Gum Diseases Beyond Gingivitis: Understanding Periodontitis

 

Gum Diseases Beyond Gingivitis: Understanding Periodontitis

Periodontitis is a serious gum infection that damages the soft tissue and destroys the bone that supports your teeth. Without treatment, periodontitis can lead to tooth loss and has been linked to systemic health issues. Here’s an in-depth look at periodontitis, its causes, symptoms, diagnosis, treatment, and prevention.

Understanding Periodontitis

Causes

Periodontitis begins with plaque—a sticky, colorless film composed primarily of bacteria. When not properly removed through brushing and flossing, plaque hardens into tartar (calculus) that brushing cannot clean. The presence of tartar and ongoing inflammation can lead to:

• Gingivitis: The mildest form of gum disease, causing inflammation and bleeding of the gums. If untreated, it can progress to periodontitis.
• Advanced Inflammation: Continued irritation and inflammation cause the gums to separate from the teeth, forming pockets that become infected. As the immune system fights the bacteria, the bone and connective tissue that hold the teeth in place break down.

Risk Factors

• Poor Oral Hygiene: Inadequate brushing and flossing allow plaque to form and remain on the teeth.
• Smoking and Tobacco Use: Significantly increases the risk of periodontitis.
• Genetic Predisposition: A family history of gum disease can increase susceptibility.
• Diabetes: Poor blood sugar control can exacerbate gum infections.
• Hormonal Changes: Such as those related to pregnancy, menopause, or birth control use.
• Other Illnesses: Diseases that affect the immune system, like HIV/AIDS.
• Medications: Certain drugs that reduce saliva flow can increase the risk of gum disease.

Symptoms

Common signs and symptoms of periodontitis include:

• Swollen, Red Gums: Gums that are puffy or purplish.
• Bleeding Gums: Especially when brushing or flossing.
• Persistent Bad Breath: Caused by bacterial build-up.
• Receding Gums: Gums pulling away from the teeth, making teeth appear longer.
• Pus Between Teeth and Gums: Indicates infection.
• Loose or Shifting Teeth: Loss of bone support leads to tooth mobility.
• Painful Chewing: Discomfort while eating.

Diagnosis

A periodontist or dentist diagnoses periodontitis through:

• Medical History Review: Understanding risk factors and symptoms.
• Oral Examination: Checking for plaque, tartar, and signs of gum disease.
• Pocket Depth Measurement: Using a periodontal probe to measure the depth of the pockets around teeth.
• Dental X-rays: Assessing bone loss and the extent of infection.

Treatment

The goal of periodontitis treatment is to clean the pockets around teeth and prevent bone damage. Treatment options include:

Non-Surgical Treatments

• Scaling and Root Planing: Deep cleaning to remove plaque and tartar from above and below the gum line and smooth rough spots on the roots to remove bacteria.
• Antibiotics: Topical or oral antibiotics to control bacterial infection.

Surgical Treatments

• Flap Surgery (Pocket Reduction Surgery): Lifting back the gums to remove tartar and then securing the gum tissue back in place.
• Bone Grafts: Using fragments of your own bone, synthetic bone, or donated bone to replace bone destroyed by periodontitis.
• Soft Tissue Grafts: Reinforcing thin or receded gums by grafting tissue from the roof of the mouth or another source.
• Guided Tissue Regeneration: Placing a special piece of biocompatible fabric between existing bone and tooth to allow bone to regrow.
• Bone Surgery: Smoothing shallow craters in the bone due to moderate to advanced bone loss.

Prevention

Preventing periodontitis involves adopting good oral hygiene practices:

• Brush Twice Daily: Use fluoride toothpaste and brush for at least two minutes.
• Floss Daily: Remove plaque and food particles from between teeth.
• Regular Dental Visits: Schedule check-ups and cleanings at least twice a year.
• Avoid Tobacco: Quit smoking or using other forms of tobacco.
• Healthy Diet: Eat a balanced diet to support gum health.
• Manage Health Conditions: Control conditions like diabetes and seek regular medical care for immune system disorders.

Conclusion

Periodontitis is a serious condition that requires prompt and ongoing management to prevent tooth loss and other complications. Through proper oral hygiene, regular dental visits, and appropriate medical treatments, the progression of periodontitis can be controlled, allowing individuals to maintain healthy gums and teeth.