What is Periodontal Disease?

The term periodontal means “around the tooth,” and periodontal disease is a common inflammatory condition affecting the supporting and surrounding soft tissues of the tooth, as well as the jawbone in more advanced stages.  It usually begins as gingivitis, a bacterial infection of the gum tissue caused by toxins in plaque.  Once this infection colonizes in the gum pockets between the teeth, it becomes much more difficult to remove and treat.

How do I Know If I Have Periodontal Disease?

Frequently, there is no pain involved in the early stages of periodontal disease, which is why it’s critical to have regular dental checkups. Know the regular signs and symptoms, and check with your dentist as soon as possible if you experience any of the following:

  •  Unexplained bleeding: Bleeding when brushing, flossing, or eating food is one of the most common symptoms of a periodontal infection.  The toxins in plaque cause a bacterial infection that makes the tissues prone to bleeding.
  • Pain, redness, or swelling: If the gums are swollen, red, or painful for no apparent reason, a periodontal infection may be the cause.  It’s important to treat this before the gum tissue becomes infected, or the infection travels through the bloodstream to other areas of the body.
  • Longer-looking teeth: Gum recession, which is a hallmark of periodontal disease, can lead to the teeth appearing longer and the smile looking toothier.
  • Bad breath/halitosis: Halitosis has many causes, but old food particles trapped in the deep gum pockets produced by periodontal disease may be a cause.
  • Loose teeth or a change in bite pattern: A sign of rapidly progressing gum disease is the loosening or shifting of the teeth in the affected area.  As the bone tissue gets destroyed, teeth that were once firmly attached to the jawbone become loose or may shift in position.
  • Pus: Pus oozing from between the teeth is a definitive sign that an infection is in progress; the pus is a result of the body trying to fight the bacteria.

Because periodontal disease is a progressive condition, the earlier it’s caught, the better off your mouth will be. You may be prescribed antibiotics and/or medicated mouthwash; the pockets under the gum line will be completely cleared of debris using a procedure called scaling and root planing, and they may be filled with antibiotics to promote healing and kill any remaining bacteria. Severe periodontal disease frequently requires a laser treatment to reduce pocket size, tissue and bone grafting to stimulate new growth, or pocket elimination surgery to directly fix the gums.  If you have questions or concerns about the signs, symptoms, and treatments for gum disease, please ask your dentist for more information.

What are the Types of Periodontal Diseases?

Gingivitis: This is both the mildest and the most common form of gum disease. People with increased risk for gingivitis include pregnant women, women taking contraceptive pills, people with uncontrolled diabetes, steroid users, and those on blood pressure or seizure medication. Thankfully, gingivitis is easily reversible, with good home care and professional cleaning. The dentist may perform root planing and deep scaling procedures to cleanse the pockets of debris, and then prescribe a combination of antibiotics and medicated mouthwashes to kill any remaining bacteria.

Chronic Periodontal Disease: Occurring frequently in people over 45, this condition involves inflammation below the gum line and the progressive destruction of gingival and bone tissue. Unlike gingivitis, it isn’t curable, but the dentist can halt its progression with scaling and root planing procedures in combination with antimicrobial treatments. If necessary, pocket reduction surgery and tissue grafts can be considered to strengthen the bone and improve the appearance.

Aggressive Periodontal Disease: This involves the same symptoms and treatments as chronic periodontal disease, but it’s characterized by the rapid loss of gum attachment and bone tissue. Smokers and those with a family history of the disease face a higher risk of developing the aggressive variant. Sufferers are more likely to require surgical intervention, as this form of the disease is harder to halt and treat.

Periodontal Disease Relating to Systemic Conditions: In some cases, gum disease can be a symptom of a disease or condition affecting the rest of the body. Depending on the underlying condition, it can be aggressive, working quickly to destroy tissue. Heart disease, diabetes, and respiratory disease are the most common systemic conditions leading to aggressive gum disease, but many medical issues intensify and accelerate its progression. Once the underlying concern is controlled, the dentist will try to halt the disease.

Necrotizing Periodontal Disease: This form of the disease rapidly worsens and is more prevalent among people who suffer from HIV, immunosuppression, malnutrition, or chronic stress, or those who choose to smoke. Tissue death, called necrosis, affects all areas of the mouth. This is a rare disease, and because it is generally linked with a serious medical condition, the dentist and physician will consult on the best treatment plan for your overall health.

How do You Treat Periodontal Disease?

Periodontal disease progresses as the sulcus, the pocket between a tooth and the gums, is filled with bacteria, plaque, and tartar, causing irritation to the surrounding tissues.  If the disease has been caught in the early stage, called gingivitis, and no damage has been done, one or two regular cleanings should clear it up.  You’ll also be given instructions on improving your daily oral hygiene habits and having regular cleanings.

If the disease has progressed, a periodontal cleaning called scaling and root planing will be recommended.  This is usually done in one quadrant of the mouth at a time.  While the area is numb, the tartar, plaque, and toxins are removed from above and below the gum line (scaling) and rough spots on root surfaces are made smooth (planing).  This procedure helps to heal the gum tissue and shrink the pockets. Medications, medicated mouth rinses, and an electronic toothbrush may be recommended.

If the pockets do not heal after scaling and root planing, periodontal surgery may be needed to reduce pocket depths.  Your dentist may also recommend that you see a periodontist, a specialist of the gums and supporting bone.  The earlier periodontal disease is caught, the less likelihood there is of needing these advanced measures.