Dental Plaque

Tooth decay can lead to the destruction and eventual loss of teeth. However, periodontal disease, a disease of the supporting tissue around the tooth, can be so severe that the teeth loosen and fall out. The teeth are seated in sockets in the bones of the upper and lower jaws in alveolar bone, (alveolar means "hollow"). The bone does not hold the teeth in place, rather, the teeth are stabilized by connective tissue called periodontal ligaments that extend between tooth-roots and sockets. The part of the tooth next to the sulcus is extremely difficult to keep free of bacterial plaque, and if not removed constantly, or left undisturbed for a few days, will form tartar - a rough, hard material that adheres to teeth. Plaque and tartar build-up constitute the primary cause of periodontal disease. Periodontal disease begins with mild gum inflammation and becomes more severe over time. Its progression can be divided into four stages. The first stage is gum inflammation or gingivitis, and the gums may become reddish or purple and slightly swollen. They may be tender and they may bleed easily. You may have a sour taste, and your breath may be offensive. You may have no symptoms. The second stage or early periodontitis will involve the sulcus becoming swollen and more inflamed. The sulcus expand its borders creating an even better environment for bacterial growth. As the inflammation spreads and worsens, it will soon attack the periodontal ligament that holds the teeth in place. At this point, a dentist would use a periodontal probe to measure the depth of each periodontal pocket. Periodontitis does not progress steadily, but rather intermittently. Symptoms and the rate of destruction vary. The third stage will see erosion of the gum, pockets will deepen, and more potent forms of bacteria develop. The periodontal ligament and alveolar bone become inflamed. In the fourth stage, there is so much ligament and bone loss that the tooth, no longer stable, will loosen in its socket. Bone loss magnifies pressure from chewing, making the tooth progressively looser. As the tooth looses its support it will fall out or require extraction.