Periodontal Disease

What is periodontal disease?

Your mouth contains millions of bacteria, most of these are harmless, but others can attack your teeth and gums. Harmful bacteria live in plaque, which is the sticky pale coating which builds up on your teeth if you don’t brush and floss or clean your teeth properly and regularly. Harmful bacteria can travel from the plaque into these spaces between your teeth and the gum, and cause inflammation, infection, a decrease in the amount of connective tissue and bone around your teeth. Periodontal disease is the term used to describe this condition.

When the connective tissue becomes affected and infected by these bacteria around the tooth. When the disease is in the early stages regular professional cleaning can stabilise the disease and allow the tissues to heal. Plaque builds up in your mouth without you knowing about it. It is a continuous process, so needs regular removal. Calculus is a form of calcified plaque and needs professional cleaning to remove it.

Why it needs to be treated.

Periodontal disease causes loose teeth. It can affect any age group from teenagers onwards.

Dental plaque increases the number of harmful bacteria in your mouth which causes damage. When the ligament that holds a tooth securely in the bone becomes affected by periodontal disease you can experience tooth mobility, pain, sensitivity, swelling, bad breath and phs extruding from the gums.

The gums can recede and lead to sensitive teeth. The gum level may stay as normal but leave a space between the gum and the tooth which isn’t attached to the tooth. This space is a periodontal pocket. It can become filled with food debris and bacteria, which leads toxin build up and stimulates the body’s immune system. Fighting this infection can result in the body breaking down further bone and connective tissue.

How do I know I have periodontal disease?

• Gums start off red, swollen, puffy or tender.
• Gums can bleed during brushing on spontaneously.
• Teeth start to look longer as gums recede.
• Your teeth feel lose or your bite feels different.
• Bad breath,
• Pus coming from between your teeth.
• Increased food packing between your teeth.

Why am I not suitable for implants if I have gum disease?

Teeth and implants are not the same. Teeth have connective tissue fibres reinforcing the gum attachment to the bone and the teeth. These are in many different directions around your tooth and are fairly resilient to disease. Implants do not have these fibres around the gum to protect them. They have a much less complex attachment, and so are more susceptible to breakdown. If your natural teeth are infected then bacteria will be much more aggressive in causing damage around an implant. Unless disease is controlled and stable you will not be suitable for clinical implants.

Periodontal surgery can involve removing infected tissue and treating the root surface of a tooth to promote healthy tissue reattachment. It can also mean extra tissue is needed to repair defects and your own individual susceptible disease sites need reinforced to prevent disease from recurring. This can be done in most cases as long as the tissue is treated to control disease before repair work is undertaken.

Plastic periodontal surgery improves the appearance of your teeth and decreases susceptibility to disease recurring. This type of surgery revives tissue grafting and careful tissue management. Receding gums can be covered, and pockets eliminated.

If you do not get periodontal disease treatment you will end up with a serious condition where you potentially will lose all your teeth not just the ones which are currently affected. The bacteria which causes the disease can get into your blood stream and are implicated in bacterial endocarditis, low birth weight babies, and premature babies.

Risk factors

Smoking: Immune system depression in smokers means disease is less readily controlled. The immune system doesn’t react to bacteria and disease progresses unchecked. Even with good treatment success is difficult to achieve.

Hormone changes in girls and women: Hormone changes make the gums more sensitive to plaque, and gingivitis develops more quickly with less bacteria to initiate it.

Diabetes: Poor disease fighting mechanisms mean diabetics are more susceptible to many disease including periodontal disease.

Stress: Research confirms stress reduces the body’s ability to fight off infections.

Illness: Diseases like cancer, HIV and their treatments can affect saliva flow and the removal of bacteria. Many different medications such as antidepressants, and asthma medication can affect oral health.

Genetics: A family history of susceptibility to gum problems “pyorrhea” or periodontal disease can be invented. Some people are more prone to severe diseases.

How do we control it?

Each time you visit the dentist they will check your teeth and your gums. We record the level of your gum health. Gingivitis is controlled by regular cleaning, and regular brushing. Periodontitis can be you need more than just a scale and polish.