious. This is a great standardized way to gauge the health of your gums and the bone underneath them. The attached video explains this well.

4. Four millimeters is a big deal.

Though there is only one millimeter difference between a healthy three millimeter pocket and an unhealthy four, dentists take this increase seriously. Floss is blocked from reaching anything below four millimeters by the surrounding gum tissue. Therefore, four millimeters is the last point at which you can definitively wipe out gum disease before it takes hold. Doctors may use a combination of deep cleanings, laser treatments and local antibiotics to treat this condition while the prognosis is still very good. Once you start hearing bigger numbers creep in, the likelihood of permanent damage and accelerated tooth loss in greatly increased.

5. All oral bacteria are not created equal.

Human mouths have over 700 different species of bacteria. They all have different jobs. Some are good at taking up space so the really bad bacteria can't settle in. Some cause gum disease. Some cause bad breath. Others cause cavities. But no matter what they do, your mouth will stay healthy if they are removed every 12 hours. After twelve, the good guys start getting replaced by the bad (more virulent) bacteria and the damage caused is accelerated. This is why it is necessary to brush twice a day.

6. The ins and outs of flossing.

If the last time you were given a lesson in proper flossing technique was when you were 8-years-old, you probably want to ask your dentist for a refresher. The quality of flossing makes just as much difference as the quantity.

7. What is a biofilm?

According to medicinenet.com, biofilm is an aggregate of microbes with a distinct architecture. A biofilm is like a tiny city in which microbial cells, each only a micrometer or two long, form towers that can be hundreds of micrometers high. The "streets" between the towers are really fluid-filled channels that bring in nutrients, oxygen and other necessities for live biofilm communities. That's right! Your plaque can build cities if not controlled on a daily basis.

8. You do shower regularly, don't you?

The vast majority of people shower every day. Presumably, this is to feel fresh and keep odors at bay. But if you take a minute to think about it, a shower for your body performs the exact same function as flossing your teeth, just on a larger scale. You are removing just enough bacteria to keep your immune system happy. You can't get them all, but enough are washed away to prevent flesh-eating infection and stop stink. Unfortunately, the mouth falls in out-of-sight, out-of-mind territory and is all to often neglected.

9. The consistency issue.

When explaining the importance of flossing to patients, I frequently use dieting as a metaphor. Everybody knows that if you diet on Mondays and Thursdays and pig out the remainder of the week, no weight will be lost. Flossing is the same. In order to keep the bacteria at bay, you must floss more often than not. Flossing two days a week will not solve your gum disease. Many have tried and failed before you.

10. Ask me!

Just as you should ask questions to ensure good care when you visit your medical doctor, you ought to be taking full advantage of the knowledge base of your dentist and dental hygienist. They have sat through many a lecture and would be thrilled to avail you of some of that hard earned knowledge. If you are not completely clear on an issue, as for an in depth explanation. Better yet, ask more than once. Everyone has a different way of explaining the science and you never know which one will resonate with you. Whether you need to be scared straight or a gentle nudge in the right direction, these professional motivators are there for you!

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