PERIODONTICS
What are Periodontal Disease?
Periodontal diseases are serious bacterial infections that affect the gums and the supporting bone that anchor your teeth in place. These infections are caused by bacteria found in plaque—a sticky, colourless film that forms on your teeth. When plaque isn’t removed through regular brushing and flossing, it can harden within 48 hours into calculus or tartar, which is much harder to eliminate without professional care.
The bacteria in plaque release toxins that irritate the gums, causing redness, swelling, and inflammation. Over time, these toxins break down the connective tissues and bone that support your teeth. As the infection worsens, the gums start to pull away microscopically from the teeth, forming periodontal pockets. These pockets trap more plaque, allowing the infection to spread deeper into the gums and surrounding bone.
Without timely treatment, progressive gum disease can lead to the destruction of both gum tissue and bone, causing teeth to loosen and, eventually, requiring removal. Periodontal disease is the leading cause of adult tooth loss, but early intervention can prevent long-term damage.
Causes of Periodontal Disease
Periodontal diseases result from various factors. There is no single cause since multiple elements contribute to gum disease. Below are the key factors that increase the risk of developing periodontal diseases:
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Genetics
A family history of periodontal disease can significantly increase the likelihood of developing gum problems. It indicates a genetic predisposition to developing these conditions.
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Systemic Diseases
Chronic health conditions like diabetes and immune system disorders can interfere with the body’s ability to fight infections, aggravating periodontal disease and accelerating gum and bone deterioration.
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Tobacco Use
Smoking and tobacco use are major risk factors, not only increasing the likelihood of developing periodontal disease but also slowing down recovery and healing after treatment.
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Diabetes
Individuals with diabetes are three to four times more prone to periodontal infections. They often experience more severe bone loss, persistent inflammation, and aggressive forms of the disease.
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Destructive Habits
Poor oral hygiene, substance abuse (including drugs and alcohol), and neglect of regular dental care can compromise gum health, contributing to the onset of periodontal diseases.
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Stress
High-stress levels weaken the immune system, making it more difficult for the body to combat infections, including those affecting the gums.
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Hormonal Changes
Life stages like pregnancy, menopause, and puberty bring hormonal fluctuations that can cause the gums to become red, swollen, and prone to bleeding, increasing the risk of periodontal issues.
Forms of Periodontal Disease
Periodontal diseases come in various forms, ranging in severity and progression. Understanding these forms can help with early detection, timely treatment, and effective management. Below are the main types of periodontal diseases:
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Gingivitis
This is the mildest form of periodontal disease, characterized by red, swollen gums that may bleed easily. It is often reversible with proper oral hygiene and professional dental care.
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Chronic Periodontitis
This common form of periodontal disease develops over time, resulting in inflammation of the supporting tissues of the teeth. It can lead to progressive bone loss and gum recession if left untreated.
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Aggressive Periodontitis
Unlike chronic periodontitis, this form progresses rapidly and can cause severe bone destruction. It often affects younger individuals and requires early intervention to prevent tooth loss.
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Localized Aggressive Periodontitis
This form of aggressive periodontitis affects a limited number of teeth, usually, the molars and incisors, leading to early and severe tissue destruction in those areas.
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Generalized Aggressive Periodontitis
In this form, rapid periodontal breakdown occurs across the entire mouth, affecting many teeth. It can lead to severe bone loss and requires urgent care.
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Periodontitis as a Manifestation of Systemic Disease
This form is associated with underlying medical conditions, such as diabetes or immune system disorders, which make individuals more susceptible to periodontal diseases. Managing the systemic disease is often essential to controlling the progression of periodontitis.
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Necrotizing Periodontal Disease
This severe form of periodontal disease involves tissue death (necrosis) in the gums, periodontal ligament, and bone. It is often associated with immune suppression, malnutrition, or severe stress and requires immediate medical attention.
Each form of periodontal disease presents unique challenges, and early diagnosis plays a critical role in successful treatment. Proper management involves a combination of professional care, lifestyle modifications, and, in some cases, the management of underlying health conditions.
Signs of Periodontal Disease
The early recognition of the signs of periodontal disease is essential for timely intervention and effective treatment. Gum disease can develop gradually and, if left untreated, may lead to serious oral health issues, including tooth loss. Below are the common signs to watch for:
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Red, Swollen, or Tender Gums
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Bleeding While Brushing or Flossing
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Loose or Separated Teeth
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Pus Between the Gum and Tooth
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Gums Pulling Away from Teeth (Recession)
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Persistent Bad Breath
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Changes in Bite Alignment
If any of these signs are present, seeking professional evaluation and treatment is important. Early diagnosis and care can help prevent further damage and effectively restore gum health.
Types of Treatment
The treatment of periodontal diseases depends on the type and severity of the condition. Your periodontist will conduct a thorough evaluation to determine the most appropriate course of action to restore and maintain your gum health
and maintain long-term oral health through preventive care.
In the early stages of periodontal disease, non-surgical treatments such as professional cleaning, scaling, and root planing (deep cleaning) may be sufficient. Surgical intervention may be necessary for more advanced stages of periodontal disease. Advanced stages treatments may include Gum tissue grafts, Bone grafts and Pocket reduction surgery.
Each treatment plan is personalized to meet the unique needs of the patient, ensuring that the condition is managed effectively. Periodontal treatment focuses on stopping the progression of the disease, repairing damage where possible, and maintaining long-term oral health through preventive care.
After Support
Maintaining optimal oral health after treating periodontal disease requires ongoing care and regular dental visits. Once the active infection is under control, patients enter the Supportive Periodontal Treatment (SPT) phase, which helps prevent the disease from recurring. This phase involves regular assessments by your periodontist to monitor the condition of your gums and ensure that your periodontal health remains stable.
Supportive Periodontal Treatment
At each maintenance visit, your periodontist will:
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Examine your mouth to assess the health of your gums and check for signs of recurring infection.
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Clean and polish your teeth to remove plaque and tartar buildup, helping to maintain healthy gums.
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Check your bite alignment to ensure that your teeth and jaw are functioning properly.
Professional Maintenance
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For patients with good periodontal health, professional cleanings (also known as prophylaxis) are recommended twice per year to prevent any buildup of plaque or tartar.
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If you have a history of periodontal disease, SPT or professional maintenance may be required three to four times yearly, depending on your specific condition and risk factors.
Periodontal diseases are often silent and may go unnoticed until in advanced stages. This may lead to significant bone loss and require professional care to prevent further damage and tooth loss.
Periodontics is a branch of dentistry that treats conditions affecting the tissues and supporting structures around your teeth. This is known collectively as the periodontium. The term periodontics is derived from two Greek words "peri" meaning around and "odóns" meaning tooth.
What is Periodontics?
Periodontal disease — also called gum disease — refers to inflammation and infection of the tissues that support your teeth. Poor oral hygiene can result in gum disease. However some people are more prone to this condition than others are, even with proper brushing and flossing.