What is periodontitis or periodontal disease
Periodontitis or periodontal disease means “inflammation around the tooth” – is a serious gum infection that damages the soft tissue and bone that supports the tooth. All periodontal diseases such as periodontitis, are infections that affect the periodontium. The periodontium is the tissue around a tooth supporting tissues of the tooth. With periodontitis, alveolar bone around the teeth is lost slowly and progressively. Microorganisms, such as bacteria, adhere to the tooth surface and multiply – a hyperactive immune system reacts to inflammation.
Periodontitis untreated will eventually lead to tooth loss, and may increase the risk of stroke, heart attack and other health problems. The plaque, a sticky, colorless membrane which develops on the surface of teeth, is the most common cause of periodontal disease.
In dentistry, periodontics deals with prevention, diagnosis and treatment of diseases affecting the gums and supporting structures of the teeth. There are eight dental specialties, and periodontics is one of them. If dental implants are desired, see a periodontist.
In most cases, periodontitis can be prevented. Usually it is caused by poor dental hygiene.
Difference between periodontitis and gingivitis
The gingivitis occurs before periodontitis. Usually gingivitis refers to inflammation of the gums, while means periodontitis gum disease and the destruction of tissue and / or bone. Initially, with gingivitis, plaque accumulates on the tooth surface, causing the gums redden and swell; teeth may bleed when brushed. Although the gums are irritated and annoyed, teeth are not loose. No irreversible damage to the bone or surrounding tissue.
If left untreated gingivitis can progress to periodontitis. With periodontitis, gums and bone are removed from the teeth, forming large holes or tunnels. Food debris collect in the spaces between the gums and teeth, and infect the area. The patient’s immune system attacks bacteria plate extending below the gumline. The bone and connective tissue that support the teeth begin to break – this is caused by toxins produced by the bacteria. The teeth become loose and fall out.
In short, the periodontitis involves irreversible changes in the supporting structures of the teeth, while gingivitis.
Signs and symptoms of periodontitis
A symptom is something that feels and describes the doctor, while a sign is something other people, including the doctor can see. For example, pain is a symptom while redness or swelling is a sign.
The signs and symptoms of periodontitis may include:
- Swollen gums (swollen), inflammation of the gums is repeated
- Red gums bright, sometimes purple
- Sore gums when touched
- The gums recede, making the teeth look longer
- Some extra spaces appear between teeth
- They may appear pus between teeth and gums
- Bleeding when brushing
- Bleeding while flossing
- Metallic taste in mouth
- Halitosis (bad breath)
- Loose teeth
- The patient’s bite feels different because the teeth do not fit the same way
Causes of periodontitis or periodontal disease
- Dental plaque forms on the teeth – this is a pale yellow biofilm that develops naturally on the teeth. Can be formed by bacteria that try to attach to the smooth surface of the teeth.
- Brushing releases the plate, but soon builds up again; in a day or two.
- If not removed, after two or three days will harden into tartar. Tartar is much more difficult to remove than plaque. Removal of calculus requires a professional – you cannot do yourself.
- The plaque may slowly and progressively damage the teeth and surrounding tissues. Initially, the patient may develop gingivitis – inflammation of the gum around the base of the teeth.
- Persistent gingivitis can lead to developing exchanges between the teeth and gums. These bags are filled with bacteria.
- Bacterial toxins and our immune system response to infection start to break down the bone and connective tissue that hold teeth in place. Finally, the teeth begin to become loose and may even fall.
Risk factors for periodontitis
A risk factor is something that increases the risk of developing a condition or disease. The following risk factors are associated with an increased risk of periodontitis:
- Smoking – Regular smokers are much more likely to develop gum problems. Smoking also undermines the effectiveness of treatments.
- The hormonal changes in women – puberty, pregnancy and menopause are times in life when a woman’s hormones are unchanged. These changes increase the risk of developing gum disease.
- Diabetes – patients living with diabetes have a much higher incidence of gum disease than people of the same age
- AIDS – people with AIDS have more gum disease
- Cancer – Cancer and some cancer treatments can usually more of a problem with gum disease
- Some medications – some medications that reduce saliva are linked to the risk of gum disease.
- Genetics – some people are more genetically susceptible to gum disease
Treatment for periodontitis
The main objective of the periodontist, dentist or dental hygienist in the treatment of periodontitis, is to clean the bacteria from the pockets around the teeth and prevent further destruction of bone and tissue.
For best results of treatment, patients should maintain good oral hygiene and proper care. This means brushing your teeth at least twice a day and floss once a day. If there is enough space between the teeth, one is recommended interdental brush. Arthritis patients and other people with dexterity problems may find that using an electric toothbrush is better for a thorough cleaning.
It is important that the patient understands that periodontitis is a chronic inflammatory disease (long-term) – this means that the oral hygiene should be maintained for life. This will also involve regular visits to the dentist or dental hygienist.
Initial treatment periodontitis
It is important to remove plaque and tartar to restore periodontal health.
The health professional will use clean (non-surgical) below the gumline. This procedure is called scaling and debridement. Sometimes you can use an ultrasound device.
- Antimicrobial mouthwash – for example chlorhexidine. Helps control bacteria in the treatment of gum disease, and after surgery. Patients use it like a regular mouthwash.
- Antiseptic – this is a small piece of gelatin filled with chlorhexidine. Controls bacteria and reduces the size of the periodontal pocket. This medicine is placed in the bag after root planing . The drug slowly closes the time.
- Antibiotic Gel – a gel containing doxycycline, an antibiotic. This medicine controls bacteria and shrink periodontal pockets. Is placed in the pockets after scaling and root planing. It is a slow release drug.
- Antibiotic Microspheres – are tiny particles containing minocycline, an antibiotic. It is also used to control bacteria and reduce the size of the periodontal pocket. They are placed in the pockets after scaling and root planing. It is also a slow release medication.
- Enzyme suppressor – keeps destructive enzymes in check with a low dose of doxycycline. Some enzymes can break down gum tissue, this drug stops the body’s response to the enzymes. It can be taken orally in pill form, and is used with scaling and root planing.
- Oral antibiotics – are found either in capsule or tablet form and is taken orally. They are used for short term treatment of acute periodontal infection or persistent home.
The types of periodontitis can take many forms, each with specific factors that contribute to its progression:
- Aggressive periodontitis – This affects people in normal health, and increases rapidly causing bone loss and destruction of the attached gingiva.
- Chronic periodontitis – is perhaps the most common form of periodontitis, which occurs primarily in adults, although anyone (regardless of age) can develop. Gingival inflammation, bone loss and increased gingival recession may progress more slowly than with other forms of periodontitis.
- Periodontitis associated with systemic diseases – Systemic diseases, such as heart disease, diabetes and certain types of arthritis, may have a correlation with periodontitis. Research suggests the connection between periodontitis and certain diseases may be due to a chronic inflammatory response, as this is common with many systemic conditions. Other theories suggest that microorganisms in the mouth are partly to blame.
- The necrotizing periodontal disease – Necrosis is the death of the gum tissue, connective tissue and bone surrounding the teeth, causing lesions in the mouth. People with diseases such as HIV/AIDS, immunodeficiency disorders, and malnutrition often display this form of periodontitis.