Chemicals and Drugs used to treat Periodontal (Gum) Disease

Dental health is important for the prepared. Gum disease can be avoided.Considering the way we have grown up, we always think a pill or an ointment will help our medical problems.  I was born way back when penicillin was discovered.  Back then, a small amount of that antibiotic would do wonders for an infection.  As time went on, it took more and more penicillin to kill the same type of bacteria.  The bugs had developed a resistance to that specific type of penicillin.  Now we have super bugs, untreatable with any medicine.  So, it follows that treatment of periodontal disease, caused by your body’s inflammatory response to bacteria, has become more difficult to treat with antibiotics.   Of course, there are many types of bacteria and many types of response that your specific body will have.  Nevertheless, there are some things that you can do to have a healthier mouth without relying on drugs or medicine.

In previous articles I mentioned that the main two problems human beings have with their teeth is decay and periodontal disease, both caused by bacterial plaque.  Decay comes sooner, as soon as a mother leaves a bottle in a baby’s mouth overnight.   A Pedodontist can instruct young families how to prevent and treat early decay.  Later in life periodontal disease rears its ugly head.  There are some early types of periodontal disease, so timely visits to the dentist are important.  But in most cases, bone loss is not noted until some bone loss is seen between the teeth on x-rays.  Most dental insurance companies will not pay for treatment until bone loss is seen, and I think that is terrible.  That bone will seldom regenerate, and with a little more bone loss, the tooth is well on its way to the wastebasket.  When the crevice around the tooth becomes deeper than three millimeters it becomes difficult to clean all of the damaging plaque away, no matter how hard you try.  And try you may.  People use hard toothbrushes, overly forceful efforts, and all kinds of chemicals and drugs to get to the plaque way down below the three millimeter space.  If those efforts and drugs were effective, we dentists wouldn’t be making dentures and implants!!

If you have been missing the bacterial plaque, your gums respond with a kind of allergic reaction, each person has his own response.  Some have none, others lose their teeth in their twenties.  You can’t change your genetic response, but there are some things you can do before you have some disaster that limits your seeing a dentist for a week or much longer.  Get a dental exam by a dentist or a periodontist, and get treatment as needed.  Get a second opinion if you wish.  It is your mouth, and unlike medical insurance, you must always pay  part or all of the bill.  You don’t always need to get the most expensive treatment, which I will mention next time.  But get your disease treated.  Antibiotics won’t fix decay or gum disease, but may give some temporary relief.   Good reason for preppers to stockpile antibiotics that do not give you an allergic reaction.  If you have pain or swelling in the mouth, take the antibiotic as the bottle directs for at least a week, even if the problem gets better in a few days.  Get to a dentist as soon as possible.

Using the cleaning methods as described in a previous article will clean to about three millimeters into the crevice between the tooth and the gum and should result in no pain or bleeding when done properly after a week or two.  It is important to have professional cleanings every six or three months, as your dentist suggests.  But if the spaces are deeper, they are harboring bacteria which may very well cause a periodontal abscess in the future and loss of a tooth.  Your general dentist or hygienist may not be concerned with a five millimeter pocket, but as a periodontist, I am concerned.  Long term use of antibiotics can help the gum disease a little, but will cause loss of the bacteria in the gut system and causes super bugs.  Mouthwash doesn’t get  into a pocket, the  space deeper than three millimeter and the alcohol and other strong products may cause other problems with long term use.  Hydrogen peroxide is useless, too.    If you insist on a mouthwash, buy one that has no alcohol and has fluoride.  Mouthwash and periodic cleanings alone won’t stop gum disease.   As a prepper, I  stockpile food instead of mouthwash.

Invest in dental health for your family.  Prevention is much cheaper than treatment.  A periodic dental exam is much nicer than a dental emergency!  And clean every day like I mentioned, with brush, floss, rubber tip and proxybrush.  Next time I will discuss some of the dental treatment options that you may consider for yourself and your family to save money.  Prepping is expensive, but well worth it when the lights go out.

Most People Deny any Possibility of Gum Disease

Gum disease is best dealt with by a periodontist.When I see a patient for the first time they try to talk me out of finding gum disease in their mouth.  “But Dr, I brush my teeth every day!”  Or, “I have been going to my dentist for years and he never mentioned gum disease.”

I have been a practicing Periodontist for over 30 years, and my opinion is that most dentists and dental hygienists don’t understand periodontal (gum) disease like a specialist like me.  Around 1983 some dental research came out showing that root planing (deep cleaning with anesthesia) was just as effective as Periodontal Surgery.  The research was flawed as it only concerned the front teeth with single roots, but the damage was done.  Ever since, the general dentists have been avoiding sending their patients to a Periodontist.  Instead, they have kept the money in the office by sending them to their in-office Dental Hygienist.  Since dental disease is often very slow and symptom-less until it is time for an extraction,  everyone is happy.  Then you have pain or swelling,  and your friendly dentist notifies you that you need an expensive implant or two.

What I suggested in my last article was getting an exam and basic treatment to get a level of dental health. That is dental prepping.  What I will tell you is what I teach my patients.  Most dental offices skip past teaching oral health quickly because dental insurance doesn’t pay for it.  But, good oral cleaning at least once a day is the most cost effective thing you can do.  Dental disease is usually decay early, gum disease later in life.  Both are caused by dental plaque.  Treatment only repairs the damage, the disease continues.  If you use a water pick device you will notice food particles coming out.  That is not enough, ten per cent of the invisible plaque remains, and the disease continues.

I teach with the patient holding a mirror and watching how to use the following:  any soft toothbrush, any type of floss, a rubber tip stimulator, and a proxybrush in between the teeth and under bridges if there is room.  Lecturing doesn’t work, and that is all you get at most dental offices.  Many patients brush back and forth, and that misses the target and causes grooves in the teeth with time..result, root sensitivity to hot or cold.  I suggest the modified Bass method, which is holding the toothbrush and rubber tip at a 45 degree angle to the tooth and vibrating into the crevice along the gum line, with any kind of fluoride toothpaste.   If your gums are sick, this will bleed and hurt, but improve after several weeks.  The problem with all of these cleaning efforts is that you can only get about three millimeters below the gums, and if you have deeper measurements you are not able to stop the plaque from causing slow bone loss (periodontal disease).  Mouthwash really doesn’t get down there either, a waste of money.

I have retired, but I suggest that you might consider seeing a Periodontist first.  You will get the best diagnosis of your possible gum disease, and may ask for a referral to a top notch dentist.  Periodontists get referrals from many general dentists and see a wide variety of competence.  It was not unusual for me to have seen a patient who has been seeing a dentist regularly, and then the patient is ready for dentures!!.   How shocked and angry the patient becomes.  They have noticed how their teeth have started to drift and get spaces, but nothing was said..or they were sent to the hygienist for a series of deep cleanings,  over and over.  By the way, those cleanings you get every six months are probably regular cleanings that your insurance pays 100%.  They don’t help much.

The inflammation of gum disease can help cause other health problems.  See www.perio.org , the periodontist’s official web site for the best information.  Next time I will talk about alternatives to implants.  Save your money for prepping supplies.  Dr. GrumpyMarine