By Mary Osborne

In the 1960′s Dentistry believed periodontal disease was caused by calculus. Inflamed gum tissue was described as being like the skin on our finger if it had a splinter in it. Dentists believed their only recourse was to remove the calculus deposits every six months, and they assumed most people would experience some level of periodontal disease as they aged. This belief was a mechanical model for treating periodontal disease.

During the seventies and eighties we understood that periodontal disease was caused by bacterial plaque. We told our patients that if they could break up the plaque before it began to destroy the supporting structures of their teeth they would have healthy gums. Once the disease began, we saw it as a gradual degenerative process. Patients were told to have their teeth cleaned more often than six months, because it was needed to break up the bacterial colonies. This was primarily a chemical model for treating periodontal disease.

Our understanding of periodontal health and disease continues to grow and change. We understand the importance of mechanical removal of hard and soft deposits. We see patients with no plaque that have acute disease, and yet we see patients with heavy plaque and little or no disease. The disease is seen as site specific and episodic. We now have a better understanding of the patient’s bite and its effect on periodontal health. Finally, some people are genetically more susceptible to gum disease.

Additional risk factors contributing to periodontal disease are stress, malnutrition, smoking, diabetes and even pregnancy. In this integrative model we are partners in caring for your teeth and gums as part of your total health. We focus our appointment on the way the oral conditions are presently and how they may change over time. After our assessment we recommend a plan to return to health because we are now finding oral health is directly related to our general health. We are here to help you understand the many changing factors of oral health and to shift from thinking of oral health as an absolute, to one of total well being.