Periodontitis

Periodontitis is a serious infection of the gums that causes damage to the soft tissues and destroys the bone that supports your teeth.

This can lead to the loss of teeth and even worse effects as risks of heart attacks or stroke and other serious challenges of health.

This is a very common condition but preventable. This is caused by poor oral hygiene.

It is recommended that teeth needs to be brushed at least twice a day and flossing daily.

Regular dental checkup will help mitigate early dental problems. 

The main symptoms of periodontitis includes

• having swollen gums,
• very bright red or purple gums,
• gums that feel tender when touched,
• gums that pull away from your teeth (recede teeth), this makes some of the teeth in your mouth look longer than normal.

Moreover, it will also be noted that some new spaces develop between the teeth, sometimes pus can also be found in between the teeth and in the gums, bad breath and taste in the mouth and some teeth may fall off as a result of loose teeth.

There several types of periodontics

Chronic periodontics is the most common and affects adults even though children can also be affected.

Aggressive periodontitis starts early in childhood and or adulthood and may affect a small number of the people. It is recommended to see a doctor when your gums change color from the normal pink.

Healthy gums also need to be firm. When gums are puffy, red, and bleed easily, this will be a sign of periodontitis. One needs to see a doctor immediately.

This will help in finding early solutions for periodontitis, preventing other serious problems. 

Periodontitis is caused by plaque buildup on the teeth.

Plagues form teeth when the start and sugars in the food interact with bacteria normally within the mouth. Brushing or flossing the teeth helps remove the plaque. However, the rate of reformation of the plaques is rapid and forms after 24 hours. Plaques which form and remain in your teeth for two or three dats harden under the gum line into tartar (Calculus).

The tartar may also form as a result of the mineral content present in the saliva. The presence of tartar makes it very difficult to remove the plaque and sometimes serves as reservoir for bacteria. One can get rid of tartar by brushing and flossing your teeth regularly. Professional dental experts can also remove them.

Depending on the duration of the plaque and tartar on your teeth, the more damage is caused on your gums. They may cause irritation and inflammation of the gingiva, which is a part of the gum around the base of the teeth. This leads to gingivitis which is the mildest form of the periodontal infection.

This may cause the formation of pockets in the gums and teeth that can fill the plaque, tartar, and bacteria. The presence of bacteria lead to the deposition of endotoxins which is a byproduct of their own metabolism. This is responsible for most of the inflammation around the teeth.

The pockets developed may deepen leading to accumulation of more bacteria leading to the advancement of more bacteria in the gum tissue. The deep infection causes a loss of both the tissue and bone.

When too much bone is destroyed, it may lead to the loss of one or more teeth. 

If you notice any symptoms of periodontitis, make an appointment with your dentist as soon as possible to receive a diagnosis.

Here's some information to help you get ready for your appointment and know what to expect from your dentist.

What you can do prepare a list of questions to ask your dentist, such as:

• What's likely causing my symptoms?
• What kinds of tests, if any, do I need?
• What's the best course of action?
• Will my dental insurance cover the treatments you're recommending?
• What are the alternatives to the approach you're suggesting?
• Are there any restrictions that I need to follow?
• What steps can I take at home to keep my gums and teeth healthy?
• Are there any brochures or other printed material that I can have?
• What websites do you recommend?

Don't hesitate to ask other questions during your appointment.

What to expect from your dentist?

Your dentist may ask you questions about your symptoms, such as:

• When did you first start experiencing symptoms?
• Have your symptoms been continuous or occasional?
• How often do you brush your teeth?
• Do you use dental floss?
• Do you see a dentist regularly?
• What medical conditions do you have?
• What medications do you take?
• Do you use tobacco products?

Depending on the extent of your periodontitis, your dentist may refer you to a specialist in the treatment of periodontal disease (periodontist).

Diagnosis of periodontitis is generally simple. Diagnosis is based on your description of symptoms and an exam of your mouth. Your dentist will look for plaque and tartar buildup and check for easy bleeding.

To determine how severe your periodontitis is, your dentist may: Use a dental instrument to measure the pocket depth of the groove between your gums and your teeth. Your dentist or a hygienist inserts a metal probe beside your tooth beneath your gumline, usually at several sites throughout your mouth. In a healthy mouth, the pocket depth is usually between 1 and 3 millimeters (mm). Pockets deeper than 5 mm may indicate periodontitis.

Take dental X-rays to check for bone loss in areas where your dentist observes deeper pocket depths.

The main objective of teeth treatment for periodontitis is to clean the pockets around the teeth and reduce damage to the surrounding bones.

