Dr. Matthew Harrison

Periodontal disease, also known as gum disease, is comprised of two separate words: perio which means around and dontal, meaning teeth. Periodontal disease is an infection of the gum that surrounds the teeth. Periodontal disease is a progressive condition that can destroy soft tissue rapidly.The leading cause of gum disease or periodontal disease is poor oral hygiene. The early stage of periodontal disease is referred to as gingivitis, while the severe stage is often called periodontists. A Periodontitis is a medical professional who helps prevent or treat periodontal disease.

Gingivitis

Gingivitis is a mild inflammation/irritation of the gum (the flesh around the teeth also referred gingiva) as a result of an excess of plaque (accumulation of bacteria on teeth) in the mouth. Gingivitis is the earliest and mildest of all periodontal diseases, and it is commonly found in teenagers. It could be acute/short-lived or chronic/prolonged; its symptoms are redness of the gum margins, swelling of the gums, and bleeding when brushing. Unlike
periodontitis, signs of gingivitis are not always visible. Gingivitis does not require surgical treatment but can be contained or cured through an active practice of personal oral hygiene.

Periodontitis

Periodontitis, unlike gingivitis, is not common in teenagers but adults. Periodontitis is the advanced stage of gingivitis. It affects not only the gums but also the bones and supporting tissues of the mouth. It starts by pulling the gum tissues away from the teeth, then forms pockets in the spaces between the tooth and gums. Over time this could lead to chronic periodontal destruction and further loss of the teeth.

Gingivitis may not cause pain and can progress to periodontitis without one’s knowledge and cause the gums to worsens until there is tooth loss. Although the damage caused by periodontitis seems beyond cure, it can be prevented.

Possible symptoms of periodontitis include re-occurrence of swollen or bleeding gums; pain when chewing; poor teeth alignment; pockets between the teeth and gums, sores in the mouth; sensitive teeth; bad breath; and persistent metallic taste. Periodontitis could be chronic, aggressive or necrotizing periodontitis.

Chronic Periodontitis

Chronic periodontitis is the most common type of this gum disease and is characterized by receding gums and the formation of pockets between the gums and the teeth. Chronic periodontitis occurs more often in adults; a majority of individuals with this condition are older than 35 years.

Aggressive Periodontitis

Aggressive periodontitis is present in both children and adults but rare in children. By age 20, individuals with unusually aggressive gum disease can lose teeth.

Necrotizing Periodontitis

Necrotizing periodontitis, also referred to as acute necrotizing ulcerative gingivitis, can damage tissues, ligaments, and bones in the mouth. Necrotizing periodontitis is most common in smokers, malnourished people, or people with immune deficiency, such as HIV/AIDS.

Genetics play a vital role in determining the risk for periodontitis as it is believed that genetics could explain why some patients with good plaque control have advanced periodontitis, while some with poor oral hygiene are free from the gum diseases. Some people are naturally more susceptible to periodontal disease because of their heredity. If any of your relatives have had periodontal disease, you may be at increased risk.

Other factors that can lead to periodontal disease or more severe illness include:

Smoking

Smoking makes periodontal disease resistant to treatment, and the more you smoke, the higher the risk. Smoking and tobacco use increase the risk of periodontal disease as tobacco leads to the acquisition of more tartar on the teeth, creates more pockets which can eventually leads to bone loss. By quitting the use of tobacco you can greatly decrease the chances of having periodontitis.

Misaligned or Crowded Teeth, Braces or Bridgework

These factors make brushing and flossing of teeth difficult. It can lead to aiding plaque and tartar formation around gingival (the gum) line, thereby increasing the chance of developing periodontal disease. There are special tools and ways of threading floss to clean around bridgework or slide under braces. If overcrowded or crooked teeth are a problem, consulting a dentist is highly recommended.

Teeth Clenching

Teeth clenching is the excessive force exerted on the teeth and tends to speed up the breakdown of the periodontal ligament and bone. Putting an end to the habit of teeth clenching is the only solution to decrease the risk of periodontitis. To do this start by taking note of periods when you clench your teeth then focus on relaxing.

Stress

Stress is another factor that can worsen periodontal diseases or even make its treatment complex. Stress weakens the body’s general immune system, which makes it harder for your body to fight off infections of any kind.

Diseases

Conditions or diseases such as diabetes, tend to be more frequent in people with periodontitis. Other conditions, such as leukemia, inflammatory bowel disease, and HIV infection, also can increase the risk. Any of the above mention diseases can make treatment of periodontal disease more difficult, but with the help of a dentist (a periodontist to be precise) gum disease is controllable.

Medications

Medications of different types can lead to xerostomia (dry mouth), including antidepressants, diuretics, and high blood pressure. Without the protection of adequate amounts of saliva, the plaque is more likely to form. Some of these medications include phenytoin (Dilantin and other brand names), used to control seizures; cyclosporine (Neoral, Sandimmune), used to suppress the immune system; and nifedipine (Adalat, Cardizem, and others) and other calcium channel blockers used to treat angina or heart arrhythmias.

Poor Nutrition

Poor diet is also a very vital factor in the development of periodontal diseases. Diet is essential for overall good health and a functioning immune system.

Prevention

Research has been able to point at increases in other diseases as a result of gum diseases. Some of the disorders are:

More ways to prevent gum/periodontal diseases are:

  1. To brush your teeth and gums a minimum of twice a day with fluoridated toothpaste
  2. To eat a healthily well-balanced diet to include fresh fruit and vegetables; lean meat, fish and whole-grains
  3. To refrain from saturated fats in diets
  4. To reduce the rate of foods containing sugar
  5. To drink plenty of fluoridated tap water.

Periodontitis could require surgery if it becomes severe. Periodontal surgery may be needed to stop progressive bone loss and regenerate lost bone. Surgical treatments for gum diseases focus on pocket reduction, bone grafts, and tissue regeneration. Regular dental checkups and a good oral hygiene routine are keys to successful treatment of gum disease.

Non-surgical treatments of gum diseases focus on antibiotics and a non-surgical deep-cleaning procedure called tooth scaling and root planing. These deep-cleaning techniques remove tartar and plaque from underneath the gum line. Doxycycline may be given to support the primary therapy of scaling. To avoid killing beneficial oral microbes, only small doses of doxycycline (20 mg) is used.

A home remedy for gum disease includes injecting antimicrobial solutions like hydrogen peroxide in pockets using slender applicators or oral irrigators. This process disrupts anaerobic microorganism colonies and is effective at reducing infections and inflammation when used daily. Meanwhile, some other products are serving the same purpose as hydrogen peroxide; but can be very costly.

When experiencing the symptoms of gum disease (gingivitis or periodontitis), you should visit the dentists to increase the chance of preventing the disease.

Dentists and dental hygienists measure periodontal disease using a periodontal probe, a measuring stick gently placed into the space between the gums and the teeth and slipped below the gumline. If the periodontal probe can slide more than 3mm below the gumline, then that patient has a gingival pocket.