This big word is the official term for the disease that many people call periodontal disease or, more simply, gum disease. Dentists and other dental professionals may refer to it as “perio” for short. This disease affects millions of Americans, and almost half of U.S. adults have some form of it. Scientists are finding that periodontitis has a significant impact on overall health, so it is definitely not to be ignored. Keep reading to learn what you need to know about periodontitis.
Periodontitis is a chronic inflammatory disease that destroys the tissues surrounding the teeth. In a healthy mouth, the roots of the teeth reside within the jawbone, connected to it by a ligament and covered by gum tissue. This foundation supports the teeth and enables normal chewing function.
Periodontitis causes a gradual loss of the attachment of the gums, ligament, and bone surrounding the teeth. The severity of the disease depends on how much attachment has been lost. The loss of attachment to the supporting structures around teeth can lead to unattractive receding of gums, bad breath from bacterial clusters in deep pockets, and when untreated, teeth that loosen and fall out.
There is one underlying cause of all periodontitis, and it is bacteria in dental plaque. There are also many contributing factors to the disease, but the primary cause is always plaque buildup. This means that periodontitis is also a bacterial infection, and it can spread from one site in the mouth to others. In severe cases, it can also develop into a dangerous infection that spreads into other areas of the body.
Several factors contribute to the development and/or progression of periodontitis. Some affect the buildup of plaque on the teeth, and others affect the body’s response to the bacterial toxins in dental plaque.
1. Poor Oral Hygiene – The purpose of oral hygiene is to remove dental plaque from the teeth through the mechanical motions of brushing your teeth and flossing. When someone does not do this effectively and consistently, the plaque accumulates on the teeth. Plaque contains disease-causing bacteria, which produce toxins into the surrounding gum tissues and prompt the inflammatory response by the body.
2. Dry Mouth – Saliva is one of our best weapons in the fight against dental diseases. When people suffer from dry mouth, either due to poor salivary gland function or as a side effect of prescription medication, they become weak in the fight against oral bacteria. Dental plaque accumulates more quickly in a dry mouth, and the texture actually change. It becomes stickier and more difficult to remove in a dry mouth. That means it has a higher risk for causing periodontitis.
3. Diabetes – One of the effects of diabetes is the shrinking of blood vessels in the extremities. (This is why diabetics often lose toes or sight.) The reason this affects the mouth is that gums are also an extremity. The lack of blood flow to the gums caused by diabetes impairs the body’s ability to bring healing cells and fight the bacterial toxins. Gum disease tends to worsen more rapidly in patients with diabetes.
4. Smoking – Smoking affects the gums in much the same way as diabetes does. It constricts the blood vessels, causing a lack of blood flow in the gum tissues. The gums of a smoker often show the least visible evidence of disease, so if you smoke and skip the dentist, you may have no idea that you have worsening periodontitis.
5. Genetics – Some people do have a genetic predisposition to gum disease. If your mother and/or father suffered from periodontitis, you have a higher risk for developing the disease and should take measures to prevent it!
The mouth is the gateway to the entire body. It is unreasonable to assume that a chronic inflammatory disease involving a bacterial infection in the mouth would stay in the mouth. Scientists have found links between periodontitis and multiple significant health problems.
Patients with periodontitis are twice as likely to suffer from cardiovascular disease (including heart attacks and strokes) than someone with healthy gums is. Research studies have shown the bacteria of periodontal disease inside the plaques in cardiovascular patients’ arteries.
We’ve already mentioned the connection between diabetes and periodontal disease in one direction (in that diabetes worsens periodontitis). The link actually goes both directions because active periodontitis leads to elevated and more difficult to control blood sugar levels!
A recent study showed the presence of the bacteria responsible for chronic gum disease in the plaques that develop in the brains of patients with Alzheimer’s disease and in their cerebrospinal fluid. This link suggests that chronic periodontitis may increase the risk for Alzheimer’s.
The chronic inflammation of periodontitis puts a major strain on the immune system, so it affects your overall health. Perhaps most current is the link between patients with active gum disease and severe complications from COVID-19 infection.
The appropriate treatment for periodontitis depends on the severity of the disease. Your dentist will determine the severity of any active gum disease using a combination of a detailed oral evaluation, precise measurements of gum attachment, and dental x-rays. It is important to understand that the long-term prognosis of treatment for gum disease is worse as the severity of the disease progresses. Mild gum disease typically responds well to treatment, and severe periodontitis often does not.
When caught early, the minimal attachment loss of mild periodontitis allows your dentist to treat your gum disease in a manner that is minimally invasive. Typically, treatment involves a series of “deep cleanings”, officially called scaling and root planing. The goal of early treatment is to remove all bacterial accumulation from the teeth (including the roots of the teeth) and allow your body to heal and reattach.
For moderate or severe disease, more invasive treatment is necessary in order for your dentist to reach the depth of the pockets around the teeth harboring disease-causing bacteria. This will usually involve a gum surgery to access and clean all of the roots of the teeth. Some surgeries will also involve reshaping the bone and gums for optimal reattachment.
In cases of large defects, your dentist may repair those areas with grafting of bone or gum tissue. Grafting helps your body rebuild those supporting tissues.
When the loss of attachment is severe, the teeth are likely to be loose. The success rates of treatment is very low, so often the best treatment is extraction of these teeth. We try to anticipate the outcome of any treatment, and when we feel that the tooth has a poor or hopeless prognosis, we do not recommend expensive surgical treatment that is likely to fail. Instead, we will recommend extraction of the hopeless teeth and discuss your tooth replacement options.
You can prevent periodontitis, even if you have multiple contributing factors. This is because the underlying cause is always the bacteria in dental plaque. That means you must do everything in your power to consistently and effectively remove plaque. We fight periodontitis on two important fronts.
1) The Home Front – At home, we fight periodontitis through our consistent and effective oral hygiene routine. It absolutely must include brushing and flossing daily. You can also add the use of mouthwash and accessory tools like water flossers, interdental brushes, etc… If you have trouble reaching certain areas of your mouth, ask your dental hygienist for a demonstration or tips for improving your oral hygiene.
2) The Professional Front – In order to successfully fight periodontitis, you must also seek professional dental care on a consistent basis. Professional teeth cleanings are preventive in nature. They remove any and all areas of bacterial buildup that you miss between visits. Your dentist and dental hygienist will catch warning signs of disease and help you make changes to fight them.
Call your nearest Premier Dental of Ohio location today to schedule a consultation about periodontitis with one of our compassionate dental experts. We can answer any question you have about periodontitis and help you understand your specific risk level for this disease. We will also go over treatment options to help you get on the road to great oral health.