Periodontal Disease: Causes, Treatment, Prevention

Periodontal disease is a term that refers to the varying stages of infection of the soft tissues, or gums in the mouth.  It can be a mild form that is easily treatable at home or with some simple visits with your dentist. It could also be very severe, requiring possible surgery and prescription medications.  Luckily, it is also highly preventable with simple methods of dental hygiene.

What Gum Disease Is And How It Happens

Periodontitis and gum disease are two terms used interchangeably for the same condition, which is an infection of the gum tissue caused by bacteria in plaque buildup.  The bacteria release toxins that cause inflammation of the gums. If you have ever noticed tenderness of your gums when brushing your teeth, or bleeding along the gum lines during brushing, you may have a slight form of gum disease known as gingivitis.  In fact, there are different stages of gum disease, and these are:

  • Gingivitis
  • Periodontitis
  • Advanced Periodontitis

Gingivitis is a mild form of periodontal disease.  As mentioned previously, bleeding along the gums is a common symptom of gingivitis, as well as tenderness and redness of the gums.  Periodontitis is the next form of periodontal disease. This happens when the minor infection of gingivitis is not treated well and the infection moves below the gum line and down to the bone under the gums.  At this point the gums may develop “pockets” where the gums have receded from the teeth. Sensitivity to hot and cold can occur due to the recession of the gums. Bleeding and tenderness will still be present.  At this point you should see a professional to halt the disease, as when periodontal disease reaches this stage it can cause more damage to your health beyond your mouth. According to WebMD, “Both gingivitis and periodontitis have been shown to raise your risk of things like diabetes, heart disease, osteoporosis, pneumonia, and cancer. Early detection is your best bet.” The last and most serious stage of gum disease is known as advanced periodontitis.  During this stage, teeth can move or even be lost due to jaw bone degradation, surgery will often be necessary to save the teeth and stop bone loss.

Treatments For Symptoms and Stages of Periodontal Disease

Periodontal DiseaseFor  gingivitis, the first stage of periodontal disease, the treatment is fairly simple and straightforward.  Often a thorough cleaning by your dentist or hygienist and then consistent brushing, flossing, and rinsing at home will be adequate to combat the infection.  Often, an extra dental cleaning or two a year may be necessary, requiring 3 or 4 visits to the dental office a year instead of two. This is a small price to pay for a healthy infection free mouth.  This treatment would simply be followed up with careful attention to regular brushing and flossing habits and regular dental visits. For the periodontitis and advanced periodontitis, treatment is usually referred to a periodontist, a dentist who specializes in treating periodontal disease.  Two treatments commonly performed are:

  • Root Planing
  • Scaling

Scaling is the term used for a “deep cleaning” a periodontist does for periodontitis.  It is similar to the removal of plaque and tartar during a normal dental cleaning, except that the cleaning extends below the gum line and deep into the “pockets” below the teeth.  This can be uncomfortable or painful and usually requires a local anesthetic. Root Planing goes a bit further. During the “planing”, the periodontist uses a special tool that “smoothes” off the surface of the tooth below the gumline to create a smooth surface for the gums to easily re-attach to after the infection has been treated.  This could involve removing some of the dentine ( bone tissue of the tooth) and cementum (tissue covering the root of the tooth). After this, it is possible that your periodontist could administer some type of medication either applied to the mouth tissues, or in pill form. According to WebMD, these are possibilities:

Antiseptic chip or antibiotic microspheres: You insert these tiny gels or particles into pockets in your gum, and they release medication slowly over time to help reduce the size of the pocket and get rid of bacteria.

Antibiotic gel: You spread this on gum pockets after a deep cleaning to help control infection.

Enzyme suppressant: You take this tablet after a deep cleaning to block certain enzymes in your mouth from breaking down gum tissue.

Oral antibiotics: For more serious infections, you can swallow these capsules or tablets.”

Depending on the severity of the infection, or the damage done, further treatment, including surgery may be necessary.  A gingivectomy may be performed to actually remove badly infected soft tissue (gum tissue) in the mouth. After this, a graft surgery could be performed to graft soft tissue from the palate to areas where the gums were removed by gingivectomy, or to cover exposed roots due to gum recession.  This is done to protect the exposed teeth from decay and further gum and bone loss. Also performed is the “flap surgery” where the gum tissue is pulled up and away from teeth to allow the periodontist to clean all tooth surfaces. The gums are then stitched back into place tight over the tooth surfaces to keep buildup from forming below the gumline.  These are serious procedures for serious infections. So whenever it is possible, preventative measures should be taken to keep procedures such as these from ever needing to be done.

Prevention Of Periodontal Infection

Periodontal DiseaseMost cases of gum disease can be prevented with basic dental care.  Brush your teeth at least twice a day for 2 minutes. Be sure to brush all surfaces of the teeth and also at the gum line.  Do not ever skip flossing, as it often can reach particles below the gum lines and between teeth that a toothbrush cannot reach.  Visit your dentist regularly, every six months is optimal, but at the least, once a year for a professional cleaning. Also, a good mouth rinse after brushing can also help control bacteria in the mouth.  These simple steps can prevent most gum infections. Further prevention can include minimizing or eliminating risks to gingival health including quitting smoking. Smokers are up to seven times more likely to develop periodontal disease.  People under stress suffer from lowered immunity to gum disease as well. Alleviating stress can lessen your risk of gum disease. Teeth clenching and grinding can weaken gum tissue, making it easier for bacteria to get below the gumline. Maintaining a healthy diet with plenty of vitamins and antioxidants can help your body to fight off infection as well as healing damaged tissue more efficiently, so try to eat well for optimal gum health!  

Now that you know the causes and risks involved with periodontal disease, and also the best treatments and preventative tools, you can monitor your teeth and gums for possible signs of gum disease and practice healthy prevention!

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