Daily News - Taking A Bite Out of Gum Disease Print article

By DR. ROCK POSITANO SPECIAL TO THE NEWS

If you know people with dentures or a bridge, chances are that they didn't lose their teeth to decay. The culprit was most likely periodontal disease.

Now there is a relatively new treatment for periodontal, or gum, disease, which affects 50 million Americans. Arestin is a powder containing a powerful antibiotic that is placed under the gums.

Periodontal disease, also known as periodontitis, is a bacterial infection that attacks and destroys the gums and bone that hold teeth in place. Infection occurs when dental plaque, a sticky, sometimes colorless film, accumulates on the surfaces of teeth. In people with healthy teeth, bone and gum tissue fit snugly around the teeth. When someone has periodontal disease, the supporting tissue and bone break down, forming pockets around the teeth. Over time, these pockets become deeper, allowing plaque to accumulate, and bacteria to spread.

"Arestin shrinks the pockets that result from gum disease," says Dr. Jan Linhart, a Manhattan dentist. A specially designed, nonneedle syringe is used to deliver the antibiotic, which is gradually released into the infected area over a two-week period.

The syringe has a soft plastic opening that fits right beneath the gum line, and there's no discomfort for the patient, he says. "A major advantage of the treatment is that it's not a systemic antibiotic. It's placed right in the area that needs to be treated," Linhart says.

Along with Arestin, dentists do a deep-cleaning to remove calculus and plaque, which harbor infection-causing bacteria. In advanced cases of periodontal disease, surgery is usually needed, but Arestin may eliminate the need for surgery. Arestin should not be used if a patient is allergic to the antibiotic tetracycline or is pregnant.

Because periodontal disease is usually painless and progresses slowly, it can go undetected for years. At its earliest stage, it can be eliminated by dental cleanings, along with daily flossing and brushing. But once it progresses, it can cause problems that go beyond losing teeth. Studies have shown a link between oral health and illnesses that cause heart disease and stroke.

Everyone should monitor their teeth and gums for periodontal disease, Linhart says. Warning signs include red, swollen and tender gums; a bad taste in the mouth; bad breath; gums that have pulled away from teeth or bleed when you brush; loose or sensitive teeth; pain when chewing, and a change in the way teeth fit when you bite.

Dr. Rock Pasitana, M.S., M.P.H., D.P.M., is on the faculty and staffof the Weill Medical College of Cornell University.