We all want healthy teeth, but for our teeth to be healthy, we need to take care of our gums and jaws as well.
Periodontal disease refers to the chronic bacterial infection of the teeth’s supporting structure. The most common types of periodontal disease are gingivitis and periodontitis. Gingivitis is a reversible condition where only the gums are affected, but periodontitis is an irreversible condition that affects both the gums and bone structure.
What are the symptoms?
- Red and swollen gums, which might be accompanied with abscesses/pus
- Bleeding, especially while brushing
- Shaky teeth with “weak bite”
- Teeth drifting/spacing
- Gum recession or “teeth getting longer”
- Non-specific low-grade discomfort/pain
However, some people may not show any symptoms even with underlying periodontal problems, so it’s still important to visit your dentist regularly.
What causes periodontal disease?
The main cause is bacterial plaque. At first it forms as a clear film on the teeth surface. Over time, it turns into a hard substance called tartar, which can serve as a harbour for even more bacterial accumulation. Tartar is not removable by normal brushing or flossing.
As bacteria accumulates, gingivitis (inflammation of the gums) occurs. This can be reversed with proper cleaning and removal of plaque. The treatment can range from getting a scaling done to simply brushing regularly/properly.
If gingivitis is not treated in time, it may progress to periodontitis. The gum attachment to the tooth is gradually lost, and plaque advances along the tooth surface deeper into the gums. The result is irreversible destruction to bone and connective tissue.
Who are at risk?
Although periodontal disease can occur to anyone at any age, risk factors that are linked to periodontitis include:
- Hormonal changes during puberty or pregnancy
- Uncontrolled diabetes
- Medication such as antidepressants and antihypertensives
- Immunosuppression due to AIDS or cancer
- Genetic susceptibility
- Halitosis (bad breath)
What is the treatment like?
The first step is a thorough examination to assess the level and architecture of the remaining bone structure. This usually includes taking a set of radiographs.
Next is initial periodontal therapy (IPT), which includes removal of tartar and plaque from beneath the gum line. This process is called scaling and root planing, and is usually done under local anaesthesia. After the procedure, teeth may become temporarily sensitive, but this can be managed by using densensitising toothpastes. Gum shrinkage and gaps may occur due to resolution of gum inflammation.
Surgery may be required in severe cases. This involves surgical access to areas that are otherwise difficult or impossible to clean thoroughly during IPT. In certain situations, bone graft materials may be used to encourage the regeneration of the supporting structures of the tooth.
After active management, it is important to have a structured regime to maintain periodontal health. The frequency of maintenance can range from three to nine months. During maintenance visits, a full periodontal assessment is done before any plaque is removed.
Thomson Specialist Dentistry