The word “periodontitis” comes from “periodontium”, which means “surrounding (peri) the tooth (odont)”. Periodontium includes all the components that hold the tooth in the jawbone: the gum (gingiva), the bone, and the Cementum – the anchoring structure on the surface of the root. The periodontium surrounds the entire root.
Periodontitis is a serious gum disease that causes severe gum infection and damages the soft tissue. Around 40 percent of people suffer from periodontitis. Among adults, it is estimated that around 70% of tooth loss is caused by periodontitis. If periodontitis is left untreated, it can destroy the bone that supports your teeth. Periodontitis can cause teeth to loosen or lead to tooth loss. It can also lead to other health problems.
Although Periodontitis is extremely common it can be largely prevented if gum disease is diagnosed at early stages. It's usually the result of poor oral hygiene. 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.
Periodontitis can then lead to problems with speaking, chewing food, as well as causing aesthetic damage to your smile.
What are the stages of gum diseases?
Have you been noticing blood in the sink every morning after brushing? Or notice blood on that Apple bite? That bleeding can be one of the first warning signs of gum disease. As mentioned at the onset, when the disease is mild, it is called gingivitis and only the gums are infected. If this is left untreated, the infection will travel below the gum line and into the bone, causing a more serious form of gum disease called periodontitis.
Both these oral health issues – gingivitis and periodontitis – not only affect dental health but have also shown to carry other health risks – like diabetes, heart disease, osteoporosis, pneumonia, and cancer.
The progression of gum disease isn't an overnight process. It happens in 2 stages.
How the Periodontal pocket is formed?
Dental plaque or bacteria grows and accumulates on the tooth and within the mouth. These bacteria use food particles and saliva to grow and multiply. The gums then start bleeding and swelling occurs which is known as gingivitis.
In order to get rid of the bacteria, the body produces chemicals to attack the bacteria which in turn harms or destroys the bone and ligaments holding the teeth in place. This causes loosening of the tooth and thereby forming a pocket. Over a period of time, these pockets get deeper, providing a larger space for bacteria to live. These deep pockets result in major bone and tissue loss, eventually leading to the extraction of the tooth.
A pocket depth varying from 1mm-3mm indicates gingivitis – an early stage of gum disease. Depth of 4mm-5mm indicates mild periodontitis infection, depth of 6mm-7mm indicates moderate periodontitis infection and 8mm and above indicate severe periodontitis infection causing a higher risk of permanent damage.
1. Gingivitis (Gum level infection)
Periodontitis begins with gingivitis – inflammation of the gums. This is the body's response to bacteria that has been accumulated on the teeth. The symptoms usually involve red, swollen gums and bleeding especially while brushing or biting on food. Unlike periodontitis , Gingivitis is an inflammation that is limited to the gum line, there is not yet any loss of the structures that hold teeth in place; while in periodontitis there is loss of the jawbone, periodontal ligament, and root cementum.
2. Periodontitis (Bone level infection)
Gingivitis, if not treated in time, can turn into periodontitis,
Treating periodontitis and advanced levels of periodontitis requires more than good oral hygiene at home. It needs professional care from a dentist or periodontist.
One of the first signs is bleeding gums. The gums may look red and swollen and you might notice a discoloured layer of bacterial plaque on the teeth. If not removed through proper cleaning of the teeth, this plaque will turn into hard deposits known as calculus or tartar, which cannot be removed by a toothbrush and you need a dentists.
Here are some obvious signs and symptoms of developing periodontitis –
Periodontitis starts with a plaque and tartar buildup. Our mouth is home to 700 different species of bacteria, most of which are harmless. But when we do not clean our teeth well enough, bacterial deposits build up next to the gums, forming a “plaque” – which creates favourable conditions for more dangerous bacteria to flourish. When this happens, natural defences of the body are also compromised too. Plaque forms on your teeth when starches and sugars in food interact with bacteria normally found in your mouth. When plaque hardens under the gumline it turns into tartar which is filled with bacteria and the longer plaque and tartar remains on your teeth, the more damage it can cause.
Additionally, ongoing gum inflammation can cause periodontitis.
There are several factors that increase your chance of developing periodontitis. Here are some of the many –
Smokers are much more likely to develop periodontitis than non-smokers.. In smokers, gum bleeding may be less noticeable. This is because of the effect of nicotine on blood vessels, which means that the progress of the disease may be hidden. However, a dentist can detect signs of the disease much earlier, during a routine dental examination. Hence make sure to visit your dentist regularly, especially if you have been in the habit of smoking.
Smokers experience greater bone loss and are more likely to develop gum pockets that house a greater number of harmful bacteria. Quitting smoking is the best option.
The way our immune system reacts to harmful bacteria can differ from person to person because of genetic differences. Hence, genetics plays an important role in how fast gum disease progresses.
Older people have more severe cases of Periodontitis than younger ones. Although it might start young and you may fail to notice until you reach a certain age.
Periodontitis and diabetes have a two-way effect on each other. Those whose blood sugar is not well managed have a higher risk of developing periodontitis. Also, patients suffering from periodontitis have a higher risk of suffering diabetes.
