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Periodontitis

Periodontitis is an inflammation of the gums around the tooth often referred to as gum disease. It is mainly caused due to the development of plaque (deposits of bacteria on teeth). When compared to females, males are more likely to develop periodontitis. It starts as gingivitis (a mild form of gum inflammation)  and gradually develops to periodontitis. Usually, at the age of 30 or 40 years, people complain of gum disease. However, it is rarely seen during teenage.

Periodontitis can be prevented with proper dental care such as brushing teeth twice a day, preventing plaque formation and regular dental checkups, as periodontitis is mainly caused by poor oral hygiene. Pregnant women are likely to develop gingivitis due to hormonal changes and increased blood supply to the soft tissues during pregnancy. With regular dental checkups, appropriate treatment can be given at an early stage.  With good oral hygiene periodontitis can be prevented.

Signs and Symptoms

Following are the signs and symptoms of periodontitis.

  • Swollen or red gums
  • Bad breath
  • Loose teeth
  • Painful chewing
  • Bleeding gums
  • Gum tenderness
  • Loose teeth
  • Sensitive teeth
  • Receding gums (exposure of roots of teeth due to gum damage)

Seeking immediate medical attention on early identification of symptoms is advisable. When left untreated, this may cause permanent loss of teeth.

Causes

Periodontitis is caused due to the formation of plaque (sticky film on the teeth) and tartar (yellow or brown discoloration on the teeth and gums). When appropriate treatment is not provided, it may lead to bacterial infection. This infection causes teeth discoloration and inflammation of gums (gingivitis), which may bleed easily.

There are three stages of periodontal disease.

  • In early periodontal disease, there is the formation of small pockets in between teeth and gums.
  • In moderate periodontal disease, due to the damaged gums, teeth roots are exposed along with pain and bleeding of teeth.
  • In advanced periodontal disease, the supporting structures of teeth such as bone, gums and other tissues are affected with infection. Foul taste, bad breath and severe pain while chewing may occur.

 

Risk Factors

Risks of periodontitis are as follows:

  • Genetic factors
  • Vitamin C deficiency
  • Immunosuppression by HIV or leukemia
  • Smoking
  • Obesity
  • Medications  interfering flow of saliva
  • Hormonal changes in pregnant women
  • Poor oral hygiene
  • Drug abuse

Complications

Periodontitis condition when left untreated leads to tooth loss. There are also chances that the causative bacteria may enter the blood stream and cause infection at other sites of the body. Thereby causing other diseases like heart disease and respiratory disease. However, with early diagnosis and management of periodontitis, complications can be prevented.

Diagnosis

Diagnosis of periodontitis can be done clinically by identifying the presence of plaque, tartar and other gum diseases. The doctor may also review the medical history of the patient.

Periodontitis can be diagnosed by the following ways:

  • Dentists may use a device called probe (tiny ruler) to measure the depth of pockets in between teeth and gums.
  • X-ray of the tooth may be done in case of deeper pockets to know the extent of bone loss.   

Treatment

The main aim of periodontitis treatment is to stop the damage caused to the affected tooth and gum along with treating the bacteria causing infection. This can be achieved by surgical and nonsurgical treatment methods depending upon the stage of periodontitis.

Nonsurgical treatment methods:

  • Treatment involving professional cleaning of the accumulated plaques and tartar from teeth and roots followed by polishing with fluoride.
  • Treatment with scaling, it is a procedure where laser or ultrasonic device is employed to clean plaques and tartar.
  • Treatment with root planning, it is a process which is employed to smoothen the root surface, thereby decreasing tartar formation and bacterial growth.
  • Treatment with antibiotics such as antibiotic gels, mouthwashes along with oral antibiotics may be used.

Surgical treatment methods:

In case of advanced stage periodontitis, surgical treatment may be required and types of surgeries are as follows:

  • Flap surgery (pocket reduction surgery) which involves treating the underlying roots and bone of affected tooth in order to reduce the pocket size.
  • Soft tissue grafts are employed to attach fresh tissue in order to treat the damaged gum line due to inflammation caused by infection.
  • Bone grafting may be done in order to treat the bone loss caused by periodontitis and fragments of the patient’s bone or synthetic bone are attached.

Prevention

Periodontitis can be prevented by following ways

  • Maintaining good oral hygiene
  • Brushing the teeth twice a day
  • Smoking  cessation
  • Replacing the old toothbrush with new one frequently
  • Using an electric toothbrush for better cleaning
  • Visiting dentists at least twice a year

Periodontitis can be prevented by following the above listed simple ways. However, regular dental visits and good oral care remains vital in preventing periodontitis

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