Toothache (cont.)

The second most common cause of toothache is gum disease (periodontal disease). Gum disease refers to infection of the soft tissue (gingiva) and abnormal loss of bone that surrounds and holds the teeth in place. Gum disease is caused by toxins secreted by oral bacteria in "plaque" that accumulates over time along and under the gum line. This plaque is a mixture of food, saliva, and bacteria. An early sign of gum disease is gum bleeding. Pain is a symptom of more advanced gum disease as the loss of bone around the teeth leads to the formation of deep gum pockets. Bacteria in these pockets cause gum infection, swelling, pain, and further bone destruction. Advanced gum disease can cause loss of otherwise healthy teeth. Gum disease is complicated by such factors as poor oral hygiene, family history of gum disease, smoking, and family history of diabetes.

Treatment of gum disease always involves meticulous oral hygiene by an individual as well as removal of bacterial plaque and tartar (hardened, calcified plaque) by a dental professional. Moderate to advanced gum disease usually requires a thorough cleaning of the teeth and teeth roots called "scaling and root planing" and "subgingival curettage." Scaling and root planing is the removal of plaque and tartar from exposed teeth roots while subgingival curettage refers to the removal of the surface of the inflamed layer of gum tissue. Both of these procedures are usually performed under local anesthesia and may be accompanied by the use of oral antibiotics to overcome gum infection or abscess. Follow-up treatment, if necessary, may include various types of gum operations. In advanced gum disease with significant bone destruction and loosening of teeth, teeth splinting or teeth extractions may be necessary. Frequent visits to the dentist are recommended for periodontal maintenance (dental cleanings) and monitoring of the teeth and gums.

Source: MedicineNet.com
http://www.medicinenet.com/toothache/article.htm