What are the signs and symptoms of a periodontal disease?
Over 75 % of Canadian adults have some form of periodontal disease.
However the majority of these people do not even realize they have it. Periodontal disease is usually painless until its advanced stages.
If left untreated, symptoms may included:
- Bad breath and bad taste
- Bleeding gums
- Red,swollen, tender gums
- Gum that have pulled away from the teeth
- Loose or separating teeth
- Pus between the gum
It is possible that you have periodontal disease and not experience any of these symptoms. Nonetheless, if the problem is not treated it will likely lead to aesthetic problems, painful chewing and tooth loss.
Factors contributing to the development of periodontitis
Although plaque is the primary cause of periodontal diseases, other factors can affect the health of your gums:
- Clenching or grinding your teeth
- Poor nutrition
- Other general health conditions
What are periodontal diseases?
A healthy tooth is surrounded by gums, bone and ligaments, which anchor the tooth firmly in the jaw. Periodontal diseases are chronic bacterial infections that destroy these supporting structures. When the infection in its early stage and limited to the gums, it is called gingivitis.
PHASE 1 – GINGIVITIS
Gingivitis is the initial phase of the disease and is defined as inflammation of the gingiva due to bacterial accumulation (ie. dental plaque). Gingivitis is completely reversible through the removal of the bacteria using traditional oral hygiene techniques (brushing and flossing). If the gingivitis is not treated, the inflammation will progress and destroy the tissues surrounding the tooth in an irreversible manner; this is what we call periodontitis.
PHASE 2 -PERIODONTISIS
Peridontal infections are responsible for approximately 70% of tooth loss in adults. The main cause of these diseases is the accumulation of bacterial plaque, a sticky, colourless film that constantly forms on your teeth. Daily home care, including proper brushing and flossing, is essential in the prevention of plaque buildup.
If plaque is not removed daily, it will turn into a hard substance called tartar. Tartar is very hard and can only be removed during professional cleaning. If tartar develops along the tooth roots below the gums, it makes plaque removal impossible, leaving you at increased risk for periodontal diseases.
Toxins produced by bacteria in plaque irritate the gums and cause infection. These toxins created an inflammation that destroys the supporting tissues around the teeth, including the jawbone. Bacteria and your immune response to the bacteria can cause the gums to separate from the teeth, forming pockets (IMAGES) that fill with even more plaque and tartar. As the diseases progess, these pockets deepen, more gums tissue and bone are destroyed, and teeth eventually become loose.
These past years, the scientific community has worked hard to find links between gum disease and medical problems. In this global approach, where the mouth is part of the entire body, gum diseases have been found to play roles in the following medical conditions:
- Hearth diseases
- Preterm low-birth-weight babies
- Respiratory disease (pneumonia)
Depending on how far the periodontal infection has progressed, treatment can vary widely. If caught in it’s early stages, simple procedures are done that will remove the plaque and tartar from below the gum line and eliminate the infection-causing bacteria.
If however the disease has advanced to the point where the periodontal pockets are deep and the supporting bone is lost, further treatment is likely. Whatever the treatment may entail, the goal is to return you to good oral health and then help you maintain it.
STEP 1 : CONTROLLING THE CAUSE AND RISK FACTORS FOR PERIODONTAL DISEASES
The first step toward periodontal health begins with oral hygiene. If you’ve been diagnosed with periodontal diseases, you are susceptible to the disease and therefore need to keep your teeth cleaner than most people. Your periodontist and hygienic will review your at-home oral hygiene routine, including tooth brushing and flossing techniques.
Other risk factors that have contributed to the development of your periodontal problem must also be identified and controlled.
STEP 2 : SCALLING AND ROOT PLANING
Scalling and root planing consist in the professional cleaning of the root surfaces to remove the plaque and tartar that has accumulated under the gums, in the deep pockets. This cleaning is much more thorough than a regular dental cleaning, and usually requires several appointements. Local anesthetic is usually used to make the treatment comfortable. After the treatment , there is usually only minimal discomfort. Tooth sensitivity to cold may increase after the treatment and may last several weeks.
Scaling and root planing, combined with good control of the risk factors for periodontal diseases, usually effectively reduces gingival inflammation and pocket depths.
STEP 3 : PERIODONTAL REEVALUATION
About six to twelve weeks after the scaling and root planing of your teeth has been done, you will be asked to return to the periodontist’s office for a reevaluation exam. The purpose of this examination is to verify the response to the treatment rendered thus far and determine if any further treatment is indicated.
STEP 4 : PERIODONTAL SURGERY (IF REQUIRED)
If further treatment is required, your periodontist will develop a treatment plan to help restore a state of oral health. This usually requires minor surgical treatment to remove any remaining infection and decrease residual pocket depths, in order to allow for long-term stability and health.
A pocket reduction procedure will be recommended if you have pockets that are too deep to clean with daily at-home oral hygiene and a professional care routine.
During this procedure, your periodontist will fold back the gum tissue, remove the disease-causing bacteria and then secure your gums back into place. In some cases, irregular surfaces of the damaged bone are smoothed to limit areas where bacteria can hide. This allows the gums to better reattach to healthy bone.
Bone regeneration can sometimes be used to recreate some of the tooth support that was lost with the disease.
The laser allows us to treat gum disease in an efficient and predictable way. The technique used is named LANAP. This laser treatment consists in disinfecting the periodontal pocket and stimulating the re-attachment of the gums to the teeth; thereby encouraging the regeneration of tissues surrounding the teeth. This non-surgical technique allows a predictable and rapid treatment (two appointments) to control the gum disease.
As opposed to the traditional surgical approach, this treatment reduces the gingival recession and the dentinal hypersensitivity that follows therapy.
STEP 5 : Periodontal maintenance
When the periodontal infection has been adequately controlled, you will begin the maintenance phase, a specialized prevention program for patients who have been diagnosed with and treated for periodontal diseases. Since periodontal diseases are chronic in nature, careful ongoing follow-ups are necessary to prevent recurrence. This phase of treatment will allow your periodontist to assess your periodontal health and make sure your infection stays under control. During maintenance visits, your mouth is examined and tartar is removed. These appointments are more thorough than traditional six month cleanings, are usually done more frequently, and will help protect the health of your teeth and gums and minimize the chance of disease recurrence.
Some elements will provoke recession. For example, some people have a weak keratinized gingiva from the beginning, whereas some people have a thick and abundant gum. Other factors provoking gum recessions are crooked teeth, orthodontic tooth movement, muscle attachments and dental restorations.
A good oral health is the best way to prevent gum recession. Brushing your teeth and gums like your dentist taught you, and flossing regularly will prevent more than 50% of the cases.