Now the most common reason for tooth loss in the United States is due to gum disease (periodontal disease). Gum disease is an infection of the gums surrounding and supporting the teeth. About three out of four adults over age 35 are affected by some form of gum disease. Gum disease and cavities are caused by plaque. In at least 20 million Americans, the problem advances to serious periodontal disease in which gums pull away from the teeth and the underlying bone is destroyed. Loss of the bone results in tooth loss.
Periodontal disease usually starts out as gingivitis (swollen gums that bleed when you brush them). Half of all Americans have gingivitis, a gum inflammation often controlled with proper brushing, flossing, and routine dental cleaning. Dental hygienists use special instruments to regularly scrape off plaque (sticky bacteria that hardens below the gum's surface) by "scaling and planing" the teeth. Dentists may prescribe topical antibiotics in severe cases of gingivitis.
Even with all this preventative care some patients still need extensive gum surgery and lose teeth. Now there may be more hope for those patients with severe periodontal disease. Just this month (October, 1998), the Food and Drug Adminstration (United States) approved a drug called Periostat®. One study demonstrated that patients who took Periostat® daily after the plaque had been scraped away had their gums reattach to teeth 52 percent better than patients who had plaque removal alone. Periostat® patients also had 67 percent more improvement in the depth of gum loss (When the dental hygienist uses that metal tool and tests the gums around each tooth for gum disease.)
Periostat® is a slightly modified antibiotic called doxycycline hyclate. Periostat® does not kill the bacteria that cause plaque but instead stops a protein called collagenase. When the gums are inflamed (gingivitis) they release collagenase. This protein then destroys the gums around the teeth and eventually
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