Periodontal Disease

What Is Periodontal Disease and How Does it Develop?

Periodontal disease occurs when dental plaque builds up on teeth. Everyone has dental plaque, a sticky biofilm that continually forms on your teeth.

Plaque contains bacteria, and it is these bacteria that cause periodontal disease. Most plaque is removed during brushing and flossing.

Plaque that remains on your teeth hardens into calculus or tartar within a couple of days. Tartar is hard and crusty, and at this point, you cannot remove it with regular at-home oral care; it must be removed professionally during a hygiene appointment.

The bacteria in dental plaque and tartar are fuelled by leftover food debris trapped around and between your teeth. This food source allows them to thrive and multiply, and as they do so, they create toxins.

These toxins inflame and infect your gums initially, before the infection spreads to the periodontal ligaments securing your teeth in their sockets, and the bone surrounding your teeth.

Without treatment, tooth loss can occur.

There are two main stages of periodontal disease, which are:

• Gingivitis, where the infection and inflammation are relatively mild. At this stage, periodontal disease is reversible with prompt professional dental care.
• Periodontitis is far more advanced and trickier to treat and can soon become chronic. At this stage, the structures around your teeth may have begun to be destroyed, and treatment could be ongoing to manage this disease rather than cure it completely.

Symptoms of Periodontal Disease

In addition to bleeding gums, you may notice other signs, including:

• Gums that feel increasingly tender.
• Swollen gums.
• Gums that look red or purple instead of a healthy pink.
• A persistently nasty taste or bad breath.
• Gum recession that can cause teeth to look longer, and you may even be able to see your tooth roots appear.
• Discomfort or pain when eating.
• Bite changes due to teeth becoming loose and shifting out of place.

A periodontal abscess can sometimes develop as a complication of periodontal disease, which is caused by a pocket of pus in the gums. It can cause significant pain and discomfort and require urgent gum abscess treatment to relieve the pain and prevent further damage.

Who is More at Risk of Gum Disease?

Anyone, including children, can develop gum disease, and it is frequently due to lax oral hygiene. However, certain other factors can increase the risk of developing periodontal disease.

Smoking

Smoking is a major risk factor for gum disease and can mean you are several times more likely to develop this condition than non-smokers.

One problem with periodontal disease is that it is easy to miss or ignore the first signs, particularly if you smoke. This is because one of the first symptoms is bleeding gums, especially while brushing and flossing. Gums are less likely to bleed in smokers since the nicotine constricts blood vessels, masking this early warning sign.

Family History

If close family relatives have periodontal disease, you could be at greater risk of developing this condition too. This could be due to poor oral care at home, or a genetic factor may be involved.

Health Issues

Certain health issues, like cardiovascular disease and diabetes, can make it harder to fight infections, as can those that affect the immune system, like lupus and Crohn’s disease.

Medications

A common side effect of many prescription and over-the-counter drugs is a condition called xerostomia, or dry mouth. Saliva has a protective effect on oral health, helping to wash away excess food particles and bacteria. Without it, bacteria will thrive in drier conditions, increasing the risk of developing periodontal disease and other oral health problems.

Hormonal Changes

During puberty, pregnancy, and menopause, hormonal levels change, increasing the sensitivity of gum tissues to plaque bacteria. This, in turn, increases the risk of the gums becoming inflamed, red, and tender, and of the disease bleeding more frequently.

Diagnosing Periodontal Disease

A diagnosis is straightforward and can be made during any standard dental exam.

Periodontal Probe

During the exam, our dentist will use a small instrument called a periodontal probe, which is inserted carefully in between each tooth and the surrounding gum.

The probe measures the depth of these spaces, which are carefully recorded so they can be read during subsequent dental exams to assess any changes. Healthy gums should have a depth of no more than 3 mm, and any deeper may indicate periodontal disease.

These spaces are called periodontal pockets. They are very harmful because they harbor the bacteria that cause periodontal disease and provide the perfect environment for them to thrive.

Digital Imaging

Other diagnostic tools include Digital dental X-rays, and we may recommend a panoramic X-ray showing all your teeth and jaws in one image, or a 3-D cone beam CT scan. All these images are used to evaluate the bone levels around your teeth and to assess the damage that may have been caused by periodontal disease as it progresses.

Treatment Options for Periodontal Disease

If we diagnose periodontal disease, we can provide a custom treatment plan based on its progression.

There are various options available, designed to reduce the number of harmful bacteria causing the infection and prevent further damage to the gum and bone around your teeth. You may need a receding gums treatment to help reduce the size of any periodontal pockets and enable your gums to fit more snugly around your teeth.

The plan recommended for you may combine nonsurgical and surgical procedures. For example, a deep-cleaning treatment called scaling and root planing is often used to help eliminate harmful bacteria from deep inside the gums. Treatment may be combined with antibiotics.

Bone grafting might be required to restore bone destroyed by this infectious condition. It may also be needed if you have lost teeth to periodontal disease and wish to replace them with dental implants. Often, after advanced periodontal disease, there is not enough bone to support implants without bone grafting.

Preventing Periodontal Disease

Periodontal disease is a preventable condition. When you first visit our dental practice, we will assess your risk of developing gum disease and provide a tailored treatment plan to reduce this risk as much as possible.

The plan will include straightforward strategies, such as improving oral hygiene at home, combined with regular periodontal assessments and professional dental cleanings.

We strongly recommend regular dental exams because they allow us to carefully assess your gum health and monitor any changes, so that, if necessary, we can provide early treatment that can help reverse this condition entirely.

Frequently Asked Questions

1. Is Periodontal Disease Painful?

Initially, periodontal disease may cause little or no pain, but as it progresses, your gums will likely feel increasingly tender, and it may become painful to eat.

2. Will Dental Insurance Cover Gum Infection Treatment?

Almost certainly, yes, as this is an essential treatment required for good oral health.

3. How Long Will Gum Disease Treatment Take?

The time needed depends on the treatment we recommend. Some treatments, like scaling and root planing, are very straightforward and typically take just a little longer than a standard hygiene appointment.

However, if you have severe periodontal disease, treatment may be ongoing, and we may need to complete a deep dental cleaning in several appointments for your comfort.