Periodontal Disease: What You Need to Know

15 August 2023

Periodontal Disease: What You Need to Know

Many people will be aware of gum disease or, to give it the correct name, periodontal disease. This is a common dental issue for millions of people of all ages and the condition is readily treatable when caught in time. 

However, if periodontal disease is left untreated, the condition will only worsen over time and will lead to periodontitis. 

This is the most severe form of gum disease and is characterized by the gum tissue receding from the teeth. This creates pockets that are easily accessible to harmful bacteria which leads to various infections, loose teeth and even tooth loss.

The good news is that even the most advanced cases of periodontitis can be treated but the bad news is that treatment can take a long time, may require surgery and can be expensive. 

This is why regular check-ups at the dentist are so vital. Any dental problems are always easier to treat when detected early and not allowed to deteriorate. 

Good dental hygiene is the single most important factor in keeping dental issues to a minimum and avoiding the problems associated with advanced gum disease is good enough reason for following a proper dental health regimen.

Early Warning Signs

In the initial stage, gum disease is called gingivitis and this occurs when plaque is allowed to build up on the teeth. The excess plaque releases toxins that irritate the gums causing them to redden, become puffy or swollen, tender and often bleeding. 

The bacteria released can also weaken tooth enamel. Removing excess plaque with proper brushing and flossing (particularly along the gumline) is vital in preventing plaque build-up as are regular cleaning sessions with a dentist.

Gingivitis will occur in around 75% of the American population during a lifetime and many of these will go on to develop periodontitis simply because of a failure to address the problem in the early stages. 

For these people tooth loss is almost inevitable and many will require dental implants, crowns, bridges and dentures to solve problems that could have been easily avoided in the first place.

Prevention

The key to preventing gum disease is to take action before the condition has a chance to take hold and this means preventing gingivitis. Proper brushing, flossing and the use of antibacterial mouthwash are key factors in maintaining good dental health. There is also a number of Do’s and Don’ts that are of tremendous benefit:

• Avoid (or quit) smoking cigarettes or using any tobacco products. Smokers are almost seven times more prone to periodontitis than non-smokers.
• Floss regularly and properly.
• Use toothpastes specifically designed to tackle plaque and tartar build-up.
• Follow a balanced and healthy diet.
• Strictly limit sugary, sweet and savoury snacks as well as carbonated drinks.
• Replace toothbrushes every three months or when showing signs of wear.
• Rinse the mouth with water about thirty minutes after meals to remove food particles.

Other factors that may impact on dental health include stress, hormonal changes (pregnancy, menopause, puberty etc.), chronic diseases and medications. Any of these should be discussed with the dentist who can make recommendations to help overcome any associated problems.

There are a range of anti-gingivitis toothpastes and mouthwashes widely available and these work by neutralizing the bacteria along the gum line. Many of these are proven to lead to healthier gums and the dentist will be able to recommend which to use and which to avoid.

Advanced Stage

Gingivitis does not progress to periodontitis overnight but over time. This can be weeks, months or years, but the symptoms may appear at any stage. While gingivitis with the accompanying swollen, sore or bleeding gums may be (foolishly) regarded as nothing more than an inconvenience, the symptoms of periodontitis are far more noticeable and serious.

Symptoms include:

• Receded gums
• Pockets (holes) between the teeth and gums
• Difficulty or pain chewing
• Tooth sensitivity
• Tooth misalignment
• Bad breath (halitosis)
• Sores in the mouth and inner cheeks

As if these issues weren’t bad enough, periodontitis can also destroy tissue, ligaments and bone leading to serious dental and physical problems. Matters should never be allowed to reach this advanced stage and taking preventive action at the first indication of possible trouble is far wiser than adopting a wait and see approach.

Treatment Options

Preventing periodontitis is far preferable to having treatment for the condition. The type of treatment will depend upon the severity of the problem and how much damage has been done. Among the treatment options available are:

• Scaling and Root Planning. This involves scraping tartar off the teeth below and above the gum before smoothing (planning) rough surfaces on the roots where bacteria tends to gather.
• Flap Surgery. When inflamed gums and pockets persist after deep cleaning, a periodontist may opt to carry out flap surgery. This is a common procedure where the open pockets are stitched closed and the gum tissue is once again close to the teeth.
• Grafts. In the most severe cases where tissue and bone have been damaged it may be necessary to undergo a bone or tissue graft to replace damaged or infected areas.

In less severe cases it may be possible to treat advanced periodontal disease without the need for surgery. 

These treatments usually involve the placement of antibiotic pills or antimicrobial chips in the pockets. These then release antibiotics or antimicrobial substances into the affected areas over a period of time to kill bacteria and harmful microbes and reduce the risks of further infections.

Last Resort

Any form of surgery, dental or otherwise, is best avoided whenever possible and only used as a last resort when no other viable options exist. Dental surgery, though safe and painless, should be avoided if possible and this is best done by taking the best care possible while the teeth and gums are still healthy.

Maintaining good oral hygiene, in tandem with regular check-ups, will reduce the risk of developing gingivitis and more serious issues further down the line. Following a simple dental routine and maintaining good hygiene is easy to do and far preferable to the unwanted and unpleasant consequences of neglect!