PERIODONTAL DISEASE

What is periodontal disease?

Periodontal or gum disease is an infection affecting the tissues surrounding the teeth. These tissues include the gums and bone supporting the teeth. Periodontal disease is usually a slow, painless, progressive condition. Most adults with this disease are unaware they have it but if diagnosed and treated early the teeth can be saved.

In it’s early stages it affects the gum only and is called gingivitis, this is reversible but if it progresses it begins to attack the bone which holds the tooth in it’s socket and is called periodontitis. This can be treated to stop further bone loss but if left untreated can result in loss of the tooth.

What causes periodontal disease?

The main cause of periodontal disease is plaque. This is a white mass of bacteria which adheres to teeth, crowns, bridges, dentures and soft tissues. When plaque is not removed it irritates the gums causing them to become red, tender and bleed easily. Over time it hardens and is then known as tartar which requires removal by professional intervention. The constant irritation from tartar results in gums becoming detached from the roots allowing ‘pockets’ to form around the teeth. Bacteria in these pockets begin to destroy bone that holds the tooth in place which may result in the tooth becoming loose and eventually lost.

The main cause of plaque accumulation is poor oral hygiene and inadequate tooth brushing technique. Other plaque retaining factors that exacerbate the condition are:
  • Badly designed dentures (false teeth). These can attract plaque and may lead to further bone loss
  • Faulty restorations e.g. fillings with ledges that act as a plaque trap
  • Tooth decay
  • Crowded teeth. Poorly contoured crowns will act as a plaque trap
  • Tobacco smoking. Oral hygiene appears to be worse in smokers compared to non-smokers. A study of periodontal disease in women smokers of 20-29 years old and non smokers of 30-59 years show a level of about twice that found in non smokers
  • Food packing between teeth
  • Orthodontic appliances (braces)
  • Grooves on root surfaces
  • Loose teeth can accumulate plaque and make the periodontal condition worse. Loose teeth may require extraction in order to save other teeth
There are also a number of host factors that can worsen periodontal disease such as diabetes mellitus, puberty, pregnancy, and menopause. The underlying cause is still plaque but these conditions can worsen your periodontal condition

What are the signs and symptoms of periodontal disease?
  • Do your gums bleed when you brush or floss your teeth?
  • Are your gums swollen, red or tender?
  • Does pus appear when you press your gums?
  • Do your teeth seem to be getting longer?
  • Can you wiggle one or more of your teeth with your tongue or finger?
  • Are there spaces between your teeth that have not always been there?
  • Do you have bad breath or a bad taste in your mouth?
  • Has there been a change in how your partial denture fits?

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