Periodontal disease or periodontitis is also called gum disease. It is a serious gum infection that damages the soft tissue in your gums. If untreated, it can destroy the bone that supports your teeth. Periodontal disease can cause teeth to loosen or lead to tooth loss.
Periodontal disease is mostly seen in adults. Note that periodontal disease and tooth decay are the two biggest threats to dental health.
According to a CDC report, around 47 percent of adults aged 30 years and older have some form of periodontal disease. The disease increases with age. Surprisingly, 70 percent of adults 65 years and older have periodontal disease. The condition is more common in men than women and affects those who live in unhygienic conditions and are active smokers. To know about the disease, keep scrolling.
What is Periodontal Disease?
Periodontal disease, or gum disease, is a common infection that damages the soft tissue and bone supporting your tooth. If the condition is not treated, the alveolar bone around your teeth is slowly and progressively lost.
The name periodontitis means inflammation around the tooth. Microorganisms in your mouth, such as bacteria, stick to the tooth’s surface and especially in the pockets surrounding the tooth, and they multiply. As your immune system reacts with these microorganisms, toxins are released, and inflammation occurs.
Untreated, periodontal disease will eventually result in tooth loss. It might even increase the risk of heart attack, stroke, and other health problems.
Bacterial plaque, the sticky, colorless membrane that develops over the teeth, is the most common cause of periodontal disease. If plaque is not removed, it can harden to form tartar, or calculus.
Most cases of periodontitis are preventable through good dental hygiene. The infection is usually the result of poor oral hygiene. Brushing at least twice a day, flossing regularly, and getting regular dental checkups can be very helpful. It can greatly improve your chances of successful treatment for periodontal disease and reduce your chance of developing it.
Fast Facts on Periodontal Disease
- Periodontal disease or gum disease affects the area around your tooth, including the bone and the gum.
- It happens when bacteria and plaque build-up around the tooth. Your immune system launches a reaction.
- Good oral hygiene is part of both periodontal treatment and prevention. But sometimes, surgery is also necessary.
- Smoking might increase the risk of gum disease. In addition, the treatment will not work if you do not quit smoking.
- There appears to be a close link between gum disease and conditions elsewhere in the body, such as heart disease.
What are the Stages of Periodontitis?
Periodontitis starts as inflammation and slowly gets worse over time.
1 Inflammation (gingivitis)
Periodontal disease begins with inflammation in the gums, known as gingivitis. The first sign of gingivitis is that your gums will start bleeding when you brush or floss your teeth.
You might also start to notice some discoloration on your teeth. This is called plaque on teeth. Plaque is a buildup of bacteria and food debris on the surface of your teeth. Indeed bacteria are always present in your mouth, they only become harmful when conditions allow them to increase dramatically. This often happens if you do not brush or floss or get dental cleanings done regularly.
2 Early periodontal disease
In the early stages of periodontal disease your gums recede, or pull away, from your teeth. As a result, small pockets form between teeth and gums. The pockets harbor harmful bacteria where the infection starts. Your immune system tries to fight the infection initially, and your gum tissue starts to recede. At this stage, you will likely experience bleeding during brushing and flossing, and possibly some bone loss.
3 Moderate periodontal disease
If the condition is left to progress to moderate periodontal disease, you might experience pain and bleed around the teeth and gum recession. Your teeth will begin to lose bone support and become even looser. The infection could also lead to an inflammatory response throughout your body.
4 Advanced periodontal disease
In advanced periodontal disease, the connective tissue that holds your teeth in place starts to deteriorate. The bones, gums, and other tissue that support your teeth are destroyed. If you have advanced periodontal disease, you might experience severe pain while chewing. In addition, you will have severe bad breath and a foul taste in your mouth. The result is you will likely lose your teeth.
Treatment of Periodontal Disease
The main focus of the treatment is to clean out bacteria from the pockets around the affected teeth and prevent further destruction of bone and tissue.
1 Good oral hygiene
To prevent the infection, you should follow good oral hygiene daily, even if the teeth and gums are healthy. Proper dental care involves brushing teeth two times a day and flossing once a day. If you have enough space between the teeth, an interdental brush is recommended.
You can try using soft-picks when the space between your teeth is smaller. Individuals with arthritis and others with dexterity problems might find that using an electric toothbrush is better for thorough cleaning.
Remember, periodontal disease is a long-term, chronic, or inflammatory disease. If good oral hygiene is not maintained, it will recur after a few days.
2 Scaling and cleaning
It is essential to remove plaque and calculus from your teeth to restore periodontal health.
