Your Gums Tell A Story – Interview with Dr. John R. Vitale

Gum disease can be a sign of other health problems. Learn more about the causes and treatment of gum disease from Dr. John Vitale.

How can you tell if you have gum disease and what is the difference between gingivitis and periodontitis?

Dr. John Vitale: Yes, people can tell if they have gum disease. Generally people are alerted when they brush their teeth and they find blood in their expectorant. That’s usually an indication that there is something going on in your mouth that shouldn’t be. There are differences between gingivitis and periodontitis. Gingivitis is the first stage of gum disease and it generally just affects the free tissue in the mouth surrounding the teeth.  When it gets to be a little more extensive and there is bone involvement then we end up with periodontitis and that situation is a gingivitis with the inclusion of bone problems causing periodontitis.

Are there risk factors that contribute to the development of gum disease?

Dr. John Vitale: Yes, there are. The main risk factor is diabetes, primary and secondary. Type 1 and Type 2 diabetes. With the onset of diabetes generally our tissue in our mouth responds with the bacteria that is present causing excessive bleeding in our mouth. It’s so, so imperative that we keep our mouth very, very clean in order to prevent this from happening. Yes, there is definitely an association between systemic diseases and periodontitis and gingivitis.

Has research proven there is a link between gum disease and heart disease?

Dr. John Vitale: Yes, research over the years has proven that plaque build-up in our mouths, the deposit of those salivary proteins around our teeth also is linked to the same type of plaque that we find in our arteries. There is a definite correlation of people who have very, very heavy plaque deposits having some sort of coronary heart disease or the possibility of getting coronary heart disease.

What other health problems have been linked to gum disease?

Dr. John Vitale: Gum disease is sometimes a secondary result of our bodies being comprised in one shape or form. For instance, if people have to undergo chemotherapy or have immune suppressing drugs or a necessity for them what ends up happening is we end up with problems in our gingiva and with periodontitis and with bleeding of our gums and extensive gum disease. There are definitely correlations and I think our general health also contributes tremendously to the existence of or the lack of existence of periodontal disease in our mouth.

If someone is suffering from gum disease, how do you treat it?

Dr. John Vitale: We treat it in phases depending on the severity. The first phase where we just have a gingival or gum involvement, we generally perform a procedure called STM or Soft Tissue Management. Basically what that is, is the cleaning of the gums. It’s a very deep cleaning of the gums where we go down to the bone level and get out all the calculus and plaque that’s accumulated between the gum tissue and the tooth. After we do that, there is a maintenance program that one undergoes to make sure that we keep these particles from attaching to the teeth again. Sometimes we prescribe chlorhexidine or other drugs similar to that or just general mouthwashes that one would use on a daily basis along with water picking, flossing and brushing properly.

If the disease becomes extensive where there is bone involvement then we have to go to a second step. Generally we will refer the person to a periodontist where periodontal procedures such as minor surgeries to remove the defects that have been caused by the accumulation of plaque and calculus. Reformation of the bone and also again afterwards, maintenance in the manner that I had prescribed before.

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