This treatment may be managed by periodontics, dentist or dental hygienist. Good dental care requires a daily routine of good oral care.

A non-surgical treatment involves the use of non-invasive procedures such as scaling which removes tartar and bacteria from your teeth and under the gums. This may be performed using instruments such as ultrasonic devices.

Root planning can also be used to smoothen the root surfaces. This discourages the formation and development of tartar and bacterial endotoxins. Antibiotics can also be administered as topical agents or oral antibiotics which can help control the development of bacterial infection.

Topical antibiotics are in the form of mouth rinse or insertion gels that contain antibiotics in the spaces between the teeth and gums or into the pockets formed after deep cleaning of the gums.

Oral antibiotics are however sufficient to clear and eliminate all the infections that caused by bacteria.

Surgical treatment will be considered only if the periodontitis is at an advanced stage and your gum tissues do not respond to the non surgical treatments and normal dental care.

Different types of surgery can be performed such as : Flab surgery which causes the reduction of pockets. In this procedure, tiny incisions are made in your gums so that a setion of the gum tissue can be lifted to expose the roots for more effective scaling and root planning.

Periodontis is associated with bone loss, which makes the underlying bones to be recontoured before te gum tissues can be sutured back to their position. After the sutured regions are completel y healed, the soft tissues are very easy to clean.

In case of loss of the gum tissue to periodontal disease, this may lead to the development of receding teeth. This may require that some of the damaged soft tissues are reinforced. This can be achieved by removing a small amount of tissue from the roof of the mouth (palate) or any other site and attaching to the site. This has been found to reduce gum recession since they cover the exposed roots and make the teeth have a more pleasant appearance.

Bone grafting can also be done in case periodontitis has destroyed the bone tissues surrounding the root. The bone graft may consist of small fragments of your own bones which may be synthetic or donated. This lower tooth loss by holding them in place. It also always bones regrowth from the natural bone.

Guided tissue regeneration can also be done to allow the regrowth of the bones that was destroyed by bacteria. This is done by placing a biocompatible fabric between the existing bones and your tooth. The materials may prevent the entry of unwanted tissues from entering the healing area, allowing the bones to grow back.

Enamel matrix derivative application can also be done to regenerate the teeth.

A special gel can also be applied to a diseased tooth root. This gel contains some of the proteins found in the developing tooth enamel and stimulates the growth or healthy bones and tissues. 

One of the best ways of preventing periodontitis is by following the oral dental hygiene care recommended by your doctor.

This also requires that it is practiced routinely throughout your life. This practice includes: brushing your teeth at least twice daily in the morning and even before going to bed and flossing you teeth at least one a day.

It is even better to brush your teeth after every meal. Complete teeth cleaning combined with flossing requires about 5 to 7 minutes.

Flossing before the teeth can be brushed allows the food particles to be loosed together with bacteria. Visit a dental hygienist or dentist regularly about every 6 or 12 months.

In the case of special risk factors that expose you to periodontitis such as dry mouth, blood pressure medications or smoking, one needs to see a profession for cleaning the mouth quite often.

To help reduce or prevent periodontitis, it is recommended that one of the following lifestyle measures can be done:

• Get regular professional dental cleaning as advised by your doctor.
• Always use a soft tooth brush and replace it every three months. If possible, use an electric tooth brush since it may be more effective in the removal of the plaques and tartar.
• Consider brushing your teeth twice daily, and floss your teeth often before brushing.
• Use a mouth rinse to reduce plague between your teeth.
• Supplement brushing and flossing with an interdental cleaner.
• Use a dental pick or inter dental brush or dental stick only recommended for cleaning between your teeth. 

There are several risks and complications associated with periodontitis.

There are several factors that increase the risk of periodontitis such as:

• Gingivitis,
• family history for heredity of the condition,
• bad oral habits,
• smoking of tobacco,
• diabetes,
• old age,
• declined body immunity in cases of leukemia and HIV or chemotherapy,
• poor nutrition,
• hormonal changes associated with pregnancy and menopause,
• substance abuse,
• poor fitting dental restorations,
• poor fitting of the teeth.

Some of the complications associated with the gum infections include:

• Loss of teeth,
• coronary artery disease,
• stroke,
• premature and low birth weight babies,
• poorly controlled diabetes,
• respiratory problems,
• rheumatoid arthritis,
• asthma.

It has been established that bacteria can enter into the blood stream through the gum tissue. This may affect the functioning of the lungs, heart, and other body parts.

Similarly, bacteria may also travel through the blood arteries to the heart, which may trigger a cycle of inflammation and arterial narrowing that contributes to the heart attacks.