In the USA, 1 in 2 adults (or 65 million people) suffer from gum disease. The word periodontal literally means “around the tooth” (One more medical word of Greek origin). Periodontal disease is a chronic inflammatory disease that affects the gums and bone supporting the teeth. Periodontal disease can affect one tooth or many teeth. It begins when the bacteria in plaque (the sticky, colorless film that constantly forms on your teeth) causes the gums to become inflamed.
Gum disease is often silent, meaning symptoms may not appear until an advanced stage of the disease
However, warning signs of gum disease include the following:
- Red, swollen or tender gums or other pain in your mouth
- Bleeding while brushing, flossing, or eating hard food
- Gums that are receding or pulling away from the teeth, causing the teeth to look longer than before
- Loose or separating teeth
- Pus between your gums and teeth
- Sores in your mouth
- Persistent bad breath
- A change in the way your teeth fit together when you bite
- A change in the fit of partial dentures
- Millions of people don’t know they have this serious infection that can lead to tooth loss if not treated
Several distinct forms of periodontal disease with varying levels of severity are known
Gingivitis is the mildest form of periodontal disease. It causes the gums to become red, swollen, and bleed easily. There is usually little or no discomfort at this stage. Gingivitis is often caused by inadequate oral hygiene. Gingivitis is reversible with professional treatment and good oral home care.
Factors that may contribute to gingivitis include, diabetes, smoking, aging, genetic predisposition, systemic diseases and conditions, stress, inadequate nutrition, puberty, hormonal fluctuations, pregnancy, substance abuse, HIV infection, and certain medication use.
Untreated gingivitis can advance to periodontitis
With time, plaque can spread and grow below the gum line. Toxins produced by the bacteria in plaque irritate the gums.
The toxins stimulate a chronic inflammatory response in which the body in essence turns on itself, and the tissues and bone that support the teeth are broken down and destroyed. Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. Often, this destructive process has very mild symptoms. Eventually, teeth can become loose and may have to be removed.
There are many forms of periodontitis. The most common ones include aggressive, chronic and necrotizing
- Aggressive periodontitis occurs in patients who are otherwise clinically healthy. Common features include rapid attachment loss and bone destruction and familial aggregation.
- Chronic periodontitis results in inflammation within the supporting tissues of the teeth, progressive attachment and bone loss. This is the most frequently occurring form of periodontitis. It is prevalent in adults, but can occur at any age. Progression of attachment loss usually occurs slowly, but periods of rapid progression can occur.
- Periodontitis as a manifestation of systemic diseases often begins at a young age. Necrotizing periodontal disease is an infection most commonly observed in individuals with systemic conditions such as HIV infection, malnutrition and immunosuppression.
Untreated gingivitis can advance to periodontitis and can eventually lead to tooth loss and other health problems
Smoking negatively affects the progression of periodontal disease
Smoking is also known to have an additive effect on the progression of periodontal disease and be detrimental to healing after treatment. Research has also shown, that there is an association between periodontal disease and other chronic inflammatory conditions, such as diabetes, cardiovascular disease,osteoporosis and respiratory diseases.
Therefore, it is very important to treat the inflammation that causes periodontal disease as soon as possible to ensure that your entire body stays healthy.
There are both non-surgical and surgical treatments for periodontitis, depending on its severity
Nonsurgical treatments can stabilize the condition of your gums but they cannot restore them to their previous condition.
The nonsurgical treatments include:
• Scaling: This is usually done in a standard professional teeth cleaning.
• Root planing: Smoothing the root surfaces to discourage further buildup of tartar and bacterial toxins.
• Antibiotics: May include topical antibiotics like mouth rinses and gels, or oral antibiotics.
The surgical treatments include Flap surgery, Tissue and Bone grafting and guided tissue regeneration. These techniques aim at reinforcing and promoting regrowth of the bone and tissue around the teeth
Ahead of any cosmetic makeover, we always recommend to my patients a comprehensive treatment of their gums. It might be a simple teeth cleaning or a periodontal treatment. This is absolutely essential in order to provide the strong and healthy ground on which we will build a beautiful smile.