Periodontal disease, also known as gum disease, is a serious inflammatory disorder that, left untreated, can lead to tooth loss. The word periodontal literally means "around the tooth." Periodontal disease is a chronic inflammatory disease that affects the gums and bone supporting the teeth. Periodontal disease can affect one tooth or many teeth.
It begins when the bacteria in plaque, causes the gums to become inflamed. Plaque is a sticky film, composed primarily of bacteria, which adhere to your teeth at and below the gum line. Plaque constantly forms on your teeth, even minutes after cleaning. Bacteria found in plaque produce toxins or poisons that irritate the gums. Gum disease is divided into two categories: Gingivitis and Periodontitis. Untreated gingivitis can advance to periodontitis and can eventually lead to tooth loss and other health problems.
Is the mildest form of periodontal disease. It causes the gums to become red, swollen, and bleed easily. There is usually little or no discomfort at this stage. Gingivitis is often caused by inadequate oral hygiene. Gingivitis is reversible with professional treatment and good oral home care.
Untreated gingivitis can advance to periodontitis. With time, plaque can spread and grow below the gum line. Toxins produced by the bacteria in plaque irritate the gums. The toxins stimulate a chronic inflammatory response in which the body in essence turns on itself, and the tissues and bone that support the teeth are broken down and destroyed. Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. Often, this destructive process has very mild symptoms. Eventually, teeth can become loose and may have to be removed.
Factors that may contribute to periodontal disease include, diabetes, smoking, aging, genetic predisposition, systemic diseases and conditions, stress, inadequate nutrition, puberty, hormonal fluctuations, pregnancy, substance abuse, HIV infection, and certain medication use.
Gum disease is often silent, meaning symptoms may not appear until an advanced stage of the disease.
However, warning signs of gum disease include the following:
Periodontal health should be achieved in the least invasive and most cost-effective manner. This is often accomplished through achieving perfect oral hygiene and non-surgical periodontal treatment. Non-surgical periodontal treatment (NST) does have its limitations. When it does not achieve periodontal health, surgery may be indicated to restore periodontal health.
Scaling and root planing is a careful cleaning of the root surfaces to remove plaque and calculus [tartar] from deep periodontal pockets and to smooth the tooth root to remove bacterial toxins. There will be a degree of sensitivity and some recession after this treatment.
This is indicated once initial scaling and root planning is completed and the pockets do not resolve as expected. The purpose of this is to get better access to the root surface and reduce the pocket depth. Reducing pocket depth and eliminating existing bacteria are important to prevent damage caused by the progression of periodontal disease and to help you maintain a healthy smile. Eliminating bacteria alone may not be sufficient to prevent disease recurrence. Deeper pockets are more difficult for you and your dental care professional to clean, so it's important for you to reduce them.
Once periodontal health is restored. You will need to have meticulous oral hygiene and regular maintenance (Scale and polish) every 3-6 months to maintain the health of your gums.
90% of the population are estimated to suffer from a form of gum disease at some stage in their life. Over 50% of the population have periodontitis. Those people most at risk of gum disease include:
Women and teenage girls are more at risk of developing gum disease because of the many hormonal changes they experience such as puberty, the menopause, as well as taking oral contraceptives and having monthly periods. During all of these times, the body experiences hormonal changes that make gums sensitive.
During pregnancy, a woman experiences a whole nine months of hormonal changes which make the gums much more sensitive than usual and more susceptible to bleeding – a well-known, common ailment experienced during pregnancy. Recent research has also shown that gum disease may be responsible for an increase in the likelihood of giving birth prematurely.
Smoking increases bacterial plaque whilst reducing the delivery of oxygen and nutrients to the gums and generates “free radicals” which delay the healing process, thus making the gums more susceptible to infection. Research shows that smoking causes 50% of all gum disease cases.
Gum disease is often considered the sixth complication of diabetes. This is because when blood sugar levels are poorly controlled, blood glucose levels rise and the higher levels of sugar in the mouth help harmful germs to grow. People with diabetes can also be more susceptible to contracting infections including infections of the gums. It is therefore vital that the first signs of gum disease are treated as wounds and infections may take longer to heal and can increase the risk of diabetic complications, thus creating a “vicious” circle.
Research shows that stress can make it more difficult for our bodies to fight gum disease.
Researchers have found that people with gum disease are almost twice as likely to suffer from heart disease as those without gum disease. There are two theories for this, one is that bacteria in the mouth can enter the blood vessels and attach to fatty plaques, causing clot formation which can obstruct blood flow and may lead to a heart attack. The second theory is that inflammation caused by gum disease increases plaque build up, which may contribute to the swelling of the arteries.
Studies have highlighted that people diagnosed with acute cerebrovascular ischemia were more likely to have an oral infection when compared to those in a controlled group.