What is Periodontitis?

Periodontitis

Periodontitis, or gum disease, is a common infection that damages the soft tissue and bone supporting the tooth. Without treatment, the alveolar bone around the teeth is slowly and progressively lost.

The name “periodontitis” means “means inflammation around the tooth.” Microorganisms, such as bacteria, stick to the surface of the tooth and in the pockets surrounding the tooth, and they multiply. As the immune system reacts and toxins are released, inflammation occurs.

Untreated periodontitis will eventually result in tooth loss. It may increase the risk of strokeheart attack, and other health problems.

Bacterial plaque, a sticky, colorless membrane that develops over the surface of teeth, is the most common cause of periodontal disease. If plaque is not removed, it can harden to form tartar or calculus.

Most cases of periodontitis are preventable through good dental hygiene.

How can I recognize periodontitis?

Periodontitis always begins with inflammation of the gums, known as gingivitis. This is not always easy to recognize but one of the first signs that you may become aware of is bleeding from the gums when you brush your teeth. The gums may look red and swollen and you might notice a discolored layer of bacterial plaque on the teeth.

Left untreated, gingivitis may progress to periodontitis, often without any obvious signs to alert you. However, some changes that you might experience over time include increased bleeding from the gums, which may be provoked by brushing or eating, or even be spontaneous; bad breath; changes in the positioning of the teeth in the jaws; lengthening of the teeth (gum recession); and possibly pain. Bleeding from the gums may be less noticeable in smokers, because of the effect of nicotine on blood vessels, and so the disease process may be masked.

It often happens that the presence of periodontitis is not recognized by an individual until they are 40 or 50 years of age, by which time a great deal of damage may have occurred. However, a dentist can detect signs of the disease at a much earlier stage during a routine examination and can monitor your periodontal status using a special assessment known as the Periodontal Screening Index.

Causes

In most cases, the development of periodontitis starts with plaque — a sticky film composed mainly of bacteria. If left untreated, here’s how plaque can eventually advance to periodontitis:

  • Plaque forms on your teeth when starches and sugars in food interact with bacteria normally found in your mouth. Brushing your teeth twice a day and flossing once a day removes plaque, but plaque re-forms quickly.
  • Plaque can harden under your gumline into tartar (calculus)if it stays on your teeth. Tartar is more difficult to remove and it’s filled with bacteria. The longer plaque and tartar remain on your teeth, the more damage they can do. You can’t get rid of tartar by brushing and flossing — you need professional dental cleaning to remove it.
  • Plaque can cause gingivitis, the mildest form of gum disease. Gingivitis is irritation and inflammation of the part of your gum tissue around the base of your teeth (gingiva). Gingivitis can be reversed with professional treatment and good home oral care.
  • Ongoing gum inflammation can cause periodontitis, eventually causing pockets to develop between your gums and teeth that fill with plaque, tartar, and bacteria. In time, these pockets become deeper, filling with more bacteria. If not treated, these deep infections cause a loss of tissue and bone, and ultimately you may lose one or more teeth. Also, ongoing chronic inflammation can put a strain on your immune system.

Risk factors

Factors that can increase your risk of periodontitis include:

  • Gingivitis
  • Poor oral health habits
  • Smoking or chewing tobacco
  • Hormonal changes, such as those related to pregnancy or menopause
  • Recreational drug use, such as smoking marijuana or vaping
  • Obesity
  • Inadequate nutrition, including vitamin C deficiency
  • Genetics
  • Certain medications that cause dry mouth or gum changes
  • Conditions that cause decreased immunity, such as leukemia, HIV/Aids, and cancer treatment
  • Certain diseases, such as diabetes, rheumatoid arthritis, and Crohn’s disease

Complications

Periodontitis can cause tooth loss. The bacteria responsible for periodontitis can enter your bloodstream through the gum tissue, possibly affecting other parts of your body. For example, periodontitis is linked with respiratory disease, rheumatoid arthritis, coronary artery disease, and problems controlling blood sugar in diabetes.

Prevention

The best way to prevent periodontitis is to follow a program of good oral hygiene, one that you begin early and practice consistently throughout life.

  • Good oral hygiene. That means brushing your teeth for two minutes at least twice daily — in the morning and before going to bed — and flossing at least once a day. Flossing before you brush allows you to clean away the loosened food particles and bacteria. Good oral hygiene prevents the development of an environment around your teeth that is favorable to specific bacteria that cause periodontal disease.
  • Regular dental visits. See your dentist or dental hygienist regularly for cleanings, usually every six to 12 months. If you have risk factors that increase your chance of developing periodontitis — such as having a dry mouth, taking certain medications, or smoking — you may need professional cleaning more often.

Resources:

medicalnewstoday.com

efp.org

mayoclinic.org

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