An unhealthy diet especially high in processed foods and refined carbohydrates increases the tendency for gums to become inflamed. An unhealthy diet filled with sugar can also increase the risk of diabetes, which can further worsen periodontitis.
Mental and emotional stress can weaken the immune system and lower the resistance of the gums to harmful bacteria. People with a weakened immune system may be more susceptible to gum disease.
Are children at Risk of Periodontal Disease?
Children are more likely to have gingivitis, the mildest form of the disease. Children who don't brush their teeth after snacking and consuming fizzy drinks may develop gum disease. Sugar, starchy food like fries feed the acids that erode the tooth enamel.
An increase in hormonal levels during puberty can also make some teenagers more susceptible to gum disease. Some girls may notice bleeding gums before their menstrual cycle begins.
Gum diseases can be prevented at early stages by regularly maintaining your oral hygiene – By brushing and flossing regularly. Also, regular dental visits
Here are a few tips to maintain good oral hygiene:
Lastly, it is important to consult your dentist or dental hygienist on the techniques to use at home to keep gum healthy.
Consequences of Periodontal Disease –
In fact, did you know – periodontitis has been linked to more than 50 diseases and conditions, including Alzheimer's Disease, chronic kidney disease, rheumatoid arthritis, and certain types of cancer.
Also, about 70% of the tooth loss is because of advanced levels of Periodontal disease.
There are several stages involved in diagnosing periodontitis.
A clinical examination is the only way to assess the condition of the gums and the tooth-supporting structures.
An initial check-up will quickly determine whether you are suffering from gingivitis or periodontal disease. The dentist will use a periodontal probe and the depth of penetration at the gum line will be measured gently and precisely at various sites in the mouth. The probe measures the distance between the gum line and the end of the pocket. At healthy sites, the probing depth is 3mm or less, but where periodontitis is present, the depth is 4mm or more.
If the dentists suspects and diagnoses periodontitis, further tests will be conducted to confirm the diagnosis and start the treatment. A periodontal chart is used to precisely record the height of the jawbone.
After the clinical examination, an X-ray needs to be carried out to confirm the diagnosis.
Only two images – “bite-wing” images are needed, but more extensive cases may require a panoramic X-ray of the whole mouth or up to 14 additional X-rays. These X-ray images show the jawbone surrounding the tooth and make it possible to estimate and understand the severity of bone loss.
Microbiological tests examine specific harmful bacteria composition. The results of these tests can provide information that will enable the periodontist to provide appropriate care, treatment and avoid unnecessary surgery, if not required.
Cases of gingivitis and periodontitis can be classified using a classifying system. Cases of periodontitis are classified according to four stages and three grades. The stages describe the severity and extent of the disease, while the grades describe the likely rate of progression. By classifying cases of periodontitis in this way, dentists and periodontists can provide the appropriate form of treatment for each patient based on the severity.
Treatments are categorised into Surgical and Non-surgical. Typical non-surgical treatment for periodontal disease is scaling and root planing (SRP).
Scaling removes tartar and bacteria from tooth surfaces and from underneath the gums. It may be performed using instruments, a laser or an ultrasonic device. Root planing levels the root surfaces, and stops the further buildup of tartar and bacteria and kills bacterial byproducts that are known to contribute to inflammation and slow healing.
In the surgical method, there is the option of traditional practice of Flap surgery (pocket reduction surgery). In this the periodontist makes small incisions in the gum so that a section of gum tissue can be elevated back, exposing the roots for more effective scaling and root planing. Since periodontitis often causes bone loss, the underlying bone may be recontoured before the gum tissue is put back in place after suturing. This method can be more painful and hence people look for alternatives. One of the alternatives is the wavelength optimised Periodontal Therapy.
Wavelength optimised Periodontal Therapy is carried out in 4 simple steps:
At Dental Solutions, Bangalore, we have successfully treated patients having severe periodontitis with Wavelength optimised periodontal therapy.
We are proud to be among the few best dental clinics in Bangalore that offer laser dentistry along with other latest dental technologies.
The oral-hygiene phase of treatment is to reduce bacteria growth in the mouth and thereby reduce the level of inflammation. The dentists will explain the causes of your periodontitis and underlying concerns if any. They will provide clear instructions on how to keep your teeth and gums clean. You will be given advice on how to use different tools and techniques: for example, the various tooth-brushing techniques and the correct use of dental floss, and antiseptic mouthwashes.
You need to visit the dental clinic to conduct a professional cleaning. In this setting, all bacterial deposits are removed from accessible areas of the teeth, and the teeth are treated with fluoride and polished. If required, the dentist will also remove all bacterial deposits and tartar from the gum pockets or root surfaces.
If oral hygiene methods do not work in controlling the mild gum disease phase, antibiotics are administered.
Weeks after diagnosing gum disease, your dentist or periodontist will make a full assessment of your gums. They will use the periodontal probe to record the depth of any periodontal pockets, check for inflammation and bleeding of the gums. If periodontal pockets greater than 3mm are still present, further treatment options will be suggested as required, including corrective surgical therapy.
At Dental Solutions Bangalore, we use advanced technology to treat periodontal disease. If you have been suffering from gum disease for a long time, and not sure how to find the right solution – drop by at our – We have all the dental solutions for your oral health concerns