What You Need to Know About Periodontitis

Periodontitis is a serious gum infection that damages the soft tissue and destroys the bone that supports your teeth.

It can cause teeth to loosen or lead to tooth loss.

Periodontitis is common but largely preventable.

It usually starts as gingivitis, which is the mildest form of periodontal disease, and it can worsen into severe periodontitis.

Researchers have found that periodontitis is among the most common chronic bacterial infections and is also one of the two most common diseases of the oral cavity.

Maintaining proper oral hygiene is the most essential practice in preventing periodontitis, and early detection is crucial for successful management.

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Updated on

May 6, 2024

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Glossary

Periodontitis

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Key Takeaways:

Periodontitis, a severe gum infection, destroys the bone and tissue supporting your teeth.
Early signs include red, swollen gums and bad breath, while later stages involve loose teeth and receding gum lines.
Plaque buildup is the main culprit, but smoking, genetics, and certain health conditions can also contribute.
While treatment can't reverse bone loss, it can halt progression and save your teeth with professional cleanings, antibiotics, or surgery in severe cases.
Maintain good oral hygiene, see your dentist regularly, and manage risk factors to prevent gum disease from developing into periodontitis.

Overview of Periodontitis

What is 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.

Stages of 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.

Diagnosis and Tests

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

Non-surgical Treatments

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.

Surgical Treatments

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

Tooth Loss

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.

Manage Risk Factors

By quitting smoking, controlling diabetes, and staying aware of how medications can affect your oral health, you can lower your risk of periodontitis.

Healthy Diet

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.

Outlook / Prognosis

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.

Periodontitis FAQs

Can you fix periodontal disease?

Periodontal disease itself can't be completely cured, especially in advanced stages where bone loss has occurred. However, you can definitely manage and halt the progression of the disease to prevent further damage and tooth loss. Here's the breakdown: Gingivitis: The early stage of gum disease is reversible with good oral hygiene practices and professional cleaning. Periodontitis: In later stages, the focus shifts to managing the infection, preventing further bone loss, and saving your teeth. This might involve professional cleanings (scaling and root planing), antibiotics, or even surgery for severe cases.

By practicing good oral hygiene, attending regular dental checkups, and managing risk factors like smoking and diabetes, you can significantly improve your gum health and prevent periodontitis from worsening.

How long does it take for periodontitis to go away?

Periodontitis itself isn't entirely reversible because it involves bone loss. However, you can manage the infection and prevent further damage. The healing timeline depends on the severity: Early-moderate periodontitis: With proper treatment like scaling and root planing, it might take 2-3 weeks for the gums to heal, but ongoing maintenance is crucial. Severe periodontitis: Recovery can take several months with dedicated treatment, and may even require surgery. Remember, these are just estimates. The key is to see a dentist for a diagnosis and personalized treatment plan to get your periodontitis under control and maintain healthy gums.

Can you reverse periodontitis?

No, you cannot completely reverse periodontitis because once bone loss has occurred, it cannot be regained. Periodontitis is an infection that destroys the bone and tissue supporting your teeth. However, there's good news! You can definitely halt the progression of the disease and prevent further damage with proper treatment. This helps to: Control the infection in your gums, Prevent further bone loss and Save your teeth. Here are some treatment options your dentist might recommend: Professional cleanings (scaling and root planing) to remove plaque and tartar buildup, Antibiotics in some cases to fight infection and Surgery for advanced cases to improve access for cleaning and potentially regenerate bone tissue. By managing periodontitis, you can maintain good oral health and prevent tooth loss.

Can I live a long life with periodontal disease?

Yes, you can live a long life with periodontal disease, but there are some key points to consider: Management is crucial: Left untreated, periodontitis can worsen and lead to tooth loss, which can impact your overall health and well-being. Early diagnosis is key: The sooner you get diagnosed and receive treatment, the easier it is to manage the disease and prevent complications. Healthy lifestyle matters: Maintain good oral hygiene habits like brushing, flossing, and regular dental checkups. Additionally, manage risk factors like smoking and diabetes, which can worsen periodontitis. By prioritizing good oral health and working with your dentist to manage periodontitis, you can live a long and healthy life.