What is Periodontal Disease A Detailed Guide

Periodontal Disease

What is Periodontal Disease?

Periodontal disease is also called gum disease. The word periodontal means around the tooth. In this condition, there is inflammation and infection of the gum tissues. Bacteria not only attack the gums but also nearby tissues that hold the teeth in place. Poor oral hygiene is the main cause of gum disease. If the disease is left untreated, the underlying bone around the teeth will be dissolved.

The infection can also spread to other areas of your mouth and other parts of your body. It can increase your risk for several health conditions, including heart disease, stroke and diabetes. In the early stages, periodontal disease is usually painless. So it’s important to know what the warning signs are. So you can get the right treatment before the disease worsens. Tell your dentist or get help if you have swollen, tender or bleeding gums. They can help you with the infection and improve your teeth and gum health.

What are the Symptoms of Periodontal Disease?

The symptoms of gum disease may resemble those of other conditions or health problems. Periodontal disease symptoms may include:

  1. Reddish or purplish gums.
  2. Bleeding and tender gums while brushing or flossing.
  3. Bad breath (halitosis).
  4. Pain when chewing.
  5. Pus between the teeth and gums
  6. Unpleasant taste.
  7. Loose teeth or separating teeth.
  8. Gums that pull away from your teeth (Gum recession).
  9. A change in bite and jaw alignment.
  10. Partial dentures that no longer fit.

See your dentist if you experience any of the above symptoms.

What are Periodontal Disease Stages?

Gums are firm to the touch, pink, attached to the teeth and supported by dense bone. They don’t bleed or swell. But periodontal disease can cause discoloured (bright red or purple), swollen, bleeding gums. If it is left untreated, gum disease can cause damage to your underlying jawbone, and in severe cases, tooth loss is possible. The breakdown of gum tissues is gradual. So most people don’t experience pain with gum disease, especially during the early stages. So, it’s essential to know the warning signs and how it begins. There are four stages of gum disease:

Gingivitis

This is the initial stage of gum disease. A buildup of bacteria causes Gingivitis. The bacteria cause inflammation of the gums, and they become red, swollen, and tender. The gums are easily irritated or may bleed easily during daily cleanings and flossing. There is no bone loss occurring at this stage. So, Gingivitis is totally reversible with proper treatment and regular care at home. Removal of the plaque buildup can help prevent the development of gum disease.

Early or Mild Periodontitis

Untreated Gingivitis can cause bacteria to seep beneath your gums, and they become more inflamed. It also affects the supporting bone and gums, which may pull away from your teeth. This will create pockets or spaces around them known as periodontal pockets.Food, bacteria, and plaque begin to hide in the pockets, where your toothbrush and floss can’t reach. This will cause infection and early bone loss around the teeth. Access to dental care can help prevent more bone erosion and gum damage.

Moderate Periodontitis.

If periodontitis is still left untreated, the symptoms become more severe. The inflammation spreads, and some pain may occur at this stage. Because bacteria begin to erode the soft tissues and bone that hold your teeth in place. This can lead to teeth loosening and receding gums. You may notice bad breath and pus around your gum line.

Advanced Periodontitis

This stage of gum disease is marked by painful abscesses, heavy bleeding, and bad breath that are caused by the infection spreading beneath the gums. It causes severe bone and tissue loss, and periodontal pockets get deeper. Your teeth may become loose, even fall out or need to be removed.

Gum disease can be reversed when it is treated at an early stage. But the disease is too advanced; it cannot be reversed because you have already lost bone around your teeth due to infection; however, with proper treatment and consistent, good oral hygiene, it can be reversed.

What Causes Periodontal Disease?

Plaque buildup is the main cause of Periodontal disease. Plaque is a sticky film mainly made up of bacteria. This plaque contains many different kinds of bacteria that can infect your gums. So if you have poor oral hygiene, you are at risk of getting gum disease. Some people may develop gum disease due to genetic factors that can alter their immune system’s response to bacteria.

What are the Risk Factors?

The factors that can increase your risk of Periodontal disease include:

  1. Poor oral hygiene.
  2. Smoking or other tobacco use.
  3. Rheumatoid arthritis.
  4. Heart disease.
  5. Crohn’s disease.
  6. Hormonal changes related to puberty, pregnancy, or menopause.
  7. Conditions that lower immunity, such as leukaemia, HIV/AIDS and cancer treatment.
  8. Poor nutrition, including vitamin C deficiency.
  9. Genetics (you are at risk of getting gum disease if your parents, grandparents or siblings have it).
  10. Certain medicines can cause dry mouth or gum changes.
  11. Using recreational drugs, such as vaping or smoking marijuana.

Is Periodontal Disease Contagious?

Yes, the gum disease bacteria can pass from person to person through saliva. This means activities like kissing, sharing utensils, or even coughing and sneezing near someone could potentially spread the infection.

What are the Complications of Periodontal Disease?

If Periodontitis disease is left untreated, it continues to worsen, leading to a vicious cycle of infection that can end in tooth loss. The bacteria can enter your bloodstream through gum tissue, affecting other parts of your body. Research has also shown that gum disease has a direct impact on your overall health. Periodontitis is linked with respiratory disease, heart disease, stroke, rheumatoid arthritis, preterm birth, low birth weight, and problems controlling blood sugar in diabetes.

How do Dentists Diagnose Periodontal Disease?

Your dentist can tell you if you have gum disease or not. During a routine examination, the dentist will ask about your symptoms and check your teeth for plaque buildup. For further evaluation and treatment, they may refer you to a Periodontist (a specialist in gum care). A dentist or Periodontist will use an instrument called a periodontal probe to measure the pockets around your teeth. It will help to determine how much bone you have lost around your teeth. The more severe the gum disease, the deeper the pockets are.

