Signs of Periodontal Disease

Periodontal disease is a progressing disease that if left untreated will worsen over time. With many dental conditions, many patients will ignore the symptoms and hope it goes away. Since periodontal disease must be treated and will not go away on its own, it's important to know the signs of it. Learning about the symptoms of periodontal disease is a good first step to take control of the disease and it’s progression.

What Is Periodontal Disease?

Periodontal disease (or gum disease) is a chronic infection of the gum tissue that can result in the eventual breakdown of the tissue through several stages. It leads to the deterioration of the bones that surrounds and supports one's teeth. This infection begins when bacteria and plaque form a sticky biofilm on your teeth. The biofilm causes a chronic inflammation of the gum tissue. Periodontal disease will continue to progress if the biofilm is not removed or reduced. By maintaining proper dental care and routine visits, this takes steps in prevention and halting of the disease. Periodontal disease is found to be the leading cause of tooth loss in adults. Studies show that somewhere between 75% and 95% of all adults are suffering some stage of periodontal disease.

The stages of periodontal disease are:

– Gingivitis (inflammation of the gum tissues). This is the first stage of periodontal disease. Gingivitis is reversible and is the mildest form of periodontal disease. The symptoms include red, swollen (or puffy), and inflamed gums from the plaque-bacteria build-up. The gums may also bleed easily when brushing or eating hard foods. During this early stage of periodontal disease, the infection process can be reversed through good dental hygiene and professional cleanings to remove the biofilm and tartar. In this initial form of periodontal disease, most people do not know they have it. This is a crucial period for the patient, as this is the time to reverse it (the bone and connective tissue that hold the teeth in place have not yet been affected). Gingivitis is common during puberty, pregnancy, periods of high stress and menopause, as hormones can make you more prone to inflammation. Regarding the rest of the population, poor dental hygiene is generally the most common cause, followed by medication and certain medical conditions.

– Periodontitis. As the disease progresses, it is now becoming harder to treat and manage it. The difference between gingivitis and periodontitis is that gingivitis only infects the gum tissue surrounding the teeth. The periodontal disease process also invades the bone that provides support and stability for the teeth. The bacteria will invade past the gum line area and destruction begins to the point that the gums may begin to separate or pull away from the teeth (taking away support and connective fibers with it). This process is called periodontal pockets. These pockets allow bacteria to invade below the gum line. They eventually become loaded with toxic plaque and bacteria that moves and works its way deeper. This will erode the bone and connective fibers below the gum line. A patient’s bite will also be affected (as the teeth shift or loosen) by the lost support, which then affects chewing and other functions.

– Advanced Periodontitis. The periodontal disease process advances further and the fibers and bone that provide support for the teeth are destroyed. At least half of the bone support (if not more) is broken down at this late stage of periodontal disease. Bone support does not grow back naturally, and the teeth may begin to loosen. Deep root cleanings and surgical intervention are typical at this stage. This may include cleaning with a periodontal microscope (Perioscope), grafting of tissue or bone, placement of growth factors (Emdogain), periodontal antibiotic regimen (Periostat), placement of antibiotics directly into pockets (Arestin), open flap surgery, and possible tooth removal.

Periodontal Disease Signs

– Puffy, Swollen Gum Tissue. This is a telling sign of gingivitis and periodontal disease in general. Your body’s natural response is to fight off this infection caused by excessive untreated debris. This occurs by bringing healing components to the area through the blood vessels. The gums will remain affected until the irritant is removed namely the plaque and bacteria building up on the teeth and below the gum line.

– Bleeding Gums. Once the tissues are puffy and receiving extra blood flow to fight off the disease process. This causes inflamed gum tissues that will bleed easily upon brushing or eating hard foods.

– Periodontal Pockets. As the disease progresses and the bacteria and plaque build up, the gum tissue will begin to separate from the teeth creating large pockets where bone will be lost. These pockets are very difficult to clean on your own and need professional cleanings.

– Infection and Pus. When there has been significant advancement of pockets, the bleeding ends and the infection begins. The dental hygienist will press on the gums and floss to release the pus into the mouth. 

– Longer Looking Teeth. As bone support is lost, the gum tissue falls back and exposes the root of the tooth. This gives the appearance of longer looking teeth.

– Constant Bad Breath. This is a hallmark of periodontal disease progression, although it can be associated with other conditions. Most of the odor relates to the infection process and tartar.

– Loose or Drifting Teeth. When periodontal disease has advanced, the support tissues are diminished, meaning the teeth will become looser. 

Periodontal Disease 

Periodontal disease has many signs and stages to help you become aware of it’s progression. The periodontal disease process can be quite aggressive, needing professional cleanings to remove it. To prevent the process of periodontal disease, you should be diligent with at home dental hygiene and regular professional cleanings.