What Is It?

Periodontitis is a term used to describe a group of conditions that involves inflammation of the gums and other structures that support the teeth. Periodontitis is caused by bacteria found in dental plaque and often, but not always, starts as gingivitis.

In trying to eliminate the bacterial infection, your body produces substances that destroy the structures that hold the teeth in the jaw, including the periodontal ligament and underlying bone. As this process continues, the teeth become loose. Pockets form between the teeth and gums, allowing more bacteria to accumulate. Left untreated, periodontitis can result in tooth loss.

Periodontitis usually is relatively painless. The onset of significant pain may signal the development of an abscess.

Older adults are more likely to have periodontitis.

People who smoke are four to seven times more likely than nonsmokers to get periodontitis. Smoking may impair the body's defense against bacteria.

Symptoms

Symptoms include:

• Reddened, swollen or bleeding gums
• Receding gums
• Loose Teeth
• Bad breath
• An unpleasant taste in the mouth

However, many people are unaware of these symptoms or do not believe they are signs of a serious problem.

Diagnosis

Your Puyallup dentist will examine your mouth, paying special attention to your gums and teeth. If you have periodontitis, a dental probeinserted between your tooth and your gums will penetrate deeper than it normally would.

Your dentist may also test for loose teeth. Teeth have a normal range of mobility, but in people with periodontitis, the teeth are looser due to the destruction of the fibers and bone supporting the teeth.

Your dentist may also order X-rays to help diagnose periodontitis. These can be compared with older X-rays to see if changes have occurred in your teeth and gums.

Expected Duration

Unlike gingivitis, periodontitis cannot be completely reversed. In some situations, the supporting fibers and bone that have been lost can be regenerated. In most cases, however, particularly in advanced stages of the disease, the effects are permanent. However, treatment and improved oral hygiene at any stage can improve the health of your gums and prevent further destruction.

Prevention

Daily brushing and flossing (morning and night) and regular visits for professional cleaning can help prevent periodontitis or allow you to have it treated during its earliest stages. If you smoke, quitting will reduce your risk significantly.

Treatment

Treatment depends on how severe your periodontitis is. Dentists classify the disease as mild, moderate or severe.

Mild periodontitis is usually treated first with a thorough cleaning called scaling and root planing. Scaling removes plaque or calculus that has accumulated on the crowns of your teeth (the parts that show) and slightly below the gum line. Root planing has two purposes: 1) to remove plaque or calculus from the roots of your teeth and 2) to smooth the roots of the teeth, making it more difficult for bacteria to cling to them. This, combined with good oral hygiene at home, often is enough for successful treatment.

Moderate periodontitis may require more than scaling and root planing. Typically, your dentist will scale and root-plane your teeth. If this does not take care of the problem, he or she may decide that you need surgical treatment. Surgery can involve reshaping the gums to fit the teeth (resective surgeries) or encouraging lost bone to regrow (regenerative surgeries). Your dentist will decide whether you will need surgery and what type you need.

Severe periodontitis likely will require surgical intervention and, in some instances, antibiotics. At this stage of disease, tooth loss is a distinct possibility.

No matter which treatment you undergo, you should start a strict regimen of brushing and flossing to help restore your teeth to health.

When To Call Your Puyallup Dentist

The best course of action is to get regular dental checkups. If you have persistent bleeding or swelling of your gums or notice loose teeth, call your dentist.

Prognosis

The outlook is good if the disease is recognized early and treated aggressively. Once bone loss occurs, the prognosis depends on the severity of the loss. Quitting smoking is very important for periodontal therapy to be successful. Lifelong maintenance will be required once the disease is controlled.

It is estimated that 35.7 million Americans are living with a bacterial infection of the gums known as periodontal disease. This infection attacks the tissue that keeps your teeth attached to your gums.

On average, more than 500 species of bacteria live in your mouth.2 Some of these bacteria are beneficial, while others under the right conditions can cause disease. Living a healthy lifestyle helps you keep the harmful bacteria under control. Not taking care of your overall health and your teeth and gums can cause an overgrowth of harmful bacteria, which may lead to serious health problems beyond the mouth, in addition to the threat of losing your teeth.

35.7 million Americans are living with a bacterial infection of the gums known as periodontal disease

Factors that predispose people to gum disease include bad oral hygiene and genetics. In fact, research has proved that up to 30% of the population may be genetically predisposed to gum disease.3

Periodontitis, a severe form of periodontal disease, is caused by plaque that develops just below the gum line, in the area called the sulcus or periodontal pocket, where it causes the attachment of the tooth and its supporting tissues to break down. The mildest form of periodontal disease is known as gingivitis and is triggered by bacterial plaque that forms at the gum line.

What Is Periodontal Disease?

Periodontal disease is an infection of the tissue that supports your teeth. It attacks just below the gum line, where it causes the attachment of the tooth and its supporting tissues to break down.


WARNING SIGNS

• Pain in the mouth
• Gums bleed when brushing
• Spaces develop between teeth
• Swollen and tender gums
• Receding gums (exposing the bottom of your teeth)
• Persistent bad breath
• Pus between teeth and gums
• Sores develop

RISK FACTORS

• Tobacco use
• Systemic diseases
• Use of certain types of medicine
• Bridges that no longer fit
• Crooked teeth
• Fillings that have become defective
• Pregnancy
• Oral cancer

If you're showing warning signs, see your Puyallup dentist. Mild gum disease may be controlled by routine professional teeth cleanings and more diligent home care. Gingivitis and early periodontitis can be kept under control by your dental team.

Scaling and root planing also may be a step your dentist or hygienist takes to control early to moderate periodontitis. Scaling removes hard and soft deposits of calculus from the crown of the tooth. Root planing smooths away calculus deposits that collect on the root surfaces beneath the gums.1

Local, needle-free methods are available to keep you comfortable during this process. Your dental professional may also choose to perform this treatment one area of your mouth at a time over a series of office visits.

For advanced gum diseases, surgical treatments using local anesthetics may be performed. To reduce the size of gingival pockets, a periodontist folds back the gum tissue and removes the disease causing bacteria. He or she may also reshape the bone and gum, add bone grafts if necessary, and then stitch the tissue back into place.