Most of us visit the dentist for our twice-a-year cleanings and, even though we might skip flossing every now and then, tooth care has become very much a priority when it comes to our overall health.
But what about gums?
Dr. Lisa Palermo-Edwards, a periodontist with Palermo-Edwards & Cacchillo Periodontics &
Photo courtesy of Dr. Lisa A. Palermo-Edwards
Dental Implants, spoke with Healthy New Albany on how to include gum care in your oral hygiene regimen.
Healthy New Albany: Do you find that patients tend to focus more on their teeth than their gums in terms of health? Does brushing, flossing and using mouthwash cover gum care in the same way?
Lisa Palermo-Edwards: Yes. I feel most people will focus on what they can easily see; therefore, the focus is on their teeth. Most people don’t realize there are different types of bacteria that contribute more to gum disease than cavities. So a combination of brushing and flossing is necessary to maintain good oral health. Flossing targets the bacteria that cause gum disease because it goes between the teeth and below the gum line, and this is where many gum problems start.
HNA: What are some signs that you might need to visit a periodontist? When should you visit a periodontist over a dentist?
LPE: If you or your dentist or hygienist notices any changes in your gum tissue – such as redness, bleeding, receding gums, increasing pocket depths, tooth migration/increased spaces, food impaction, loose teeth and/or soreness – it may be time to see a periodontist. As a periodontist, I specialize in the treatment of gum diseases along with many other aspects of oral health such as dental implants to replace missing teeth, aesthetic procedures to enhance your smile and treatment of oral pathology.
Also, many people do not know that inflammation of the mouth has been linked to systemic conditions such as diabetes, infertility, rheumatoid arthritis and cardiovascular disease. A periodontist can evaluate your mouth and diagnose and treat oral disease that may be affecting your overall health.
HNA: What are the most common periodontal diseases? How can they be prevented?
LPE: Gingivitis is the most common periodontal disease. It is reversible with early identification, good dental care and effective home care. If gingivitis is not treated, it can lead to periodontitis, which destroys the gum and supporting bone, ultimately compromising the structural support around teeth. If periodontitis is not treated, teeth can be lost and further systemic body complications may occur.
HNA: Everyone knows smoking cigarettes or chewing tobacco is horrible for your mouth. But are there any existing medical conditions that can put you at risk for gum-related issues? How can you be proactive?
LPE: Smokers are at high risk for periodontal disease due to the effect that smoking has on the tissue cells in the gum tissue as well as on the body’s immune response. Additionally, smoking and drinking alcohol are among the greatest risk factors for oral/throat cancer. An oral cancer screening should be completed on everyone at every dental check-up. Like many cancers, if detected early, it is far more treatable.
Many systemic conditions are related to periodontal disease. Genetics can make a person more likely to develop periodontal disease. Hormonal changes such as pregnancy or menopausal changes can affect your mouth as well. Making sure you and your dentist are monitoring for changes in your mouth through clinical probing depth measurements as well as periodic comprehensive radiographs can help identify if a referral to a periodontist is warranted.
HNA: When it comes to the color of your gums, how red is too red? Should we immediately be concerned by a little bleeding?
LPE: There are several shades of gum tissue, from red to pink as well as darker pigments, as found in skin. Every person is individual, so if a patient notices change in his or her mouth or bleeding, receding gum line, swollen gums or possibly soreness, it would warrant a visit to the dentist to have it evaluated. Surprisingly, pain is not always reported with periodontal disease, so it is critical that the dentist and hygienist monitor for changes.
HNA: It’s recommended we floss daily, but plenty of people don’t. Is mouthwash a suitable substitute?
LPE: Flossing is the most effective way to disturb bacteria when it is in between teeth. Mouthwash can’t always access the same places as dental floss. Flossing also introduces oxygen to the area below the gum line, and this is toxic to some bacteria. There are many types of mouth rinses available, and some are proven to be more effective than others. Depending on the type, mouthwash can be a great adjunct to use in addition to the basics of effective brushing and flossing for further reduction of bacteria, to combat sensitivity or strengthen the tooth.
HNA: How long should you use mouthwash for it to be effective?
LPE: Each brand has different manufacturer guidelines regarding the amount you should use and time of exposure for it to do the things it claims it can do. For example, a mouth rinse with fluoride may have a longer exposure time than one without. Asking your oral health care provider for a recommendation of the most appropriate rinse for your oral health needs is the best way to approach this aid.
HNA: How can you tell if you have receding gums? Is surgery always the best option?
LPE: Receding gums can be a sign of gum disease or unstable gum tissue. The teeth may appear longer, the gums may appear inflamed or loose, or the teeth and/or roots may become sensitive. There are many contributing factors; however, the patient and dentist or hygienist need to be able to identify any changes that have occurred. Each person’s normal is different. It is ideal to have a baseline evaluation and be able to track it over months and years to determine how stable the gums are.
Consistent dental visits and monitoring through visual exams and radiographs are the best way to identify if treatment is indicated. Surgery may be an option when it is identified that the tissue needs to be thickened or stabilized, if the patient is experiencing sensitivity, or if a contributing factor is identified and can be corrected. It is critical to include the patient’s individual circumstances and history when considering surgery.
About Dr. Lisa Palermo-Edwards
Lisa Palermo-Edwards is currently in private practice, limited to periodontics and dental implants, in Reynoldsburg.
She earned her DDS degree from The Ohio State University College of Dentistry in 1992. Palermo-Edwards then completed her residency in periodontology and received a master of science from the OSU College of Dentistry in 1995.
Palermo-Edwards has been in full-time private periodontal practice since 1995. She is a current member of the American Dental Association, Ohio Dental Association, Columbus Dental Society, American Academy of Periodontology, Ohio Academy of Periodontology and Columbus Academy of Periodontology, as well as a past president of the Columbus Academy of Periodontology.
In 2013, she was elected to serve on the Columbus Dental Society Board of Directors for 2014, 2015 and 2016.
Hannah Bealer is an assistant editor. Feedback welcome at ssole@cityscenemediagroup.com.
