Michael C. Goldman, DDS

Gum Disease vs. Gum Health

A Matter of Attitude

Periodontal Disease and its Treatment

Did you know that the most universal disease known to man is gum disease? Decay and gum disease have plagued the human condition forever. Did you also know that gum (periodontal) disease is almost entirely preventable? Most of us do really know these things and yet there is nevertheless a continuing high rate of disease. Fortunately for most patients, dentists have almost put themselves out of the cavity business by their promotion of the use of fluoride in the drinking water of most communities. It is not unusual today for youngsters to get to teenage with one or two or even no cavities!

We know the key elements to prevention of gum problems has a lot to do with regular check-ups and cleanings (one to four times a year for most people), and the regular and diligent use of brush and floss at home daily. Why would otherwise very intelligent individuals who highly value having control over their lives sabotage themselves by avoiding what they know to be helpful?

Some of the reasons given include "I'm lazy, I guess"...probably said by someone with multiple degrees and working a fifty to sixty hour week as head of something-or-other. Another is "My parents lost their teeth by my age...", but that doesn't make sense in view of what we know now. Another is "At my age, what's the point..." even though we hope to live relatively long and we know that it's not the number of years as much as the quality of those years that we care so much about.

Why would we do that? Perhaps it has to do with old ideas we absorbed from past generations and incorporated into our minds without critical reasoning. Another very common malady known to man is denial. These outdated modes of thinking coupled with denial can result in years of advancing gum breakdown. More subtle is the adverse effect of this kind of thinking during what appears to be treatment for a gum problem. In such a scenario home efforts are half-hearted and unenthusiastic while the "treatments" might be performed quite adequately. The results will be greatly compromised, which will then of course support the negative thinking, etc. etc.. It gets going in a circular destructive pattern.

The point is that very often what is needed more than just getting "gum treatments" is an attitudinal shift. A recognition of a new paradigm ! The recognition of your own will and desire to be healthy and the willingness to let go of whatever thought form may have been holding you back.

Now, that's a mouthful. Usually we don't have in our conscious awareness what we are thinking that might be holding us back. So how can we work toward re-thinking it ? Well, I think it has to do with looking at our overall attitudes about health in general, rather than trying to look at dental-health specifically, which is often too emotionally loaded.

Exposure to nutritional counseling, meditation practices, mind-body therapies like osteopathy, psychotherapy, acupuncture and others can each from its own unique angle wake up our self-awareness. The more we become in touch with our subtler thought and feeling processes, the more we become aware of what we really want and what is getting in the way of our achieving it.

Right now you are probably wondering when I am going to talk about gum disease and how it is treated, right? Well the truth is that most treatment of gum disease is no big deal ! Mostly - unless advanced damage has occurred - treatment consists of careful cleaning of your teeth and that's about it. Realistically that isn't always simple because it's a very meticulous and difficult job to do well and the gums may be very sore to begin with. But with local anesthetic and appropriate time given the task it can usually be done with little or no discomfort. The catch that I have been talking about is that the treatment is just the beginning. In order for the treatment to work really well, the patient must be sufficiently motivated to be healthy to be willing to work at (if not excited about...) discovering how much he can facilitate his own healing by developing skill at home in brushing and flossing.

There is a lot of talk these days about "balancing" the body. If that seems like a strange concept to get, try imagining the body as an organization - like a club, or business. Now you can easily imagine how if every person in that organization looks at his or her task the same way and with uncompromised concentration and enthusiasm, that organization will be a winner for sure! But if there is in-fighting and one part of the organization has to spend much of its effort and time compensating for the deficiencies in another part, then the results will obviously be compromised. So it is with the body/mind. If our back aches, we can't concentrate on something else. If our immune system is already fighting three different battles in our body, how much is left to fight yet another.

Diet plays a role as does lifestyle habits like smoking, grinding and clenching teeth, drug use - both prescribed medications and illegal substance abuse. Stresses of any kind deplete the immune system's ability to fight infection ( gum disease is an infection ).

Often the question comes up about surgical vs. non-surgical periodontal treatment. Does non-surgical treatment work ? Well, yes...and no. From what I have seen, it can work. But it often does not because it is places much more responsibility on the patient who may not be willing to maintain the high degree of motivation necessary to stay in control of the disease process. To me a practical approach is to see over a period of time how much responsibility a patient is willing to take for his process and when a problem cannot be kept under control by the patient's efforts, then the treatment needs to assume more of the control, which might mean more frequent treatments and/or surgical intervention. The purpose of most gum surgery (except in quite advanced stages of disease) is not to fix anything...get that? It is mainly to reshape things so that the patient does not have to work so hard to maintain the problem area!

If you have a periodontal problem, consider the ideas I have mentioned here. Dialogue with yourself as honestly as you can to assess your level of motivation - and see that as distinct and separate from any fear or anxiety which may very well be there. Re-assess your overall feelings about becoming and staying healthy. Try to determine how active a role you really do wish to play in your treatment process. You may wish to play very little, and while that's not ideal, we can work with that. On the other hand, you may want to be very actively involved. We really can do more as partners!

Then, as the lawyer on the TV commercial always says..."let's talk about it".



This pamphlet was written in the hope that it will increase understanding about a topic that seems important from time to time. Obviously it is only part of the whole story, so if you have questions after reading this please do not hesitate to ask or call. Also, if there is a topic that you think would be helpful, please suggest it.

Michael C. Goldman, DDS
General and Cosmetic Dentistry
3815 East-West Highway
Chevy Chase, Maryland 20815
Phone (301) 656-6171


Holism in dentistry is an approach to dental treatment, primarily  caring for  patients' health and safety from both a conventional as well as  "alternative healthcare" point of view.   It is sometimes called "biological" dentistry or "biocompatible" dentistry.  In it's fullest sense, I believe it   acknowledges and deals with  the mind, body and spirit of the patient, not just his or her "teeth".  See Topics / Info.....

Cosmetic dentistry is about doing   quality , esthetic dentistry in a way that looks natural to begin with, and furthermore,   can even  improve  one's  attractiveness through techniques such as bonding, bleaching, veneers, caps, implants and more.  It can   be like "instant orthodontics" in correcting  crooked, twisted or misplaced teeth in many instances.  Dark or misshapen teeth can be restored.   Smiles that lack youthful vigor or beauty can be revitalized! See Topics / Info..

Bleaching, veneers, bonding, caps, bridges, and implants  are cosmetic dentistry treatments that are also  discussed in  Cosmetic Dentistry, and more...