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Gum Disease

Periodontitis is a serious form of gum disease. It’s a bacterial infection that starts by inflaming the soft tissues around your teeth. Left untreated, it erodes the bone that supports your teeth, leading to mobility and tooth loss.

Who does periodontitis affect?

Periodontitis is fairly uncommon in people under age 30. It’s more likely to happen as you age. Still, it can affect anyone with poor oral hygiene — those who don’t brush their teeth and floss regularly. Some people are also more genetically prone to periodontitis than others. If your biological parents or grandparents have a history of gum disease, you’re more likely to develop it as well.

Symptoms

Healthy gums are firm to the touch and fit snugly around your teeth. In comparison, periodontitis symptoms include:

•             Reddish or purplish gums.

•             Swollen gums.

•             Gums that bleed easily.

•             Tender gums.

•             Bad breath.

•             Pus (infection) around your gum line.

•             Loose teeth.

•             Tooth loss.

•             Gum recession (when your gums pull away from your teeth).

•             Pain when chewing.

•             New gaps or spaces between your teeth.

•             Changes in the way your teeth fit together.

Causes

The main cause of periodontitis is poor oral hygiene. Bacteria cling to plaque and tartar on your teeth surfaces. If you don’t clean your teeth as well or as often as you should, bacteria travel down beneath your gum line, where your toothbrush and floss can’t reach. These harmful bacteria erode the tissues that support your teeth, leading to infection, bone loss and tooth loss.

Other factors can increase your risk of developing periodontitis, including:

Other risk factors for periodontitis

•             Smoking, the most significant factor, weakens your body’s ability to fight infection.

•             People with diabetes have a higher risk of developing infections, including periodontitis.

•             Your genetics and family history can put you at higher risk for gum disease.

•             Hormonal changes in women and people assigned female at birth, such as pregnancy or using birth control pills, can increase your chances of developing periodontitis.

•             Health conditions that cause inflammation in your body — such as arthritis, COVID-19 and cardiovascular disease — are linked to periodontitis.

What happens if periodontal disease goes untreated?

Periodontal disease progresses and becomes more problematic over time. There are four gum disease stages, including:

1.            Gingivitis: This is early-stage gum disease and it’s less severe than periodontitis. With gingivitis, your gums become red and swollen, but you haven’t started losing bone around your teeth yet. Gingivitis is reversible if you clean your teeth better and go to your dentist regularly for cleanings.

2.            Mild periodontitis: Left untreated, gingivitis turns into mild periodontitis. At this stage, your gums pull away from your teeth and you begin to lose some bone around them. As a result, you’ll develop periodontal pockets. Plaque, tartar and bacteria become trapped in these pockets, where your toothbrush and floss can’t reach.

3.            Moderate periodontitis: As periodontitis progresses, you lose even more bone around your teeth. Bacteria continue to erode the ligaments and soft tissues that support your teeth and keep them healthy. At this stage, your gums may become sore and tender.

4.            Severe periodontitis: When periodontitis remains untreated, the disease becomes more severe. As bone loss continues, your teeth may become loose and can potentially fall out. In addition to bleeding gums, there’s often pus and infection around your gum line, which can lead to chronic bad breath (halitosis).

In addition to poor oral health, periodontitis can result in poor overall health. Research highlights an important link between oral health and whole-body health. People with periodontitis have a higher risk of developing heart disease, stroke, dementia and other serious health issues.

How is periodontitis treated?

Gum disease treatment depends on the extent and severity of your condition. There are nonsurgical and surgical options for treating periodontitis.

Nonsurgical periodontitis treatments

Nonsurgical options often work well for people with mild to moderate periodontitis. These treatments include:

•             Antibiotics: Oral antibiotics may be prescribed to fight infection. Or they may place a topical antibiotic underneath your gums to target the affected area.

•             Scaling and root planing: Also known as a deep dental cleaning, scaling and root planing are similar to a routine cleaning. The difference is that you’ll receive local anaesthesia to numb your gums. This allows your dentist or hygienist to sweep away bacteria deep beneath your gum line. They’ll also smooth your teeth roots to deter further plaque and bacteria from accumulating. Scaling and root planing is often done in two or more visits. It’s important that you see your periodontist a month after this cleaning to check your gums and see how well the treatment worked.

Surgical periodontitis treatments

If you have moderate to severe periodontitis, you’ll probably need surgical intervention. Surgical treatments include:

•             Flap surgery: During this procedure, a periodontist (gum specialist) makes an incision along your gum line and temporarily lifts your gum tissue away from your teeth. This allows them to see your teeth roots easily and clean them thoroughly. If infection caused bone loss, your periodontist may re-contour your underlying bone ridge. This makes the affected areas much easier to clean once healing takes place.

•             Dental bone grafts: If you have a lot of bone loss, a dentist or periodontist may recommend a bone graft. During this procedure, they’ll place bone-grafting material in the areas where you’ve lost bone tissue. (The material may be your own bone, donated bone or a synthetic material.) The graft serves as a scaffolding for new bone growth. The goal is to reduce your risk of future infection and tooth loss.

•             Gum grafts: Periodontitis can cause your gum tissue to pull away from your teeth. This is gum recession, and it exposes your teeth roots, making them appear longer. To replace lost tissue around your teeth, a dentist or periodontist may recommend a gum graft. During this surgery, they’ll place a tissue graft around the affected teeth and suture it into place. (They may obtain the tissue from the roof of your mouth or they may purchase it from a licensed bone and tissue bank.) Gum graft surgery covers exposed teeth roots, improves your smile’s appearance and reduces your risk for further recession.

•             Guided tissue regeneration: During this procedure, a dentist or periodontist places a special biocompatible membrane between existing bone and your tooth. This membrane keeps unwanted tissue from growing into the area, and encourages bone to grow back instead.

•             Platelet-rich plasma (PRP): If you’ve lost bone or gum tissue, PRP can help regenerate it. A dentist or periodontist obtains platelet-rich plasma from a sample of your own blood. After taking a blood sample, they’ll spin it in a centrifuge to separate your plasma from your red and white blood cells. Next, they’ll place the platelet-rich plasma in deficient areas to encourage new bone growth.

How can I reduce my risk for periodontitis?

The best way to prevent periodontitis is to have regular dental cleanings and practice good oral hygiene at home between visits. People who are prone to periodontitis may require more frequent cleanings than people without gum disease.

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