What is Periodontitis?

Periodontitis or 'Gum Disease' and is a very common condition in which the gums and deeper tooth supporting structures become inflamed.

This inflammation of the gums results in redness, swelling and a tendency to bleed during tooth brushing. Inflammation is the body’s response to certain bacteria that have been allowed to accumulate on the teeth.

Although part of the body’s defence system, this inflammation can eventually cause serious damage. If left unchecked, the inflammation can spread down below the gums and along the roots of the teeth, causing destruction of the periodontal ligament and the supporting bone. This ultimately leads to the loosening and potential loss of the teeth.

What is periodontitis?

Periodontitis is inflammation of the gums and supporting structures of the teeth. It is one of the most common human diseases.

Periodontitis is caused by certain bacteria and by the local inflammation triggered by those bacteria. Although these periodontal bacteria are naturally present in the mouth, they are only harmful when the conditions are right for them to increase dramatically in numbers. This happens when a layer of bacteria and food debris, known as plaque, builds up and is left undisturbed on the teeth, commonly in hard-to-reach areas such as between the teeth.

The more dangerous bacteria are able to thrive and multiply, producing some harmful by-products which stimulate the body’s defensive inflammatory response in the gums. As the disease progresses, chronic inflammation causes the bone of the jaw to be destroyed and the teeth to be lost.

How can I recognise periodontitis?

Periodontitis always begins with inflammation of the gums, known as gingivitis. This is not always easy to recognize but one of the first signs that you may become aware of is bleeding from the gums when you brush your teeth. The gums may look red and swollen and you might notice a discoloured layer of bacterial plaque on the teeth.

Left untreated, gingivitis may progress to periodontitis, often without any obvious signs to alert you.  Some changes that you might experience over time include:

• increased bleeding from the gums (when eating, brushing or even on your pillow in the mornings)

• bad breath

• Your teeth may move and gaps between them develop

• The teeth may look longer (gum recession)

• Your gums may be sore

What are the causes of periodontitis?

A healthy mouth has lots of different types of bacteria in it most of which are completely harmless and live in harmony with the person. However, when tooth cleaning is not thorough enough, the bacterial deposits build up next to the gums, forming a plaque, and more dangerous bacteria start to flourish. These overwhelm the natural defences of the body.

If the soft bacterial plaque is not removed by brushing, minerals are deposited within it over time and it becomes a hard deposit on the tooth called calculus. Calculus is a roughened surface and encourages the growth of more bacterial plaque deeper beneath the gum. As the inflammation progresses deeper, the gum loses its attachment to the tooth root and a gap if formed that we call a pocket.

You cannot clean into these pockets and the harmful bacterial increase and make the pocket and the disease worse. These bacteria release toxins.

What can I do to prevent periodontal disease?

Developing gum disease can be preventing by good oral hygiene habits, alongside regular professional examinations and support.

The basic elements of a good oral hygiene routine are:

• Cleaning the chewing surfaces and sides of the teeth twice daily, with a toothbrush (we normally recommend an electric toothbrush) and toothpaste.

• Cleaning in between the teeth - a toothbrush cannot reach here - for tight gaps with floss or with a bottle brush/interdental brush that feels snug in the space (as they come in different sizes). This should be done

  twice daily.

If, as a result of an inadequate cleaning technique, plaque deposits are left on the teeth, these will become mineralised and turn into hard, fixed deposits (calculus) that cannot be removed with a toothbrush.

What are the consequences of periodontal disease?

Periodontitis is the leading cause of tooth loss.
If the progress of periodontal inflammation is not halted, the supporting structures of the teeth, including the surrounding bone, are destroyed. This leads to the teeth becoming loose and then being lost or requiring extraction. As part of this process patients may also experience include painful abscesses, teeth changing position and gum recession causing the teeth to look longer.

Scientific research has shown that untreated periodontal disease can have negative effects on general health; including increased risk for pregnancy complications and also an increased risk for heart disease and diabetes.