Elderly man with mouth discomfort.
Elderly man with mouth discomfort.
Elderly man with mouth discomfort.

Periodontal Diseases

What are periodontal diseases?

The word periodontal means "around the tooth." Periodontal diseases are also called gum diseases. They are serious bacterial infections that attack the gums and the nearby tissues that hold the teeth in place. If it's left untreated, the disease will continue. The underlying bone around the teeth will dissolve. The bone will no longer be able to hold the teeth in place. Generally, periodontal disease isn't painful. So it's possible to have it and not know it.

The different types of periodontal disease are often classified by the stage of the disease, including:

  • Gingivitis. This is the mildest form of periodontal disease. The gums are likely to become red, swollen, and tender. They may bleed easily during daily cleanings and flossing. Treatment by a dentist and proper, regular care at home helps resolve these problems.

  • Mild to moderate periodontitis. Untreated gingivitis leads to mild to moderate periodontitis. At this stage of gum disease, periodontal pockets start to form. This is when gums pull away from the teeth, causing the small space between the teeth and gums to deepen. It also causes early bone loss around the teeth. Dental care is needed right away to prevent more bone erosion and gum damage.

  • Moderate to advanced periodontitis. This is the most advanced stage of gum disease. It causes major bone and tissue loss, and periodontal pockets get deeper. There may be receding gums around the teeth, heavy bleeding, and bad breath. Teeth may loosen and need to be removed.

What causes periodontal diseases?

As with many other oral health diseases, bacteria and plaque buildup is often the cause. In fact, plaque buildup (which contains many kinds of bacteria) is the leading cause of gum disease. Other factors that help lead to gum disease include:

  • Genetics

  • Poor oral hygiene

  • A diet low in nutrients

  • Smoking or the use of smokeless tobacco

  • Autoimmune or systemic diseases

  • Diabetes

  • Hormonal changes in the body

  • Frequent, uncontrolled clenching or grinding of the teeth (bruxism)

  • Certain medicines

  • Drinking too much alcohol

What are the symptoms of periodontal diseases?

These are the most common symptoms of gum disease:

  • Red, swollen, sore gums

  • Bleeding and tender gums while brushing or flossing

  • Gums that pull away from the teeth (receding gums)

  • Loose or separating teeth

  • Persistent bad breath (halitosis)

  • Partial dentures that no longer fit

  • Pus between the teeth and gums

  • A change in bite and jaw alignment

The symptoms of gum disease may look like other conditions or health problems. See a dentist or other oral health specialist for a diagnosis.

How are periodontal diseases diagnosed?

To diagnosis periodontal disease, a dentist will: 

  • Check your gums for any sign of inflammation

  • Measure any pockets around your teeth. A tiny tool called a probe is used to do this.

  • Ask about your health history and any other health conditions you may have. This information helps identify risk factors you might have, such as diabetes.

  • Ask about your smoking history

  • Take X-rays to find if there is bone loss

If you have gum disease, the dentist may also refer you to a periodontist. These are dentists who are experts in the diagnosis and treatment of gum disease. A periodontist will evaluate your teeth and gums and provide you with treatment options for your condition.

How are periodontal diseases treated?

Treatment may include one or more of the following:

  • Tartar (calculus) and plaque removal beneath the gums. Deep cleaning (also called scaling and root planing) can help remove tartar beneath the gums and infected tissue in the early stages of the disease. It also smooths the damaged root surfaces of the teeth. The gums can then reattach to the teeth.

  • Medicine. Antibacterial medicines may be placed topically in the periodontal pockets or taken orally.

  • Surgery. When the disease is advanced, the infected areas under the gums will be cleaned, and the tissues will then be reshaped or replaced. Types of surgeries include:

    • Pocket reduction

    • A regeneration procedure

    • A soft tissue graft

    • Crown lengthening

How can I prevent periodontal diseases?

Periodontal diseases can be prevented by:

  • Brushing and flossing your teeth at least twice a day

  • Brushing your tongue each time you clean your teeth

  • Getting a dental checkup once a year or more often if you have dental problems

  • Not using tobacco products, including smokeless tobacco

  • Following medical advice for the management of chronic illnesses, such as diabetes

  • Eating a balanced, healthy diet

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