Periodontal disease : an affliction of the gums
Periodontal disease normally first appears around the age of 30 and gradually develops and gets worse as the decades pass. It’s a condition caused by the build up of bacteria in dental plaque. In the absence of treatment and without good oral hygiene, it can lead to the degeneration and loss of teeth. To prevent and treat periodontal disease, it’s first necessary to properly understand it.
What is periodontal disease?
Periodontal disease is an infection caused by the stagnation of bacterial pathogens on and around the gums. It mainly affects the supportive tissues of the teeth, i.e. the gums, the cementum, the alveolar bone and the periodontal ligament. Its progression is more rapid in smokers and patients with diabetes. There are in fact two types of periodontal disease: gingivitis and periodontitis.
Gingivitis is characterised by inflammation of the gums where they meet the teeth. It’s an infection aggravated and made worse by smoking, stress, tartar build up and diabetes.
An inflammatory condition, it usually manifests through bleeding of the gums when brushing. The gums become dark red and swollen. The teeth become more sensitive to heat and cold. To get a more exact diagnosis of the presence of gingivitis, it’s best to visit the dentist for an oral examination and an X-ray.
Gingivitis is the earliest stage of gum disease. It has the potential to evolve into periodontitis, a more severe form of periodontal disease, if complications occur.
Periodontitis is a more serious condition that can potentially destroy the bones and gums that support the teeth. It’s characterised by the formation of periodontal pockets caused by the gums becoming detached from the teeth, the destruction of tissue by proteolytic enzymes, and the loss of supporting bone tissue.
Though asymptomatic, the disease is identified through:
• Bleeding gums;
• Migration of teeth;
• Receding gums;
• Bad breath;
• A bad taste in the mouth;
• The appearance of abscesses;
• Pain in the gums.
If periodontitis is not treated, it can lead to loss of teeth.
What’s the medical treatment?
The treatment used depends on the stage the periodontal disease has reached. To determine this, the dentist will carry out an oral examination. After carrying out the diagnosis, the dentist may recommend teeth cleaning, surgical treatment or a course of antibiotics. I particularly recommend this dental practice if you live in or around the Nice area.
Determining the stage of the disease via periodontal examination
In order to work out a personalised treatment plan, the dentist will need to conduct a periodontal examination. This involves carrying out a diagnosis by measuring the periodontal pockets (breeding grounds for bacteria) and taking X-rays.
Decontaminating the periodontal pockets through teeth cleaning
All types of periodontal treatments begin with teeth cleaning or root planing. This can sometimes suffice to stop the condition progressing, if it’s not too serious.
It involves carrying out a thorough scaling to:
• Remove tartar and bacteria from the cutting teeth (incisors and canines), the molars and their exposed roots;
• Reduce inflammation of the gums;
• Smooth the surfaces of the teeth’s roots;
• Decontaminate the periodontal pockets;
• Limit the proliferation of bacteria;
• Help the gums that have become detached to adhere to the teeth ;
• Stimulate the healing and regeneration of periodontal pockets.
The treatment is normally carried over one or two sessions under local anaesthetic. Dentists often use ultrasonic devices or hand scalers (curettes) when performing this procedure. Disinfectant mouth washes may be prescribed prior to treatment to reduce the amount of bacteria in the oral cavity.
It’s important to note that root planing must also be accompanied by a good standard of oral hygiene. Regular brushing and the use of dental floss are recommended. If the patient’s condition is found not to have improved once a periodontal re-evaluation has been carried out, the dentist will often recommend surgical treatment.
In most cases, periodontal disease can be treated with root planing alone. Where this isn’t the case, surgical treatment becomes necessary. This involves the dental surgeon making an incision in the gums so that the tartar can be removed and the periodontal pockets cleaned. The gums are thus able to move back to their original positions, heal and adhere to the clean teeth.
The dental surgeon may also recommend regenerative periodontal surgery if there is significant damage to the bone. This technique ensures the teeth are properly anchored in place and enables more effective healing by restoring the teeth’s supporting tissue.
It’s also possible to repair the damage to the bone using other surgical techniques.
The dental surgeon can :
• Perform a bone graft using tissue taken from the palate;
• Use biomaterials to regenerate the bone tissue;
• Perform a gum graft to stop the gums retracting and receding from the teeth.
Treatment with antibiotics
In the majority of cases, mechanical or surgical treatment is enough to treat periodontal disease.
However, the dentist may prescribe antibiotics to :
• Supplement the treatment in cases of aggressive periodontitis;
• Treat the disease in cases of relapse or reinfection of the pockets;
• Supplement the treatment in patients with cardiac disease or type 2 diabetes.
It’s important to note that periodontal disease can aggravate other conditions if not treated properly. It makes managing blood sugar levels more difficult and increases the likelihood of cardiovascular conditions developing. Periodontitis treatment is therefore not something to be taken lightly.
How can these diseases be prevented ?
Periodontal disease prevention begins with good oral hygiene. The dentist will also recommend simple daily steps to take to prevent the condition appearing or stop it getting worse.
Good oral hygiene is essential if periodontal disease is to be effectively prevented. It’s therefore advisable to :
• Brush teeth and gums both morning and evening to prevent dental plaque building up and to disrupt and dislodge it;
• Use both dental floss and interdental brushes
• Use dental floss every day to remove food remains and prevent bacteria building up between the teeth.
There are also some other simple preventative steps you can take to prevent periodontal disease. Speaking, chewing and movements of the tongue can be effective in eliminating a portion of the dental plaque responsible for encouraging the build up of the bacteria that cause the disease.
Getting teeth scaled and polished regularly at the dentist is also recommended. Cessation of smoking is necessary to prevent the disease progressing.