What is Periodontitis?
Your teeth are supported by your jaw bones and by ligaments connecting your teeth to the jaw bones. Your gums then lie on top of the jaw bones.
The area of jaw bone supporting each tooth along with the ligaments are termed the Periodontium . Inflammation and break down of this area is called periodontitis or periodontal disease.
The area of jaw bone supporting each tooth along with the ligaments are termed the Periodontium . Inflammation and break down of this area is called periodontitis or periodontal disease.
Periodontal disease - signs and symptoms
The inflammation of this Periodontium is reversible but the damage done by the inflammation is not reversible and so can be catastrophic to your teeth and can cause early loss of teeth. Signs and symptoms are:
1. Bleeding gums as often a later stage of gingivitis
2. In smokers, the gums may not bleed which can mask the severity of the condition
3. Sore gums or painful gums
4. Gum recession (receding gums) due to erosion of the underlying supporting tissues
5. Sensitive teeth as a result of the gum recession (receding gums)
6. Possible food trapping
7. Possible abscesses in the gums.
8. Black spaces appearing between your teeth (black triangles)
9. Bad breath/halitosis
10. Loose teeth
11. Drifting and Spreading out of teeth where they have lost their support
2. In smokers, the gums may not bleed which can mask the severity of the condition
3. Sore gums or painful gums
4. Gum recession (receding gums) due to erosion of the underlying supporting tissues
5. Sensitive teeth as a result of the gum recession (receding gums)
6. Possible food trapping
7. Possible abscesses in the gums.
8. Black spaces appearing between your teeth (black triangles)
9. Bad breath/halitosis
10. Loose teeth
11. Drifting and Spreading out of teeth where they have lost their support
Types of Periodontitis?
Chronic
This can be generalised or localised which means: around the whole mouth or around certain teeth in the mouth. Chronic simply means ongoing and over a longer period of time, this may occur over an entire lifetime or a number of decades leading to eventual tooth loss
Aggressive
This again can be generalised or localised as above but is much more rapidly progressive than chronic periodontitis and often does not respond well to normal treatments. This is less common but much more difficult to treat and prevent. This can cause very early tooth loss
Risk factors for Periodontitis
- Genetics - some people are at increased risk of periodontitis despite good oral hygiene but it is definitely worsened if combined with poor oral hygiene.
- Gingivitis - as is often predisposing to periodontitis
- Poor oral health habits - poor oral hygiene leading to chronic periodontitis
- Tobacco use
- Diabetes - poor blood sugar control linked directly to poor gum condition
- Compromised immune system such as in the elderly, infirm or HIV sufferers.
- Poor nutrition
- A few medications including antidepressants and anti-epileptic drugs.
- Hormonal changes
- Poor-fitting crowns, bridges and fillings
- Unusual bite problems or tooth grinding/clenching problems
Periodontitis Treatment
- Oral hygiene advice, scaling and polishing - Your dentist or hygienist can teach you the best way to remove all the plaque off your teeth by brushing. They may need to scale any hardened plaque off your teeth to make them easier for you to clean yourself.
- Removal of ledges and replacement of poor fitting crowns and bridges - this again is to enable you to clean your teeth as easily as possible and remove any areas where food may get trapped and the gums may become unnecessarily inflamed.
- Deep cleaning (Root surface debridement) - This is where the gum pocketing around your teeth is cleaned out to remove and/or disturb bacteria within the gums that are causing the periodontitis. This is essential to halt the disease process but it is futile/pointless if the teeth are not then kept clean afterwards to prevent return of the periodontal disease. This will often require use of local anaesthetic (numbing) in order to make sure it is not painful
- Antibiotics - In the case of periodontal abscesses or gum pockets that consistently do not respond to conventional treatment then antibiotics can be given in various forms to help tackle the periodontal disease.
Periodontal Surgery
- If your periodontal disease does not respond to repeated conventional treatment despite good oral hygiene and good root surface debridement then you may need surgical treatment.
- This is usually carried out by a specialist periodontist and will involve lifting your gum to clean directly beneath it before suturing it back into place.
- A periodontist can also reposition your gums where they have receded, graft bone into areas of lost bone and a number of other procedures to help treat or overcome periodontal disease and early tooth loss.
Periodontitis - Summary
- Brush your teeth effectively at least twice a day, if your dentist recommends and electric toothbrush do not delay in buying one
- See your dentist regularly and if they suggest seeing the hygienist then make sure you make the appointment and turn up!
- Floss daily or use inter-dental brushes/floss sticks to ensure good cleaning between your teeth
- Use a mouthwash to supplement brushing your teeth. If you have bleeding gums use Corsodyl mouthwash at a different time to toothbrushing
- Limit the risk factors that are within your control; namely: Smoking, Oral hygiene, Nutrition, attending the dentist and hygienist when requested, good blood sugar control in diabetics, not leaving things like deficient crowns and fillings that you are aware of needing replacement.
We Hope you found this information useful and are now informed on Periodontal Disease. If you still have any questions please do not hesitate to ask our dentists below: