Periodontal (gum) disease, is a condition involving inflammation of the gums, and loss of supporting structures around a tooth.
If left untreated, periodontal disease will lead to tooth loss.
As opposed to other conditions in the mouth, periodontal disease can advance without any symptoms experienced by patients.
The main risk factors involved in periodontal disease are poor oral hygiene and smoking.
If the teeth are not regularly cleaned and monitored, plaque (collection of bacteria) builds up, leading to an increase in the toxins produced by the bacteria. This leads to inflammation. If not dealt with in time, the plaque will lead to loss of gum attachment to the tooth, and hence a space is created between the surface of the tooth and the gum, which is called a periodontal pocket. This in itself, will lead to more plaque migration down the pocket, which triggers more inflammation, hence causing gradual bone loss, and if left untreated, to tooth loss. This cascade of events is called periodontitis, which is irreversible.
Periodontal disease usually progresses with few obvious signs and symptoms. The following are the most common symptoms of periodontal diseases:
You may have periodontal disease and not have any of these symptoms.
Most people don’t experience pain with periodontal disease.
The first line of treatment is effective daily cleaning of your teeth, and regular attendance to your dentist or hygienist.
If the condition is advanced or complicated, then your dentist or hygienist could refer you to a specialist periodontist.
Specialist periodontists are experts in dealing with any advanced and complicated periodontal conditions.
The first appointment with the periodontist will involve a thorough examination of your teeth and gums, followed by appropriate investigations including radiographs.
Chronic periodontitis is a common disease affecting the structures supporting the teeth: the gums, the bone that the teeth are in and the ligament that joins the tooth to the bone. In patients who do not attend on a regular basis, and have poor oral hygiene, over a period of time, the plaque that forms on the teeth next to the gums combines with the body’s defence response to cause the gums to detach from the teeth. With time, the teeth can become loose. Ultimately if left untreated, complete bone loss may occur and lead to tooth loss. Smoking and diseases such as uncontrolled diabetes can make the disease worse. Severe forms of gum disease affect approximately 15% of the population.
Aggressive periodontitis tends to be seen in less than 1% of the population. The cascade of events is similar to the chronic periodontitis. HOWEVER, the amount of bone destruction is not proportionate to the amount of plaque present. Hence in these patients, usually oral hygiene is good, but there is severe destruction of the supporting structures. There is a genetic background and tends to run in the family. It could affect patients as young as 12 years old.
Unfortunately, gum disease is painless. You need to attend to your dentist and hygienist on a regular basis for checkups. They in turn will carry out simple measurements, where they could tell if you have gum disease. This could be supported by radiographs.
Bleeding gums are a sign that you may have a problem. In later stages of the disease you may notice swelling of the gums, loose teeth or increased spaces between your teeth.
A hygienist has experience in dealing with some forms of gum disease in its simple to moderate cases. Once the case is advanced, you will require seeing a specialist periodontist for further more advanced intervention.
It is crucial that you do see your hygienist on a regular basis.
Periodontists work alongside hygienists to ensure optimum results for patients. Other conditions such as correcting recession defects, or managing gummy smiles, can only be dealt with by periodontists, not hygienists.
4. Can periodontitis be cured?
There is no cure for periodontitis. In most cases, the bone that has been lost around the teeth cannot be regrown. The aim of periodontal treatment would be to stop the disease progressing any further, and hence maintaining and retaining the teeth over longer period of time.
On the other hand, in certain cases, depending on the amount and shape of bone loss around a tooth, some of the lost soft and hart tissue can be regenerated using specific techniques and materials through surgical periodontal treatment procedures.
There are numerous proven studies to suggest that if periodontitis is left untreated, the ultimate outcome is tooth loss.
Periodontitis could lead to tooth mobility. This could affect your chewing, speech, and also from an aesthetic point of view will be compromising.
Teeth with periodontitis, if left untreated, will lead to more bone loss. Hence future replacement of those teeth with implants would be much more difficult, due to less bone present.
Having your own teeth over longer period of time is
Remember, gums act as the foundation in the mouth. Anything you build will need a healthy foundation. Hence any complex treatment in the mouth such as braces, crowns, bridges, or implants, will require healthy and stable gums and bones.