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Gum Conditions

Gum Disease and Children

Chronic gingivitis is common in children. It usually causes gum tissue to swell, turn red, and bleed easily. Gingivitis is both preventable and treatable   with a regular routine of brushing, flossing, and professional dental care. However, left untreated, it can eventually advance to more serious forms of periodontal disease.

Aggressive periodontitis can affect young people who are otherwise healthy. Localized aggressive periodontitis is found in teenagers and young adults and mainly affects the first molars and incisors. It is characterized by the severe loss of alveolar (jaw) bone, and ironically, patients generally form very little dental  plaque or calculus (tartar).

Generalized aggressive periodontitis may begin around puberty and involve the entire mouth. It is marked by inflammation of the gums and heavy accumulations of plaque and calculus. Eventually it can cause the teeth to become loose.

Signs of periodontal disease

Four basic signs will alert you to periodontal disease in your child:

  1. Bleeding. Bleeding gums during tooth brushing, flossing, or any other time;
  2. Puffiness. Swollen. and bright red gums;
  3. Recession. Gums that have receded away from the teeth, sometimes exposing the roots; and/or
  4. Bad breath. Constant bad breath that does not clear up with brushing and

Importance of good dental hygiene in adolescents

Hormonal changes related to puberty can put teens at greater risk for getting periodontal disease. During puberty, an increased level of hormones, such as progesterone and possibly estrogen, cause increased blood circulation to the gums. This may cause an increase in the gums’ sensitivity and lead to a greater reaction to any irritation, including food particles and plaque. During this time, the gums may become swollen, turn red, and feel tender.

As a teen progresses through puberty, the tendency for the gums to swell in response to irritants will lessen. However, during puberty, it is very important to follow a good at-home dental hygiene regimen, including regular brushing and flossing, and regular dental care. In some cases, a dental professional may recommend periodontal therapy to help prevent damage to the tissues and bone surrounding the teeth.

Advice for parents

Early diagnosis is important for successful treatment of periodontal diseases. Therefore, it is important that children receive a comprehensive periodontal examination as part of their routine dental visits. Be aware that if your child has an advanced form of periodontal disease, this may be an early sign of systemic disease. A general medical evaluation should be considered for children who exhibit severe periodontitis, especially if it appears resistant to therapy.

The most important preventive step against periodontal disease is to establish good oral health habits with your child. Here are basic preventive steps to help your child maintain good oral health:

  1. Establish good dental hygiene habits early. When your child is 12 months  old, you can begin using toothpaste when brushing his or her teeth. When the gaps between your child’s teeth close, it’s important to start flossing.
  2. Serve as a good role model by practicing good dental hygiene habits yourself.
  3. Schedule regular dental visits for family checkups, periodontal evaluations,  and cleanings.
  4. Check your child’s mouth for the signs of periodontal disease, including bleeding gums, swollen and bright red gums, gums that are receding away from the teeth, and bad breath.

The progression of gum disease can be halted if the bacteria and debris are removed from the pockets in the gums. In years past, traditional gum treatment consisted of cutting away the diseased gum with the hope that the remaining tissue would heal and be healthy. Fortunately, a variety of new techniques has allowed us to treat chronic gum infections much more conservatively. Removing large amounts of diseased gum and then “packing” the gums is a thing of the past.

There are many forms of periodontitis. The most common ones include the following:

Aggressive periodontitis

Occurs in patients who are otherwise clinically healthy. Common features include rapid loss of tooth attachment and bone destruction, and this condition tends to run in families (familial aggregation). Chronic periodontitis results in inflammation within the supporting tissues of the teeth, progressive loss of tooth attachment, and bone loss. This is the most frequently occurring form of periodontitis and is characterized by pocket formation and/or recession of the gingiva (gum). It is prevalent in adults but can occur at any age. Progression of attachment loss usually occurs slowly, but periods of rapid progression can occur.

Periodontitis as a manifestation of systemic diseases

Often begins at a young age. Necrotizing periodontal disease is an infection characterized by necrosis (death) of gingival tissues, periodontal ligament, and alveolar (jaw) bone. These lesions are most commonly observed in individuals with systemic conditions such as HIV infection, malnutrition, and immunosuppression.

Comprehensive periodontal evaluation

If gum disease is suspected, appropriate X-ray films will be taken to evaluate if bone loss exists around the teeth. Next, you should expect a comprehensive periodontal evaluation to take place. This evaluation is a way to assess your periodontal health by examining your teeth, gum tissue, plaque (bacteria) around the teeth, bite, bone structure, and risk factors.


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