New Treatments Ease Gum Disease

It can sneak up on you, eventually making you look and feel older. The first hint might be blood on your toothbrush--or there might not be any clue of something gone wrong.

Gum disease--the No. 1 cause of tooth loss in adults--afflicts 75% of Americans past age 35, according to the American Dental Assn.

Recently, though, the outlook has become less grim. Researchers have zeroed in on a handful of bacteria--from a cast of hundreds--that seem to be the culprits. New tests, some not yet approved for general use, can help detect the disease very early and help pinpoint when treatment is needed.

And a new less-is-more treatment approach can reduce expense and pain.

Gum disease starts as a bacterial infection that sparks inflammation, explains Max Anderson, an assistant professor of restorative dentistry at the University of Washington, Seattle. It occurs when certain bacteria in plaque create toxins. These toxins then break down the attachment of gum tissues to teeth, resulting in the formation of “pockets” around the teeth.

Untreated, gum disease can progress from bleeding gums to wiggly molars, as the bacteria attack bones supporting the teeth.

One detection test takes a sample of plaque and analyzes it for the presence of bacteria, says Michael G. Newman, an adjunct professor of periodontics at the UCLA School of Dentistry.

Another test involves placing blood drops taken from the finger on a special paper containing five bacteria associated with gum disease, says Stanley Holt, a professor of periodontics at the University of Texas Health Science Center, San Antonio.

If the patient is infected, antibodies in the blood react to the bacteria, changing the paper’s color, says Holt, a test co-developer. The test, done in a dentist’s office and analyzed in a lab, is not yet approved by the Food and Drug Administration.

Already on the market is Perio-Temp, a device billed as a dental probe with a brain. Traditionally, a periodontist uses a hand-held probe to measure the depth in millimeters of pockets, assessing the severity of the disease. PerioTemp works on the premise that heat is an objective indicator of inflammation.

The probe takes the temperature between teeth and gums. A monitor attached to the device converts that data into sound signals and color-coded lights. Red stands for “hot spots,” or sites of active disease, yellow signals borderline areas, green represents healthy gums.

By pinpointing active disease sites, a dentist can treat only the infected areas, saving patients the discomfort and expense of whole-mouth treatment.

In the near future, one possible localized treatment might be a tetracycline-soaked fiber. Wrapped around the affected teeth, it reduces the pockets and kills bacteria, studies have found. The fiber is not yet FDA-approved, but it may be soon.

How can gum disease be minimized?

* Regular brushing and flossing.

* Reduce stress, which has been linked to worsening of gum disease.

* Stop or reduce smoking. “Cigarette smoking is bad for gum disease,” says Newman. “The smoke may increase plaque buildup.”

* See a dentist regularly.