Perio Other – Periodontal Disease

Periodontal disease, or gum disease, includes inflammatory conditions which impact the tissues surrounding the teeth. In the early stage, this condition is called gingivitis. Gingivitis causes the gums to be swollen, red and may even bleed. When periodontal disease progresses to a more serious form, it is called periodontitis. Periodontitis can result in cases of gums pulling away from the teeth, bone loss, loose teeth and even the teeth falling out. The condition can also cause bad breath or halitosis.

Periodontal disease is typically the result of bacteria in the mouth which infects the tissue around the teeth. Risk factors for the disease include things such as smoking, diabetes, HIV/AIDS, a family history and some medications. A diagnosis of the disease occurs with the inspection of the gum tissue around the teeth visually. It may also include the use of a probe or X-rays to evaluate bone loss.

Treatment for the disease typically includes good oral hygiene practices and regular dental visits with a professional teeth cleaning. A recommended oral hygiene routine includes brushing the teeth twice each day and flossing daily. In some cases, surgery or antibiotics may be necessary. About 538 million people throughout the world are affected by the disease. In the United States, about half of patients over 30 years old are impacted and nearly 70% of patients over 65 years old have the condition. The disease is more prevalent in males than females.

Signs and Symptoms

In the early stages, periodontitis does not have many obvious symptoms. It is common for the disease to progresses significantly before most patients seek treatment.

Symptoms of periodontitis may include:

  • Bad breath, a metallic taste or halitosis
  • Deep pockets between the teeth and the gums
  • Gingival recession, which gives the impression of longer teeth
  • Loose teeth, often occurs in later stages of the disease
  • Redness or bleeding of gums while brushing teeth, using dental floss or biting into food
  • Reoccurring swelling of the gums

Patients should be aware that bone destruction and gingival inflammation do not always cause pain. While many people assume that bleeding without any pain after brushing their teeth is insignificant, it may be a sign of periodontitis.

Periodontitis is associated with a higher risk of the following conditions: stroke, myocardial infarction, atherosclerosis and hypertension. It has also been associated with impairments in delayed memory and calculation abilities in patients over the age of 60. Individuals who have impaired fasting glucose and diabetes mellitus often have higher degrees of periodontal inflammation. They also often have a challenge in balancing their blood glucose levels due to the constant systemic inflammatory state caused by the periodontal inflammation. While there is no proven association, there has been an association identified between chronic periodontitis and erectile dysfunction, heart disease and pancreatic cancer.

Causes

Periodontitis is an inflammation of the periodontium, the tissues which support and surround the teeth. The periodontium consists of four different tissues:

  1. Alveolar bone: the bony sockets into which the teeth are anchored
  2. Cementum: outer layer of the roots of teeth
  3. Gingiva: gum tissue
  4. Periodontal ligaments (PDLs): the connective tissue fibers that run between the cementum and the alveolar bone

The primary cause of gingivitis is due to bad oral hygiene. This allows plaque to accumulate at the gum line. Other factors which commonly contribute to the condition include poor nutrition and underlying health conditions like diabetes. In order to control and prevent periodontal disease, patients with diabetes must be extra diligent with their oral care.