Periodontitis
Periodontitis is a serious gum infection that damages the soft tissue and, without treatment, can destroy the bone that supports your teeth. It can cause teeth to loosen or lead to tooth loss. Periodontitis is common but largely preventable. It’s usually the result of poor oral hygiene. Regular brushing at least twice a day, flossing daily, and getting regular dental checkups can greatly improve your chances of successful treatment for periodontitis and can also reduce your chance of developing it.
Causes of Periodontitis
Periodontitis begins with plaque, a sticky film composed mainly of bacteria. If not treated, here’s how plaque can eventually advance to periodontitis:
- Plaque forms on your teeth: When starches and sugars in food interact with bacteria normally found in your mouth, plaque forms on your teeth. Brushing your teeth twice a day and flossing once a day removes plaque, but plaque re-forms quickly.
- Plaque can harden under your gumline into tartar (calculus): Tartar is more difficult to remove and is filled with bacteria. The longer plaque and tartar remain on your teeth, the more damage they can do. You can’t get rid of tartar by brushing and flossing — you need a professional dental cleaning to remove it.
- Gingivitis: The longer plaque and tartar remain on your teeth, the more they irritate the gingiva, the part of your gum around the base of your teeth. In time, your gums become swollen and bleed easily. This is known as gingivitis, the mildest form of gum disease.
- Ongoing inflammation: Eventually, gingivitis can advance to periodontitis, causing pockets to develop between your gums and teeth that fill with plaque, tartar, and bacteria. Over time, these pockets become deeper, filling with more bacteria. If not treated, these deep infections cause loss of tissue and bone, and ultimately you may lose one or more teeth. Chronic inflammation can also put a strain on your immune system.
Symptoms of Periodontitis
Healthy gums are firm and pale pink and fit snugly around teeth. Signs and symptoms of periodontitis can include:
- Swollen or puffy gums
- Bright red, dusky red, or purplish gums
- Gums that feel tender when touched
- Gums that bleed easily
- Gums that pull away from your teeth (recede), making your teeth look longer than normal
- New spaces developing between your teeth
- Pus between your teeth and gums
- Bad breath
- Loose teeth or loss of teeth
- Painful chewing
- A change in the way your teeth fit together when you bite
Treatment of Periodontitis
Treatment may be performed by a periodontist, a dentist, or a dental hygienist. The goal of periodontitis treatment is to thoroughly clean the pockets around teeth and prevent damage to surrounding bone. Treatment may be successful if you maintain a daily routine of good oral care. Options include:
Non-surgical Treatments
- Scaling: Scaling removes tartar and bacteria from your tooth surfaces and beneath your gums. It may be performed using instruments, a laser, or an ultrasonic device.
- Root planing: Root planing smooths the root surfaces, discouraging further buildup of tartar and bacteria, and removes bacterial byproducts that contribute to inflammation and delay healing or reattachment of the gum to the tooth surfaces.
- Antibiotics: Topical or oral antibiotics can help control bacterial infection. Topical antibiotics can include antibiotic mouth rinses or insertion of gels containing antibiotics in the space between your teeth and gums or into pockets after deep cleaning. However, oral antibiotics may be necessary to completely eliminate infection-causing bacteria.
Surgical Treatments
- Flap surgery (pocket reduction surgery): Your periodontist makes tiny incisions in your gum so that a section of gum tissue can be lifted back, exposing the roots for more effective scaling and root planing.
- Soft tissue grafts: When you lose gum tissue, your gumline recedes. You may need to have some of the damaged soft tissue reinforced. This is usually done by removing a small amount of tissue from the roof of your mouth (palate) or another donor source and attaching it to the affected site.
- Bone grafting: This procedure is performed when periodontitis has destroyed the bone surrounding your tooth root. The graft may be composed of small fragments of your own bone, or the bone may be synthetic or donated. The bone graft helps prevent tooth loss by holding your tooth in place. It also serves as a platform for the regrowth of natural bone.
For those seeking relief from dry mouth symptoms associated with periodontitis, consider using Biotene Oral Balance Gel.
Prevention of Periodontitis
The best way to prevent periodontitis is to follow a program of good oral hygiene, one that you begin early and practice consistently throughout life. This means brushing your teeth for two minutes at least twice a day — in the morning and before going to bed — and flossing at least once a day. Flossing before you brush allows you to clean away the loosened food particles and bacteria. Regular dental visits are also important. See your dentist or dental hygienist regularly for cleanings, usually every six to 12 months. If you have risk factors that increase your chance of developing periodontitis — such as having dry mouth, taking certain medications, or smoking — you may need professional cleaning more often.
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