What are periodontal diseases?
The word “periodontal” literally means “around the tooth.” Periodontal diseases are bacterial gum infections that destroy the gums and supporting bone that hold your teeth in your mouth. Periodontal diseases can affect one tooth or many teeth.
The main cause of periodontal diseases is bacterial plaque, a sticky, colorless film that constantly forms on your teeth. If the plaque is not removed, it can turn into a hard substance called calculus or tartar in less than two days. Tartar is so hard it can only be removed by an oral health professional, such as a dentist or periodontist. The bacteria in plaque infect the gums, and release poisons that cause redness and inflammation (irritation). The inflammation and the poisons themselves cause destruction of the tissues that support the teeth, including the bone. When this happens, the gums separate microscopically from the teeth, forming “pockets” that fill with even more and deeper plaque, which makes it very difficult to reach even with good brushing and flossing technique, causing even more infection. The gum tissue and then the supporting bone are slowly destroyed. If enough bone tissue is destroyed, the teeth loosen and are eventually lost.
What causes periodontal disease?
Periodontal diseases are multi-factorial. This means that there is not just one cause of periodontal diseases but rather multiple factors that can affect the health of your gums.
- Poor oral hygiene (lack of adequate brushing and flossing)
- Genetics and family history of periodontal diseases indicate a greater likelihood of developing these diseases.
- Tobacco use significantly increases the risk of developing periodontal diseases and can negatively affect treatment.
- Hormonal changes during pregnancy, puberty and menopause can cause the gums to become red, tender and bleed easily.
- Stress can make it more difficult for the body to fight off infection, including periodontal diseases.
- Some mecications such as oral contraceptives, antidepressants and certain heart medicine, can affect oral health.
- Destructive habits such as improper oral hygiene technique, oral piercing, drug or alcohol abuse can affect periodontal health.
- Poor nutrition can make it harder for the body to fight off infection.
- Systemic diseases that interfere with the body’s immune system may worsen the condition of the gums and supporting bone.
What are the signs of periodontal diseases?
Periodontal diseases are often silent, meaning that symptoms may not materialize until significant bone loss has occurred. Some people may have periodontitis and not experience any symptoms and be unaware that they have disease.
We can detect gum disease early and prevent or repair its damage. Bleeding is a strong indicator of gum inflammation. Healthy gums do not bleed at all when brushed or flossed. If you have any gum bleeding when you clean your teeth, your gums are inflamed.
Common symptoms and signs of periodontal diseases include:
- Red, swollen or tender gums
- Bleeding while brushing or flossing
- Gums pulling away from the teeth making teeth look longer
- Loose or separating teeth
- Pus between the gum and tooth
- Persistent bad breath
Are all forms of periodontal diseases the same?
There are many types of periodontal diseases. The following is an overview of the most common:
Gingivitis:
As the mildest form of the periodontal diseases, gingivitis causes the gums to become red, swollen, and bleed easily. There is usually no discomfort at this stage.
Chronic Periodontitis:
Chronic periodontitis is a condition resulting in inflammation within the soft tissues surrounding the teeth causing progressive attachment and bone loss. It is diagnosed by bone loss on a dental X-ray, the formation of gum pockets and/or receding gums. It is most common in adults, but can occur at any age.
Aggressive Periodontitis:
This form occurs in patients who are otherwise in good health. Common features include rapid attachment loss and bone destruction. There are two forms of aggressive periodontitis:
✓ Localized aggressive periodontitis – Most often occurs near puberty and usually involves attachment loss around first molars and/or front teeth but may involve one or two additional teeth.
✓ Generalized aggressive periodontitis – Usually, but not always affects people under 30 years of age. It involves attachment loss on at least three permanent teeth in addition to first molars and incisors.
As the name indicates, this form is associated with one of several systemic diseases that are related to periodontitis, such as diabetes.
Necrotizing Periodontal Diseases:
These types of periodontal diseases cause ulcers in the gums between the teeth and are most commonly observed in individuals with certain conditions including, but not limited to, HIV infection, malnutrition and immunosuppression. Stress, smoking, and poor oral hygiene sometimes can contribute to this problem.
How can the periodontal diseases be prevented?
Good oral hygiene and professional care are the keys to keeping your teeth for a lifetime. The best way to prevent periodontal diseases and tooth decay is to remove the bacterial plaque by thorough brushing and flossing every day. Good oral hygiene habits will help keep the formation of dental tartar to a minimum.
Regular dental visits that include a periodontal examination are also important to detect any changes in periodontal health and, if necessary, to remove hardened tartar in places that your toothbrush and floss may have missed. A professional cleaning (often called a prophylaxis) at least twice a year is recommended for patients with good periodontal health. If you have had any form of the periodontal diseases, you may need professional maintenance more frequently.
Congratulations on taking the first step to achieving periodontal health! Preventing and/or controlling periodontal diseases is a worthwhile commitment that will keep you smiling for life!