Your Gum Health Explained, Part 2: Periodontitis
In our previous blog, you would have learnt the basics about gum disease, what gingivitis is and how it can be treated and prevented. Now, we’re going to talk about Periodontitis, the next stage of gum disease – you know, the one where your teeth can actually fall out of your head…
What Is Periodontitis?
Periodontitis, or periodontal disease, is a more advanced stage of gum disease compared with gingivitis. Plaque and calculus build up around your teeth and gums and in some people, gingivitis can turn into periodontitis. The inflammation caused by this plaque can activate your body’s immune response to the germs. And in some people, this response becomes so big that the tissue that surrounds the tooth (gum, periodontal ligament, bone) gets destroyed. Unfortunately, the damage is irreversible.
If left untreated, you may end up losing the affected teeth.
But wait, unfortunately, there’s more! Periodontitis is also linked to a bunch of other health conditions like heart disease, type II diabetes, pre-term and low birth weight babies and most recently, it has been linked to Alzheimer’s disease!
And one of the worst things about periodontital disease (apart from infection, toothache, losing teeth) is that it’s usually a slowly progressing disease. This means that like termites hidden inside the walls of your house, it goes unnoticed until irreversible damage has occurred!
What are the Symptoms of Periodontitis?
While gum disease may progress slowly and painlessly (not every case), there are some symptoms that you should look out for. They include:
- Gums that bleed during and after brushing
- Swollen and red gums
- Receding gums
- Persistent bad breath or a bad taste in the mouth
- Tenderness when biting
- Loose teeth, or teeth that have moved or shifted over time
- Changes to your bite or fit of partial dentures
Be on your toes. Even if you don’t have any of these symptoms, it doesn’t mean you don’t suffer from periodontitis.
This can lead to a rude awakening at your next trip to the dentist. We often see patients who have been suffering from no pain or problems, that have underlying periodontitis. They’ve probably suffered from it for years. These poor people can be surprised by the diagnosis because they’ve always thought that no pain means no problem.
How do I know if I have Periodontitis?
Your dental professional is the only person who can tell you if you suffer from gum diseases like gingivitis or periodontitis. And, a simple visual inspection simply doesn’t cut it when it comes to a thorough diagnosis.
When periodontitis is present, the gums and ligaments surrounding the tooth pull away from the tooth. This results in a “pocket” which can only be detected with a periodontal probe.
During your regular checkup appointments, your dentist should always measure the depth of these “pockets” to assess for any gum disease. The probe is basically a super skinny, super tiny “ruler” which measures how deep these “pockets” are. The depth of the pocket indicates how far the disease has progressed. The deeper the pocket, the worse the gum disease.
Once the “pocket” reaches more than 3mm and the bone surrounding the tooth is also damaged by the inflammation, the possibility of losing the tooth could soon become a reality. This is why it’s sooooooooooooo important that you keep to your regular checkups and cleaning appointments with your dentist.
Do I need x-rays for Periodontital disease?
If gum disease is present, your dentist may also take x-rays to determine the extent of the damage. Small x-rays taken inside your mouth (bitewing and periapical) look in between the teeth and around the roots. Full mouth x-rays (OPG) look at all of your teeth, jaw bone and sinuses in one shot. X-rays allow your dentist to fully assess the severity of the gum disease and see how much of the jaw bone has been damaged by it.
Can gum disease be treated?
Yes! Of course it can! But…
The thing about gum disease treatment is TIME! The earlier gum disease is diagnosed and treated, the better the chances of managing the disease effectively. If diagnosis and treatment is left too late, you may be left with only one option – tooth extraction.
We can’t stress enough how important early treatment is in affecting the outcome of the disease. Early treatment saves teeth!
How is gum disease treated?
The goals of treatment for periodontitis are:
- Remove plaque and calculus from around the teeth and gums
- To promote reattachment of healthy gums to teeth
- Reduce inflammation
- Reduce the risk of acute infection
- And ultimately to stop the progression of the disease.
Treatment involves using specialised instruments to remove the hardened calculus that is around your teeth and under your gums (where you can’t get to it!). Most patients will require local anaesthetic to help make sure the procedure is as comfortable as possible.
Depending on the stage of the disease and your overall health, each individual’s response to the treatment will vary. You’ll need to revisit the dentist every 3 months until your dentist is satisfied that the disease is well controlled and that your gums and teeth are back to full health.
Can my dentist treat my periodontitis, or do I need to see a Periodontist?
If the “pocket” depths are too deep or there is too much damage to your gums and bone already your dentist may refer you to a Periodontist. These are specialist dentists, who have further training, expertise and equipment to be able to treat patients with severe gum disease.
At Method Dental, we work with a number of local Periodontists to help you with severe gum disease, gum surgery and dental implants.
How to prevent gum disease
You’ve probably guessed it…
Brushing thoroughly and effectively twice daily for 2 minutes each time, flossing daily and visiting your dentist for a check-up and clean when advised.
Obviously, like the rest of our health, leading a healthy lifestyle will make a positive impact on our oral health too. We recommend:
- Avoiding sugary foods and drinks. If you must, have it with your main meal. Avoid snacking.
- Drinking plenty of tap water (it contains fluoride). Find out more about how fluoride helps with tooth decay here
- Quit smoking – You can get more information from Quitline here
What increases my risk of gum disease?
Unfortunately, genetics play a pretty big role in a person’s risk for gum disease. The American Academy of Periodontology says that up to 30% of people may be genetically more prone to gum disease, and those who are genetically predisposed may be up to 6x more likely to develop some form of gum disease.
This means that if anyone in your family has suffered/suffers from gum disease, it may mean that you are at greater risk. Given that this is the case, keeping your checkup and clean appointment is more important than ever. That way, if you did develop gum disease, at least it can be identified and treated right away, giving you the best chance at making a full recovery.
Does gum disease affect anything else?
For over the past few decades, researchers from all across the world, including the Centers for Disease Control and Prevention have uncovered strong links between gum disease and other serious health conditions.
If you remember from earlier in the blog, it’s our own body’s immune response to the plaque that results in the destruction of the tissue and bone surrounding the tooth. Not so much the bacteria in the plaque itself.
In light of this, in people with healthy immune systems, the bacteria in our mouth that makes its way into the bloodstream (yes, it does that) is usually harmless. But, under certain circumstances, the bacteria can cause some serious damage.
Gum disease increases your risk of stroke and is strongly linked to preterm birth and low birth weights. It also leads to a higher risk of developing heart diseases, poorer control of diabetes, rheumatoid arthritis, oral and pancreatic cancer and most recently, a journal published in January 2019 revealed a strong link between gum disease and Alzheimers.
Given the above, it is clear that what happens in the mouth has a direct effect on our overall health. We need to start taking our oral health seriously. We can’t keep thinking that “what goes on in our mouth, stays in our mouth.”
In our next blog, we’ll explore how gum disease affects our overall health and the consequences of neglecting our oral health.
Dr. Grant McGrath BDSc
Co-Founder, Principal Dentist
Jasmine Ooi BPharm