Periodontitis

Overview of Periodontitis

Periodontitis (مسوڑے کی بیماری) is a gum infection that causes the damage to the soft tissue and bone supporting the tooth. Without treatment, the alveolar bone might be destroyed over the period, leading to loosening tooth or tooth loss.

Periodontitis literally translates to ‘inflammation around the tooth. Inflammation occurs as a reaction of the immune system to the microorganisms that stick to the surface of the tooth while multiplying.

Periodontitis is a serious condition that is preventable only if proper measures are taken.

Periodontitis Prevalence

Periodontal diseases affect almost 20 to 50 percent of the global population. In Pakistan, the prevalence of periodontal diseases is 18 percent and out of these 18 percent, 31 percent have periodontitis.

Stages of gum disease

Signs and Symptoms of Periodontitis

Signs and symptoms of Periodontitis include:

  • Swollen gums
  • Gums tender to touch
  • Bright red or purple gums
  • Bleeding from the gums
  • Bleeding while brushing or flossing
  • Bad breath
  • Pus between the tooth and gums
  • New spaces between teeth
  • Loose teeth or tooth loss
  • Receding of the gums from the teeth

Types of Periodontitis

There are several types of periodontitis, including:

  • Chronic periodontitis: This is the most common type of periodontitis, and it is characterized by slow and progressive destruction of the gums, bone, and connective tissues that support the teeth.
  • Aggressive periodontitis: This type of periodontitis is characterized by rapid and severe destruction of the gums, bone, and connective tissues that support the teeth. It typically affects younger individuals and may be hereditary.
  • Necrotizing periodontitis: This is a severe type of periodontitis that involves the death of gum tissue, connective tissue, and bone. It is often associated with underlying health conditions such as HIV or malnutrition.
  • Periodontitis as a manifestation of systemic diseases: This type of periodontitis is associated with underlying health conditions such as diabetes, heart disease, and respiratory disease.
  • Refractory periodontitis: This is a type of periodontitis that is resistant to treatment and may be caused by factors such as genetics, smoking, or immune system disorders.

It's important to note that the treatment for periodontitis will depend on the type and severity of the disease.

 

Causes of Periodontitis

Plaque is the usual cause of periodontitis. Plaque consists of sticky bacteria that damage the teeth.

  • Plaque forms on the teeth due to the interaction of bacteria with sugar and starches
  • If the plaque is not removed, it hardens and forms calculus
  • This leads to gingivitis, the early stage of periodontitis
  • Chronic gingivitis leads to periodontitis and more deep infections
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Risk Factors of Periodontitis

Risk factors of periodontitis include:

  • Poor oral hygiene
  • Smoking
  • Chewing tobacco
  • Gingivitis
  • Obesity
  • Recreational drugs
  • Vit C deficiency
  • Less immunity
  • Diabetes
  • Certain medications that cause dry mouth and gum changes

Complications of Periodontitis

 

This condition can cause tooth loss in an individual. The bacteria that have caused this infection can enter the blood flow through the infected gums. They can then affect the other body parts as well. This disease is also linked with the onset of chronic respiratory disease, rheumatoid arthritis, and coronary artery disease.

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Prevention

The best possible preventions of periodontitis are as follows:

  • Practice Oral Hygiene

The best possible means of preventing the onset of periodontitis is making sure that you are keen on your oral hygiene. Brush your teeth twice a day and start flossing.

  • Visit Your Doctor

 

Make sure to schedule a visit with your dentist in case of bleeding or swollen gums.

 

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Diagnosis

To diagnose periodontitis, the dentist reviews the medical history of the patient and the contributing factors to the disease.

  • The mouth is examined for plaque and calculus
  • The space between the gums and teeth is checked known as the pocket depth
  • A dental x-ray is done to check for deeper infections and bone loss

In some cases, periodontitis found can be:

  • Aggressive Periodontitis:

It is also known as localized aggressive periodontitis and is a very rare condition that shows the rapid growth of the infection.

  • Juvenile Periodontitis

It is an uncommon condition leading to severe attachment loss of the gum and destruction of the alveolar bone.

Treatment of Periodontitis | When to Consult a Doctor

The goal of the treatment is to prevent tooth damage and clean the pockets around the teeth. Good oral care alongside treatment is very necessary. 

  1. Non-Surgical Procedures

For initial stages or mild cases, non-surgical procedures are performed including:

  • Scaling

This involves removing the calculus or tartar from the tooth surface and gums.

  • Root planing

It removes all bacterial components and promotes healthy teeth without calculus formation.

  • Antibiotics

Oral antibiotics can help fight bacterial infections. Mouth rinses or gels can effectively kill the bacteria residing in the teeth. 

  1. Surgical Procedures

For advanced staged periodontitis, surgery may be performed which includes:

  • Soft Tissue Grafts

After the gum line recedes, damaged tissue is reinforced to reduce further damage.

  • Flap Surgery

Tiny incisions are made to lift back the gum tissue so that non-invasive procedures can be performed easily.

  • Bone Graft

It is done when the tooth root is destroyed by the infection. The graft may be synthetic or from your own bone. It helps by holding the tooth in place.

  • Tissue-stimulating Proteins

A special gel is applied to the tooth root which promotes healthy bone and tissue.

Bleeding and inflammation of the gums is usually the first sign of periodontitis. If this persists, go see a dentist immediately.