Your dentist will carry out scaling and debridement to clean the deposits below the gumline. This might be done using hand tools. Your dentist might also use an ultrasonic device that breaks up the plaque and calculus build-up. Root planing is done to smooth away rough areas on the roots of the treated teeth. It is done because bacteria can lodge within the rough patches, increasing your risk of gum disease.
Depending on how much plaque and calculus buildup has been deposited you might require one or two visits. Cleaning is normally recommended twice a year and more often, depending on how much plaque accumulates.
A number of medicated mouthwashes and other treatments are available to treat periodontal disease.
Prescription antimicrobial mouth rinses, like chlorhexidine are quite popular: This is used to control bacteria when treating gum disease, especially after surgery. You can use it just as you would a regular mouthwash.
Antiseptic chip: It is a small piece of gelatin that is filled with chlorhexidine. It can effectively control bacteria and reduce periodontal pocket size. Your dentist will place it in the pockets after root planing. The medication is slowly resealed over time.
Antibiotic gel: The gel contains doxycycline, which is an antibiotic. It helps shrink periodontal pockets and control bacteria. The gel is placed in the pockets after a scaling and root planing session. It is a slow-release medication.
Antibiotic microspheres: These are very small particles containing minocycline, an antibiotic, are also placed into pockets after scaling and root planing. It is a slow-release medication that is also used to control bacteria and reduce periodontal pocket size.
Oral antibiotics: These antibiotics are available in capsule or tablet form and are taken orally. They are used short-term for the treatment of acute or locally stubborn periodontal infection.
Enzyme suppressant: This effectively keeps destructive enzymes in check as it has a low dose of doxycycline. Some enzymes can also break down gum tissue, but this medication can delay your body’s enzyme response if taken for long. It is taken orally, in the form of a pill, and it is used with scaling and root planing.
The effects of periodontitis can be stopped with regular checkups and treatment. In addition, continued good oral hygiene can also reduce infection. Home remedy is also a part of treatment once an infection occurs.
Hence it is important for you to:
- Brush your teeth with a suitable toothbrush and toothpaste at least two times a day. You should carefully clean the chewing surfaces and the sides of the teeth.
- Use an interdental brush and floss every day to clean between the teeth, especially in the spaces that the brush cannot reach. Dental floss can clean small gaps easily, but a dental brush is useful for a larger space.
- You should take extra care when cleaning around uneven surfaces. For example, if you have crooked teeth, closely-packed teeth, crowns, dentures, fillings, and more.
- After brushing, you can use an antibacterial mouthwash to help prevent harmful bacteria from growing. The mouthwash can also reduce any inflammatory reaction in the mouth.
According to the American Dental Association or ADA, it is best to:
- Brush your teeth for two minutes, twice a day, with either a manual or electric toothbrush having soft bristles.
- Try using fluoride toothpaste.
- Rinse the brush well after use and always store it upright.
- Also, replace the toothbrush every 3 to 4 months, even more, if the bristles are matted or frayed.
- Try choosing a brush with the acceptance seal on it.
- You should never share brushes, as bacteria can pass from person to person in this manner.
Periodontal Disease vs. Gingivitis
Gingivitis or gum disease occurs before periodontitis. The condition usually refers to gum inflammation, while periodontal disease refers to gum disease and the destruction of bones and tissues.
Gingivitis: When bacterial plaque accumulates on the surface of your tooth, causing your gums to become inflamed and reddish. Your teeth might bleed during brushing. The gums are bothersome and irritated, but the teeth are not loose. There is no irreversible damage to your bone or surrounding tissue.
Untreated gingivitis can progress to periodontal disease.
Periodontal Disease: The gum and bone pull away from the teeth, forming large pockets. As a result, food particles and debris collect in the spaces between the teeth and gums and infect the area.
The immune system attacks the bacteria as the plaque starts to spread below the gumline into the pockets. Bone and connective tissue that hold your tooth start to break down because of the toxins produced by the harmful bacteria. The affected teeth become loose and start to fall out. The changes may be irreversible.
Periodontal disease can be stopped if caught and treated early enough. Treatment is typically very successful in most cases.
Regular follow-ups with your dentist are essential to ensure that the disease does not continue if you have the infection. You will surely have to change your dental hygiene habits and cooperate fully with your dentist’s instructions for a positive outcome. The long-term results depend on your efforts with oral hygiene plus the ongoing assessment of your dentist.
You should follow your dentist’s recommended schedule for regular checkups. If you notice any signs and symptoms of periodontal disease, make an appointment with your dentist at the earliest. The sooner you seek care, the better are your chances of reversing damage from the disease.