Overview of Periodontitis
Periodontitis is a severe infection that can lead to significant dental problems if not treated properly.
It is caused by the bacteria found in plaque, a sticky colorless film that forms on your teeth.
The bacteria often cause inflammation of the gums, which can also affect the bone supporting the teeth.
This can lead to tooth loss if not treated and managed correctly.
Periodontitis can affect one tooth or many and begins when the bacteria in plaque causes the gums to become inflamed.
How Common is Periodontitis?
Periodontitis is more common than most people realize and can afflict anyone, regardless of age.
According to the Centers for Disease Control and Prevention (CDC), about 47.2% of adults aged 30 years and older have some form of periodontal disease.
The prevalence increases to over 70% for adults 65 years and older.
This means that millions of people have periodontitis or are at high risk of developing it.
The risk increases with age, but men are at higher risk than women.
Symptoms and Causes of Periodontitis
What Causes Periodontitis?
The primary cause of periodontitis is the long-term effects of plaque deposits on your teeth.
However, several factors increase the risk of developing periodontitis, including:
Smoking: Cigarette smoking is one of the most significant risk factors associated with the development and progression of periodontitis.
Hormonal changes in girls/women: These changes can make gums more sensitive and make gingivitis more likely.
Genetics: Some people may be more susceptible to severe periodontal disease.
Certain medications that cause dry mouth: Examples include some antihypertensive drugs, antihistamines, and antidepressants.
Illnesses: Certain diseases, such as diabetes, can increase the risk of periodontitis, as can HIV.
Poor oral health habits: Not brushing or flossing your teeth as recommended can lead to plaque build-up.
Symptoms of Periodontitis
Early Signs and Symptoms
The early stage of periodontitis is called gingivitis, which is an inflammation of the gums caused by plaque.
If you notice any of these signs, contact your dentist:
Gums that bleed easily: Healthy gums should not bleed with regular brushing or flossing.
Swollen, red, or tender gums: It is common for gums to be red and inflamed when infected, and painful to touch.
Bad breath: Consistently bad breath or a bad taste in the mouth is a warning sign.
Advanced Signs and Symptoms
Advanced stages of periodontitis can cause your gums to pull away from your teeth and can contribute to tooth loss.
Other signs include:
Receding gums: Periodontitis can cause your gums to recede or pull away from your teeth, making your teeth look longer than normal.
Loose or separating teeth: Can be a result of impacted bone damage from periodontitis.
Increased spaces between teeth: Gums pulling away from teeth can result in larger-than-normal spaces.
Pus between your teeth and gums: Can be a sign of an infection that is progressing.
Pain when chewing: Pain is often a sign of an infected or inflamed gum pocket.
Changes in the fit of your teeth: Teeth can shift as a result of bone loss from periodontitis.
Gingivitis: The Reversible Stage
Gingivitis is the mildest form of periodontal disease.
It causes the gums to become red, swollen, and bleed easily.
There is usually little or no discomfort at this stage, and prevention can quickly reverse the effects.
Mild, Moderate, and Severe Periodontitis
Early Periodontal Disease
In the early stage of periodontitis, pockets are deeper and can begin to separate from the tooth.
This stage is reversible with proper care.
Moderate Periodontal Disease
The supporting bone is destroyed, and the teeth may shift or become loose.
This stage is not reversible and has a high risk of tooth loss.
Advanced Periodontal Disease
Evidences of advanced periodontal disease include profound pockets, extensive bone loss, and often, loose or severely drifting teeth.
This stage can have a variety of complications and may require surgical treatment.
How is Periodontitis Diagnosed?
The diagnosis of periodontitis is typically determined through the use of dental X-rays and a comprehensive examination of the mouth and gums by a dentist.
X-rays help to identify the amount of bone loss, which is a key indicator of the stage and severity of periodontitis.
Dentists also measure pocket depth to determine the severity of the disease.
Treatment for Periodontitis
Professional Dental Cleaning (Scaling and Root Planing)
This deep-cleaning treatment involves scraping tartar from above and below the gum line, in order to smooth rough spots on the tooth root, so bacteria are less likely to stick.
Improved Oral Hygiene Practices
Your dentist will work with you to show you the proper way to brush and floss your teeth, which is critical for prevention.
Flap Surgery
Flap surgery is a procedure in which your dentist makes a small incision in the gum so that the tissue can be moved back to allow deep cleaning, removing the tartar and bacteria from the pockets which also helps shrink them.
Bone Grafting
Bone grafting is a surgical procedure that promotes the growth of bone in an area that has lost bone due to periodontal disease.
Soft Tissue Grafts
Soft tissue grafts can be used to reinforce thin gums or to fill in places where gums have receded.
Complications of Untreated Periodontitis
The more severe stage of periodontitis, the greater the chance you will lose teeth; untreated periodontitis does not only cause tooth loss, but over time can also affect the way you eat and speak.
Increased Risk of Systemic Health Problems
While the connection is not entirely clear, some studies indicate that periodontitis may be associated with several other diseases and conditions beyond the mouth, including heart disease, stroke, and diabetes.
Prevention of Periodontitis
Maintain Good Oral Hygiene
Brushing and flossing your teeth to remove plaque and help prevent the plaque buildup that can lead to periodontitis.
Regular Dental Checkups and Cleanings
Professional cleanings can remove plaque that regular brushing and flossing can't.
By quitting smoking, controlling diabetes, and staying aware of how medications can affect your oral health, you can lower your risk of periodontitis.
Eating a variety of fruits and vegetables, and avoiding high sugar and high carb foods can help prevent plaque from developing.
Living With Periodontitis
When Should I See My Dentist?
You should see a dentist if you notice any symptoms or have concerns about the health of your gums or teeth.
What Questions Should I Ask My Dentist?
You should ask about the treatment plan, the prognosis, and any lifestyle changes that may improve your oral health.
Each treatment and surgery comes with a list of risk factors and potential side effects or points of concern, and it's essential that you discuss these with your dentist.
Importance of Early Diagnosis and Treatment
Early diagnosis and treatment can help stop the progression of periodontitis.
Maintenance of Good Oral Health for Overall Well-being
Taking care of your mouth can help keep the rest of your body healthy.
Can Periodontitis Be Cured?
While you can control the progression of periodontitis with early detection, it is not reversible.
It's a lifelong commitment to maintaining improved dental habits, along with regular check-ups and cleanings.
However, it is possible to give the teeth and gums the best chance for survival.
