‘Long in the Tooth’ The Simple Truth
Chronic Periodontitis is a mouthful, which is why Periodontist and Specialist Dr Mohammed Shorab has coined the term, ‘Jaw Bone Rot Disease’. Here, he explains what it is, how it happens and what you can do about it.
What is Jaw Bone Rot Disease (JBRD)?
Chronic osteolytic and collagenolytic inflammatory disease of the periodontium is more often called Gum Disease or Chronic Periodontitis. To my patients, I call it ‘Jaw Bone Rot Disease’ as that clearly describes what is happening to the jaw bone that supports teeth. It is a serious condition, in which the bone and ligaments supporting the teeth ‘melts’ or ‘rots’ away.
What causes Jaw Bone Rot Disease?
We all have bacteria in and on our bodies, including in our mouths. When that bacteria invades the connective tissue surrounding the teeth, such as the gums and jaw bone, inflammation occurs. Bacteria attacks the body when your immunity is compromised, which could be due to genetic factors, certain medications and/or poor oral hygiene.
“Close to 50% of the world’s population would be suffering Periodontitis at this very moment, but only 2% would know they’ve got it.”
How common is Jaw Bone Rot Disease?
Close to 50% of the world’s population would be suffering Periodontitis at this very moment, but only 2% would know they’ve got it. You see, Chronic Periodontitis (JBRD) is painless. Usually it will only get diagnosed if a dentist suspects there is an issue, probes the gums around teeth and/or takes an X-ray to find that the patient is losing bone around their teeth.
What are the symptoms?
Often there are no symptoms, or very subtle symptoms so you don’t realise you have an issue until your gums bleed or your tooth is loose. If you do experience symptoms, these could be:
• Increased sensitivity, as the bone melts or rots away, and the root can become exposed, hence the sensitivity.
• Bad breath.
• A metallic taste, caused by pus coming from the gums.
• Food getting stuck between your teeth more often than usual, due to the bone loss creating space between teeth.
• Pressure between your teeth that flossing does not relieve, because it’s not actually food stuck between your teeth causing the pressure, but inflammation.
• Receding gums, which is where the term ‘long in the tooth’ comes from, because teeth actually appear longer.
• Lost tooth, that has fallen out without pain.
What issues can Chronic Periodontitis (JBRD) create?
Jaw Bone Rot Disease can cause serious issues for sufferers, beyond bleeding gums, bad breath, gum recession, and loss of teeth. Inflammation caused in Periodontitis can allow bacteria to enter the blood stream and travel to the heart and in patients with heart valve problems, it can cause endocarditis which can be fatal if not treated early.
Another extreme consequence relates to pregnant women with periodontitis, who are far more likely to have preterm labour or miscarriage than women without the condition. During pregnancy, a woman’s tissue response becomes more aggressive and inflammation is more severe. Prostaglandin is one of the chemicals produced during that inflammation process, and it also causes uterine contractions.
A recent brain study in Auckland, NZ, found a bacteria (P gingivalis) present in Chronic Periodontitis that is also in the brains of patients with Alzheimer’s disease. They are currently studying neuro-inflammation, meaning the role of inflammation in the nerves of the brain and its relationship to Alzheimer’s.
Current studies are also looking into potential associations between Chronic Periodontitis and issues like arthritis and respiratory illness, but the research is still underway.
Treatment options
The best treatment option is always prevention, which comes down to good oral hygiene and regular dentist appointments. Of course, this isn’t always successful, for whatever reason. The optimal time for treatment, as with any disease, is the early stages of the disease. At your regular dental checks, your Dentist may use a Periodontal probe, to identify whether there is loss of bone support and disease-associated periodontal pockets. If you are pregnant, make sure your dentist assesses the periodontium, using this probe. If you have a pocket depth of more than four or five millimetres, you will be referred to a Periodontist/Specialist for treatment.
Part of my research work at Otago University in New Zealand was to do with bone regeneration using bone growth factors. This is still in research stages and bone regeneration has limited application but we were able to grow bone, in the jaw bone. This is promising science for those who suffer Chronic Periodontitis (JBRD), but it is still experimental. I am also doing research work at James Cook University to take periodontal care to much needed communities in developing countries.
Dr Shorab travels between six 1300SMILES clinics throughout Queensland: Belgian Gardens (Townsville), Cairns Central, Smithfield (Cairns), Ingham, Mackay and Rockhampton.
