Periodontitis

Overview

Periodontitis is a serious gum infection that damages the soft tissue around teeth, leading to bone loss and potential tooth loss if left untreated. It results from poor oral hygiene and can be prevented by brushing at least twice a day, flossing daily, and getting regular dental checkups. Symptoms may include swollen, bright red or dark purple gums that bleed easily. Gingivitis, the mildest form of gum disease, can progress to periodontitis if left untreated. Risk factors include poor oral health care habits, smoking, and hormonal changes.

Understanding the disease

Symptoms

Symptoms of periodontitis may include swollen or puffy gums, bright red, dark red, or dark purple gums, gums that feel tender when touched, gums that bleed easily, a toothbrush that looks pink after brushing your teeth, spitting out blood when brushing or flossing your teeth, bad breath that won't go away, pus between your teeth and gums, loose teeth or loss of teeth, painful chewing, new spaces that develop between your teeth that look like black triangles, gums that pull away from your teeth, making your teeth look longer than usual (receding gums), and a change in the way your teeth fit together when you bite. If you notice any of these symptoms, it's recommended to see a dentist as soon as possible for proper evaluation and treatment.

Risk Factors

Risk factors for developing periodontitis include poor oral care habits, smoking or chewing tobacco, older age, dry mouth, poor nutrition (including vitamin C deficiency), dental restorations that don't fit properly or crooked teeth that are difficult to clean, conditions that decrease immunity (such as leukemia, HIV/AIDS, or cancer treatment), certain drugs (like phenytoin and some calcium channel blockers), hormonal changes (related to pregnancy, menstrual cycle, or use of birth control pills), genetics, medical conditions (such as certain viral and fungal infections), and obesity. Additionally, poor oral health care habits, gingivitis, hormonal changes (such as those related to pregnancy or menopause), recreational drug use, low vitamin C levels, genetics, certain medicines that cause dry mouth or gum changes, and conditions that lower immunity can contribute to periodontitis.

Development

Periodontitis develops as a result of ongoing gum irritation and swelling (inflammation) caused by plaque, which is a sticky film mainly made up of bacteria. Plaque can form on teeth when starches and sugars in food interact with bacteria commonly found in the mouth. If not removed through proper oral care habits such as brushing and flossing, plaque can harden under the gum line into tartar, a more difficult-to-remove substance. Tartar and plaque are filled with bacteria, which can cause further damage to the gums and surrounding tissue if left untreated. The longer they stay on the teeth, the more damage they can do. Over time, this can lead to the development of periodontitis, a serious gum infection that can cause tooth loss if left untreated. Risk factors for periodontitis include poor oral health care habits, smoking or chewing tobacco, hormonal changes, older age, dry mouth, poor nutrition, dental restorations that don't fit properly or crooked teeth, conditions that decrease immunity, certain drugs, hormonal changes, genetics, medical conditions, and poor oral care habits.

Assessment and Diagnosis

Triage

If symptoms of periodontitis are present, it is recommended to make an appointment with your dentist as soon as possible. The sooner you get care, the better your chances of reversing damage from periodontitis.

Diagnosis

To diagnose periodontitis, a dentist may review your medical history, examine your mouth for plaque and tartar buildup, measure pocket depth using a dental probe, and take dental X-rays to check for bone loss in areas with deeper pockets. Pockets deeper than 4-5 mm typically indicate periodontitis.

Management and Treatment

Complications

Untreated periodontitis can lead to several complications, including tooth loss, a decrease in immunity, and other health problems. Some of the potential complications include:

1. Tooth loss: Periodontitis can cause deep pockets to form between the gums and teeth, which can lead to the loss of tissue and bone support. Eventually, this can result in tooth loss.
2. Decreased immunity: Ongoing inflammation caused by periodontitis can strain the immune system, making the individual more susceptible to other health problems.
3. Other health problems: Research has suggested a possible link between periodontitis and various other health issues, such as cardiovascular disease, diabetes, and respiratory infections. It is essential to receive professional treatment and maintain good oral hygiene habits to prevent the progression of periodontitis and its potential complications. If you notice any symptoms of periodontitis, consult your dentist as soon as possible.

Prevention

periodontitis can be prevented by practicing good oral hygiene and visiting the dentist regularly. Brushing your teeth for two minutes at least twice a day, flossing at least once a day, and using mouthwash can help prevent periodontitis. Additionally, regular dental check-ups and cleanings, usually every 6 to 12 months, can help identify and treat any early signs of gum disease before it progresses to periodontitis.

Home Remedies

It is important to consult with a dentist for proper diagnosis and treatment of periodontitis.

Treatment

Treatment for periodontitis depends on its severity and may involve both nonsurgical and surgical procedures. Here is a summary of the options:

1. Nonsurgical treatments: a. Scaling: removes tartar and bacteria from tooth surfaces and below the gumline. b. Root planing: smooths root surfaces, helps prevent further buildup of tartar and bacteria, and helps the gums reattach to the teeth. c. Antibiotics: topical or oral antibiotics can control bacterial infection.
2. Surgical treatments: a. Flap surgery (pocket reduction surgery): involves cutting the gums to access the teeth for effective cleaning, reshaping the bone if necessary, and then stitching the gums back in place. b. Soft tissue grafts: involve reinforcing damaged gum tissue, either by taking tissue from the roof of the mouth or using donor tissue, to reduce further gum loss, cover exposed roots, and improve the appearance of the teeth. In addition to these treatments, maintaining good oral hygiene, regularly visiting the dentist, and managing health conditions that impact dental health are crucial for successful treatment and prevention of further damage. Quitting tobacco use is also essential.

Preparing for medical consultation

To prepare for an appointment for periodontitis, follow these steps:

1. Make a list of your symptoms: Include any mouth discomfort, bleeding gums, bad breath, or other symptoms you're experiencing.
2. Gather personal information: Prepare a list of any medical conditions you have, major stresses or recent life changes, and all medications you're taking, including dosages.
3. Prepare questions for your dentist: Write down questions such as "What's causing my periodontitis?" or "What tests do I need?" to make the most of your time during the appointment.
4. Gather dental records: Bring any relevant medical or dental records, including test results, related to your periodontitis.
5. Bring a support person: Consider bringing a family member or friend to provide emotional support and help remember important information discussed during the appointment.
6. Inquire about mouthwash and restrictions: Ask your dentist if they recommend using mouthwash and if there are any specific restrictions you should follow for your oral health.
7. Ask for educational materials: Request brochures, printed materials, or recommended websites to learn more about periodontitis and its treatment. Remember to be open and honest with your dentist about your symptoms and medical history. Following these steps will help you have a productive appointment and work towards managing your periodontitis effectively.