Periodontitis
Periodontal diseases
What is periodontitis?
Periodontal diseases affect the periodontium, which is the supporting tissues of the teeth. The two most common forms are gingivitis and periodontitis.
Gingivitis
Gingivitis is the initial stage of periodontal diseases. In the case of gingivitis, the gum appears red, swollen, and bleeds very easily when brushing. If we do not treat gingivitis, it can progress to periodontal disease and cause irreversible loss of the tooth’s supporting tissues: the bone, the periodontal ligament, and the gingival tissues.
Periodontitis
Periodontitis is an inflammatory disease initiated by bacteria. In susceptible individuals, this inflammation causes bone loss around the teeth. The gum detaches from the teeth, periodontal pockets form, and the infection develops inside these pockets. As the disease progresses, the teeth become loose and eventually fall out.
By understanding the signs and stages of these diseases, we can intervene quickly and prevent serious complications
How do I know if I have periodontitis?
Periodontitis always begins with an inflammation of the gums, called gingivitis. You may notice bleeding gums when you brush your teeth, which is one of the first signs.
Your gums may appear red and swollen, and you might see a layer of bacterial plaque on your teeth. If you do not treat gingivitis, it can develop into periodontitis, often without obvious signs to alert you.
Signs and symptoms
However, over time, you might notice some changes, such as:
- Increased bleeding of the gums, triggered by brushing, eating, or even spontaneously
- Bad breath
- Changes in the positioning of the teeth on the jaws
- Lengthening of the teeth due to gum recession
- Sometimes pain
Smokers may notice less gum bleeding due to the effect of nicotine on blood vessels. This can mask the disease process.
Early diagnosis
Often, you only recognize the presence of periodontitis at the age of 40 or 50, by which time significant damage may already be present. However, a periodontist can detect the signs of the disease much earlier during a clinical examination.
By being vigilant and regularly consulting a professional, you can take steps to treat periodontitis before it causes significant damage.
What are the causes of periodontitis?
A healthy mouth hosts more than 700 different species of bacteria. Most of them are completely harmless and live in harmony with their host. However, when you don’t clean your teeth sufficiently, bacterial deposits accumulate against the gums, forming plaque. This creates favorable conditions for the proliferation of more dangerous bacteria. Additionally, your body’s natural defenses also play a role.
In any case, the accumulation of bacteria causes periodontitis.
How does periodontitis progress?
When you do not brush properly, soft bacterial plaque remains on your teeth. Over time, minerals deposit on it, forming a hard deposit called tartar. Tartar then promotes the growth of bacterial plaque towards the dental roots.
As the inflammation progresses, the gum detaches from the root. A space or periodontal pocket then forms between them. This pocket becomes an ideal place for harmful bacteria to colonize and multiply, thereby worsening the disease. In their new habitat, bacteria release toxins, products of their metabolism, which further trigger the body’s defense mechanisms.
The severity and speed of progression of periodontitis depend on several factors:
- The number and type of bacteria present
- The strength of the individual’s defense mechanisms
- The presence of certain risk factors
In summary, it is crucial to maintain good oral hygiene to prevent the formation of tartar and the progression of periodontitis.
What are the factors that contribute to the onset and progression of periodontitis?
Some risk factors can further weaken the body’s defenses and accelerate the disease process. Similarly, certain medications such as antihypertensives, vasodilators, and immunotherapy affect the inflammatory response, making patients more susceptible to gingivitis.
Tobacco
Patients who smoke are much more likely to have periodontal problems. Studies have shown that tobacco is arguably one of the most significant risk factors in the development and progression of periodontal disease.
Diabetes
Diabetics are more likely to have periodontal problems.
Other diseases
Other diseases interfere with an individual’s inflammatory system and worsen gum health. For example, cardiovascular diseases and rheumatoid arthritis. Diseases that affect the body’s defense system, such as leukemia or AIDS, can severely worsen the condition of the gums.
Genetics
Although some patients have excellent brushing habits, they may still develop periodontal disease more frequently.
Stress
Stress can reduce your ability to defend against disease. Research has shown that stress makes the host more vulnerable in the fight against infections.
Bruxism
Grinding teeth can exert excessive forces on the supporting tissues of the teeth, thereby contributing to the worsening destruction of periodontal tissues.
Diet
Your diet can impact your oral health. A diet low in essential nutrients can alter the immune system, making it harder for the body to fight infections.
What are the consequences of periodontitis?
Periodontitis is the leading cause of tooth loss. If we do not stop the progression of periodontal inflammation, we destroy the supporting structures of the teeth, including the surrounding bone. Thus, the teeth eventually become loose and fall out, or require extraction. Other problems that patients may encounter include painful abscesses, tooth migration that can interfere with eating, and unsightly tooth lengthening with root exposure.
Effects of Untreated Periodontal Diseases on General Health
Untreated periodontal diseases can also affect your general health. They increase the following risks:
- Complications during pregnancy, such as pre-eclampsia, premature births, and low birth weight
- Worsening of diabetes
- Heart diseases
- Strokes
- Lung diseases
- Erectile dysfunction
How to treat periodontitis?
Main objective
We aim to eliminate irritants and pathogenic bacteria that cause inflammation of the gums and supporting tissues of the teeth.
Non-surgical periodontal treatment
We often begin the treatment of periodontal disease with etiological therapy. This approach includes scaling and root planing of the entire mouth, as well as reinforcing hygiene techniques. After this treatment and effective oral hygiene, we usually observe a significant improvement in the condition of the gums. They deflate, firm up, and reattach to the teeth, thereby reducing the depth of periodontal pockets.
Surgical periodontal treatment
For advanced cases, we proceed with corrective surgical phases. The objectives of these treatments are multiple, including:
- Accessing root surfaces in the presence of deep pockets.
- Removing tartar.
- Eliminating deep inflammation.
- Reducing pocket depth.
- Regenerating the supporting tissues of the tooth.
We also use other surgical treatments to cover exposed roots and treat gingival recessions, such as gum grafts. Other methods may complement periodontal treatments, such as orthodontics for tooth movement, and the replacement of missing teeth or those requiring extraction with various prosthetic or implant devices.
Periodontal maintenance
After treating the disease, we establish supportive periodontal therapy or maintenance. This step is essential to maintaining periodontal health. During these sessions, we monitor and intercept any recurrences of pocket formation. We also reinforce hygiene techniques and perform a thorough cleaning to reduce the amount of plaque and deposits that are difficult for the patient to access. Generally, these sessions are scheduled every 3 to 4 months.
Periodontal disease can be effectively treated. The key to success is to follow the treatment proposed by your periodontist and to eliminate the bacterial plaque that triggers the disease process by maintaining excellent oral hygiene.
