Periodontology - Periodontitis

Periodontitis, which is also called gum disease, is a serious gum infection that damages the soft tissue in the mouth. Without treatment, the disease can destroy the bone that supports the teeth. Periodontitis can also result in loose teeth or even lead to the loss of a tooth.

While it is common, periodontitis is very preventable. It is usually caused by poor oral hygiene. Brushing the teeth twice daily, flossing and getting regular dental checkups can improve your ability to successfully treat and prevent periodontitis.

Signs and symptoms

In the early stages, periodontitis does not have many symptoms. For most patients, the disease has progressed prior to seeking treatment.

Typical symptoms may include the following:

• Swollen, puffy gums
• Red or purplish gums
• Gums which are tender to the touch
• Gums that bleed
• Presence of blood when brushing or flossing
• Bad breath
• Pus between the teeth and gums
• Loose teeth or loss of teeth
• Pain when chewing
• The development of spaces between your teeth
• Gums which pull away from your teeth
• Change in the way your teeth fit together when biting

It is important to note that gingival inflammation and bone destruction do not always cause pain. Many people assume that bleeding without pain after teeth cleaning is irrelevant. However, it can be a sign of periodontitis.

Risk Factors

Factors that can increase your risk of having periodontitis include the below:

• Gingivitis
• Poor oral hygiene
• Tobacco use
• Hormonal changes, including pregnancy or menopause
• Recreational use of drugs
• Obesity
• Poor nutrition
• Genetics
• Medications which cause dry mouth or a change in the gums
• Conditions with lowered immunity, such as leukemia, HIV/AIDS and cancer treatment
• Diseases including diabetes, rheumatoid arthritis and Crohn's disease

Causes

In most cases, periodontitis begins with plaque. When it is left untreated, plaque can ultimately advance to periodontitis as follows:

• Plaque forms on your teeth when the starches and sugars found in food interact with bacteria that is present in your mouth. While brushing and flossing helps to remove the plaque, it tends to re-form quickly.
• Plaque hardens under your gumline into tartar or calculus if it remains on your teeth. Tartar is more difficult to remove and is full of bacteria. When plaque and tartar remain on your teeth, they can begin to cause damage. Regular brushing and flossing can’t remove tartar. A professional dental cleaning is required to remove it.
• Plaque can cause gingivitis, which is a mild form of gum disease. Gingivitis involves irritation and inflammation of the gum tissue that surrounds your teeth. Gingivitis is reversible through professional treatment and good oral hygiene.
• Ongoing gum inflammation can lead to periodontitis, which eventually causes pockets to develop between your gums and teeth. These pockets eventually fill with plaque, tartar and bacteria. Over time, the pockets grow deeper and fill with additional bacteria. When left untreated, these deep infections can result in a loss of tissue, bone and can ultimately result in the loss of teeth. Chronic inflammation can also put a strain on your immune system.

Prevention

The best way to prevent periodontitis is have good oral hygiene practices. It is important to begin these practices early and stay consistent with good oral care.

• Good oral hygiene includes brushing your teeth for two minutes twice daily. Brushing should occur in the morning and after your last meal of the day. This also includes flossing daily. Flossing prior to brushing allows you to clear the loosened food particles and bacteria. Good oral hygiene helps to prevent the development of an environment with bacteria that can cause periodontal disease.
• It is also important to visit your dentist regularly for cleanings. For most patients, these visits should occur every six to 12 months. For patients with increased risk factors for developing periodontitis, these visits may need to occur more frequently.