Periodontitis, the more severe disease, is not reversible. It involved destruction of the bone supporting the teeth. There are different forms, and it is the #1 reason for tooth loss in the United States for adults.
What causes gum disease?
Most gum disease is started by dental plaque and your susceptibility to it. As it ages, if left on the teeth, it can harden into dental tartar or calculus. The plaque creates inflammation. It can be worsened by other factors such as smoking, hormonal issues and systemic diseases such as diabetes
What can it do?
Gingivitis, an earlier or less aggressive form of the disease, is reversible. It causes gingival swelling and bleeding. Often this is associated with blood on your toothbrush or something more serious.
What are periodontal diseases?
The word "periodontal" literally means "around the tooth." Periodontal diseases are bacterial gum infections that destroy the gums and supporting bone that hold your teeth in your mouth. Periodontal diseases can affect one tooth or many teeth.
The main cause of periodontal diseases is bacterial plaque, a sticky, colorless film that constantly forms on your teeth. If the plaque is not removed, it can turn into a hard substance called calculus or tartar in less than two days. Tartar is so hard it can only be removed by an oral health professional, such as a dentist or dental hygienist. The bacteria in plaque infect the gums, and release poisons that cause redness and inflammation (irritation). The inflammation and the poisons themselves cause destruction of the tissues that support the teeth, including the bone. When this happens, the gums separate microscopically from the teeth, forming pockets that fill with even more plaque causing even more infection.
Periodontal diseases are multi-factorial. This means that there is not just one cause of periodontal diseases but rather multiple factors that can affect the health of your gums.
Are all forms of periodontal diseases the same?
There are many types of periodontal diseases. The following is an overview of the most common:
As the mildest form of the periodontal diseases, gingivitis causes the gums to become red, swollen, and bleed easily. There is usually no discomfort at this stage.
Chronic periodontitis is a condition resulting in inflammation within the soft tissues surrounding the teeth causing progressive attachment and bone loss. It is diagnosed by bone loss on a dental X-ray, the formation of gum pockets and/or receding gums. It is most common in adults, but can occur at any age.
This form occurs in patients who are otherwise in good health. Common features include rapid attachment loss and bone destruction.
There are two forms of aggressive periodontitis:
Periodontitis as a Manifestation of Systemic Disease
As the name indicates, the form is associated with one of several systemic diseases that are related to periodontitis, such as diabetes.
Necrotizing Periodontal Diseases
These types of periodontal diseases cause ulcers in the gums between the teeth and are most commonly observed in individuals with certain conditions including, but not limited to, HIV infection, malnutrition and immunosuppression. Stress, smoking, and poor oral hygiene sometimes can contribute to this problem.
What are the signs of periodontal diseases?
Periodontal diseases are often silent, meaning that symptoms may not materialize until significant bone loss has occurred. Some people may have periodontitis and not experience any symptoms and by unaware that they have disease. Common symptoms and signs of periodontal diseases include:
If you notice any of these symptoms, you should see a periodontist for a complete periodontal examination. A periodontist is a dentist who specializes in the prevention, diagnosis and treatment of tissues surrounding the teeth. In addition, periodontists are experts in the placement and maintenance of dental implants.
During a periodontal examination, the periodontist will gently
place a small measuring instrument calling a periodontal probe in
the pocket between the teeth and gums to measure pocket depths and
help make a diagnosis. Probing depths measuring 1-3mm are usually
considered healthy. Four to 5mm may indicate mild periodontitis,
5-6mm suggest moderate periodontitis, and 7mm or greater may
indicate severe periodontitis. In addition to probing depth
measurements, X-rays may be taken to evaluate the health of the bone
supporting the teeth.
Once your periodontal health has been evaluated, your periodontist will work with you to determine the best treatment options to control your disease and bring you back to health. Treatment can vary depending on how far the disease has progressed. If diagnosed and treated in the early stages, simple non-surgical periodontal therapy may be sufficient. If periodontitis has advanced to the point where the periodontal pockets are deep and significant amounts of bone lost, surgical therapy may be necessary.
Once periodontitis has been controlled, patients will require ongoing periodontal maintenance procedures to sustain health. This ongoing phase of treatment will allow your periodontist to assess your periodontal health and make sure that your infection stays under control or remains eliminated. During these re-evaluation appointments, your mouth will be examined, new calculus and plaque will be removed and, if necessary, your teeth will be polished and your bite will be checked. Periodontal diseases are chronic diseases, just like diabetes. Without careful, ongoing treatment, periodontal diseases can and often to recur.
How can the periodontal diseases be prevented?
Good oral hygiene and professional care are the keys to keeping your teeth for a lifetime. The best way to prevent periodontal diseases and tooth decay is to remove the bacterial plaque by thorough brushing and flossing every day. Good oral hygiene habits will help keep the formation of dental tartar to a minimum.
Regular dental visits that include a periodontal examination are also important to detect any changes in periodontal health and, if necessary, to remove hardened tartar in places that your toothbrush and floss may have missed. A professional cleaning (often called a prophylaxis) at least twice a year is recommended for patients with good periodontal health. If you have had any form of the periodontal diseases, you may need professional maintenance more frequently.
Congratulation on taking the first step to achieving periodontal health! Preventing and/or controlling periodontal diseases is a worthwhile commitment that will keep you smiling for life.