Your Periodontist will also check your bite to determine how much your gums are pulling away from your teeth (receding) and how loose your teeth are. They also take dental X-rays to detect the areas of bone loss in detail. Your Periodontist will also ask for older X-rays to see how your bone has changed with time. They may ask about your health history to identify risk factors, such as diabetes.

What is the Treatment of Periodontal Disease?

There are many Periodontal treatments available. Depending on the severity of your condition and many other factors, such as your health, whether you smoke, and what treatments you have had in the past, can help you consider what’s right for you.

Dental Cleaning

Early Periodontal disease (Gingivitis) may be reversed with routine dental cleaning and improved oral hygiene. The infection did not spread, and no bone loss has occurred yet, so this will help people get rid of harmful oral bacteria through good oral hygiene. It helps to eliminate any chances of disease progression. The dentist may recommend brushing two to three times a day, daily flossing and regular dentist visits for dental checkups and cleanings.

Scaling and Root Planing

Both are similar to routine dental cleaning. It cleans and removes tartar and plaque from your tooth surfaces and below your gumline. Your dentist scales the plaque from your teeth using instruments, an ultrasonic device or a laser. Then, smoothing the root surfaces during root planing. Root planing will help prevent further buildup of tartar and bacteria. Scaling and root planing can do deep cleaning as they reach beneath your gums, where your toothbrush and floss can’t reach. People with mild gum disease can benefit from this treatment. Before the procedure, your Periodontist will use local anaesthesia to numb the gums. It is recommended to be done in at least two visits.

Antibiotics

Antibiotics may be placed topically in the Periodontal pockets or taken orally to help control bacterial infection. Topical antibiotics are put into gum pockets, including mouth rinses or gels. Sometimes oral antibiotics are also recommended to get rid of bacteria that cause infections.

Pocket Reduction Surgery

This option is good for people with moderate to advanced gum disease.

Pocket reduction surgery is also called osseous surgery. In this procedure, deep tartar and plaque buildup are removed from under the gums that your hygienist can’t reach. A Periodontist makes a small cut in your gums and creates a flap during this procedure. They temporarily move your gums back from your teeth roots.

Then clean the plaque, tartar and bacteria from your tooth roots and smooth out any rough areas. They will reposition your gums and close the incision with stitches once the procedure is completed. Periodontists often combine pocket reduction surgery with other regenerative procedures, such as gum grafting, bone grafting, or guided tissue regeneration.

Gum Grafting

Gum graft surgery, also called tissue grafting, is recommended if you have lost gum tissue due to Periodontal disease. The Periodontist will cover exposed tooth roots and add thickness to your gum line during this procedure. They will add tissue to the areas where recession of the gum occurs. This tissue may be taken from your mouth roof, or your provider may purchase it from a licensed tissue and bone bank.

Bone Grafting

This treatment is best when you have lost gum due to Periodontal disease. Your Periodontist may replace bone by using a dental bone graft after cleaning the infection. Then, place bone grafting material into the areas where the bone has eroded. This material acts as a space holder or scaffolding, giving your body time to regenerate its own bone over time.

Platelet-rich Plasma (PRP) and Platelet-rich Fibrin (PRF)

Both contain growth factors that speed up healing and tissue regeneration. In this treatment, your Periodontist can get PRP and PRF from your blood sample. The sample is then put in a centrifuge (a lab machine that uses centrifugal force and spins rapidly) to separate plasma from the red blood cells. This platelet-rich plasma or fibrin will then be placed at the surgical site. This therapy has healing power, which also shortens recovery times and reduces post-surgical pain. As it comes from your own blood, so it is completely safe.

LANAP (Laser-assisted new attachment procedure)

Pocket reduction may also be done with LANAP. LANAP is less invasive than the traditional pocket reduction surgery. Periodontists recommend this procedure to treat periodontitis using a handheld laser. The laser targets diseased gum tissue without damaging the healthy tissue.

Guided Tissue Regeneration (GTR)

Guided tissue regeneration is usually in combination with a bone graft. GTR helps repair periodontal defects (areas of broken-down bone) and prevents soft tissue from growing into these areas. Your Periodontist places an artificial membrane between your gums and the newly placed bone grafting material during GTR. As the soft tissue regenerates faster than bone, this artificial membrane between your gums keeps that space open, so new bone can grow there rather than soft tissue.

How Can I Prevent Periodontal Disease?

Yes, Periodontal disease can be prevented in most cases with consistent and good oral hygiene. However, some people get gum disease due to other health conditions or genetics. Also, you may need more regular cleanings with your dental hygienist. To reduce your risk of Periodontal diseases:

  1. Brush your teeth for two to three minutes two to three times every day, or after every meal or snack.
  2. Floss between your teeth daily to clean away the loosened food bits and bacteria.
  3. Use a soft toothbrush and replace it at least every three months.
  4. An electric toothbrush may be used to more effectively remove plaque and tartar.
  5. Brush your tongue each time you clean your teeth.
  6. Use an antibacterial mouthwash.
  7. Don’t smoke or chew tobacco.
  8. Follow medical advice for the management of chronic illnesses, such as diabetes.
  9. Eat a balanced and healthy diet.
  10. Getting a dental checkup once a year or more often if you have dental problems.

When Should I See a Dentist?

You should see a dentist as soon as possible when you experience bleeding, tender or swollen gums. Early detection is essential for the treatment. Your dentist will refer you to a Periodontist for treatment if you need more than a routine dental cleaning.