Periodontitis

Periodontitis is an inflammatory condition of the periodontium, which is the set of tissues that surround and support the teeth. Periodontitis is destructive, damaging the soft tissues of the periodontium and gradually destroying the bone that supports the teeth. If left untreated or treated insufficiently, periodontitis can cause the teeth to loosen and eventually fall out. While common, periodontitis is highly preventable and usually arises because of inadequate oral hygiene.The best defense against periodontitis is properly brushing twice daily with fluoride toothpaste and a soft-bristled brush, as well as flossing or otherwise cleaning between the teeth daily. Professional dental checkups and cleanings are also instrumental in preventing periodontitis. These preventative steps are also instrumental to the treatment and management of the disease when it does arise.

Periodontitis can manifest multiple symptoms, depending on its severity. These symptoms can include swelling and redness or other discoloration of the gums, tenderness or pain in the gums when stimulated, and bleeding upon brushing the teeth, and, in more severe cases, symptoms can include the presence of pus in the mouth, loose or mobile teeth, and receding gums. Sometimes, the symptoms of periodontitis can be relatively painless or otherwise difficult to detect; in these instances, dental checkups can be instrumental in early diagnoses. When symptoms do occur, prompt dental care is recommended, as gum diseases in their earlier stages can often be reversed.

Periodontitis is caused, in most cases, by the accumulations of dental plaque on the teeth, both above and below the gumline. Plaque forms on the teeth when simple sugars in food and drinks interact with bacteria in the mouth. While this plaque can be managed by daily brushing and flossing, new plaque will continue to form nearly constantly. When residual bits of plaque harden and turn into dental calculus, also known as tartar, they can’t be removed with traditional home hygiene methods and must be removed by a dental health professional. Dental calculus also encourages the accumulation of greater amounts of bacterial plaque, making it easier for plaque to adhere to the teeth. If not managed sufficiently, this accumulation of calculus and plaque leads to inflammation; when not treated promptly, chronic inflammation can lead to periodontitis. Periodontitis is characterized by the presence of periodontal pockets, which are deepend pockets between the gums and teeth that fill with additional plaque and calculus. The more inflammation there is, the deeper these pockets become, and the more they fill with damaging bacteria. This bacteria and inflammation lead to a loss of tissue and bone, and it can also lead to loss of the teeth. It can also lead to other systemic conditions that are exacerbated by inflammation.

While an accumulation of bacteria due to poor oral hygiene is the most common cause of periodontitis, certain risk factors can increase the likelihood of periodontitis developing. These risk factors may include smoking or chewing tobacco, hormonal changes, recreational drug use, obesity, malnutrition, medications, certain diseases and systemic conditions, and genetics. In the presence of these risk factors, treatment may include behavior modification recommendations in addition to dental deep cleaning and careful training in proper oral hygiene methods.