What is Periodontal Disease?

Periodontal disease (perio = around, dontal = the teeth) refers to a severe form of gum and jaw bone disease. Periodontal disease can be caused by a lack of regular brushing and flossing. It can also be caused by tooth clenching and grinding (bruxism), health conditions (e.g. diabetes), smoking or genetic factors.

It’s a very serious condition because while it might not show up when you smile in the mirror at first, it will eventually affect your entire mouth, and can cause tooth loss. In addition to negatively impacting oral health, periodontal disease is correlated with the existence of heart disease, Alzheimers Disease and other serious medical conditions.

Quick Note: Gingivitis, or gum disease, is not the same as periodontal disease. Gingivitis means “inflammation of the gums.” It can happen at any age and is often a precursor to periodontal disease. Most patients with gingivitis who start taking better care of their teeth will never develop periodontal disease.

Your dentist is usually the one who diagnoses periodontal disease. Treatment is largely dependent on how serious the condition is along with your current health condition and lifestyle.

What Causes Periodontal Disease (Periodontitis)?

Your mouth is filled with all kinds of bacteria – some worse than others. When you eat, breathe, talk, smile – these bacteria mix and mingle with saliva, mucous and other particles – forming a slick coating on your teeth. We call this coating plaque. When you brush and floss regularly, this plaque is almost completely washed away. When you visit the dentist for a checkup and cleaning, a thorough dental cleaning eliminates the rest of it.

If, however, you skip any of these important oral hygiene steps, plaque hardens and solidifies – becoming tartar. While visible plaque and tartar on the teeth is unsightly, the most dangerous plaque and tartar is the kind that becomes trapped between the teeth and gums (this is the stuff we use a metal pick and/or a water pick to dislodge before we clean your teeth). Over time, the bacteria harbored there can infect the gums and cause bone loss around your teeth.

Bruxism is tooth clenching or grinding. Many people experience bone loss because they clench or grind their teeth causing inflammation in the periodontal ligament which holds the teeth into the jaw bone. This inflammation can cause bone loss over time.

Symptoms of periodontitis

While these are common symptoms of periodontitis, they do not mean you have gum disease. If any of these sound familiar to you, call us and schedule a checkup.

• Bad breath with no other explanation
• Swollen, bleeding and/or tender gums
• Painful chewing
• Receding gums or teeth that look longer than they used to (looking through old photos and comparing them to your current smile is an accurate way to see if your gums have receded)
• Sensitive teeth

In mild cases, periodontitis may cause inflamed gums. In more moderate to severe cases, inflamed gums begin to pull away from the teeth, forming pockets. These pockets allow plaque and tartar to form underneath the gum line, where further infections ensue.

In the meantime, your body launches an immune system attack to fight these infections. In doing so, the same bacterial toxins released to fight the bacteria also break down the connective tissue and bone that holds teeth in place. Ultimately, untreated periodontal disease can cause teeth to loosen and fall out. It will also continue to destroy the gums, bones and other tissues that hold teeth in place.

Who’s at Risk for Developing Periodontal disease?

Anyone who doesn’t take proper care of his or her teeth (brushing and flossing at least twice a day, and visiting a dentist at least twice per year) is at risk of developing gum disease. However, certain risk factors increase your chances even further. These include: Smoking and chewing tobacco; Hormonal changes in girls/women, particularly during pregnancy; Diabetes; Prescription and over-the-counter medications that cause dry mouth; People who clench or grind their teeth.

In the early stages

If caught in the early stages, you may be able to get by with a thorough dental cleaning and strict instructions regarding brushing, flossing and more regular visits to the dentist. Your dentist may also recommend lifestyle changes such as quitting smoking, minimizing sugary foods and beverages, etc. They may request a consultation with your physician to reduce health factors. An occlusal splint (night guard) is often suggested in cases suspected of tooth grinding.

In the middle stages

If infections are beyond the scope of good oral hygiene, your dentist will discuss other treatment options that include:

Deep teeth cleaning (scaling and root planing)

This type of cleaning goes beyond the normal dental cleaning – using specialized instruments that access teeth and roots underneath the gums. First, we scale the teeth to remove tartar build-up. Then we plane both the tooth and the roots as needed, scraping away uneven patches that tend to harbor bacteria.
This treatment can result in swollen and very tender gums, but they typically heal fairly quickly. We may also prescribe an antibiotic medication to eradicate existing – and prevent further – infection.

Bone and tissue grafting

As mentioned above, severe periodontitis will eat away at the gums, bone and surrounding tissues. Both of these procedures are typically handled by an oral surgeon and we will consult them with you.

Dental implant placement

When bone support of teeth becomes too extensive, replacement of teeth with dental implants is often the best remedy. This will halt the progression of the disease in the areas that the teeth are replaced.

Preventing Periodontal Disease is Always Better Than Treating It

It’s important for patients to understand that severe periodontitis cannot automatically be fixed using dental implants. Your dentist will work with you to monitor your oral health and make sure that the disease is diagnosed and treated before tooth replacement is impossible. If you are concerned that you have gum disease or that it has progressed, we’ll be happy to review your condition and all of your options with you.