Periodontitis is a devastating condition for your teeth, causing not only pain and soreness in the gums, but also problems with chewing, unpleasant changes in the length and position of the teeth, low self-esteem, withdrawal from social activities and an increased risk of other inflammatory conditions including diabetes.
To avoid their appearance, we advise you to follow these 6 recommendations:
- Periodically check your gums with a specialist to receive a correct diagnosis.
- Brush your teeth at least twice a day with a manual or electric toothbrush.
- Also use an interdental brush (or floss if spaces are too tight).
- Use specific mouthwashes or toothpastes in addition to cleaning to reduce inflammation, if recommended by your dentist.
- If you have diabetes, controlling your blood sugar level is essential.
- Do not smoke, maintain a healthy weight, eat a balanced diet, exercise, reduce stress.
See How to prevent and eliminate dental tartar. A complete guide
What is periodontitis
Periodontal diseases initially cause inflammation of the gums, which become red, swollen and may bleed during brushing. Gingivitis is the body’s immune response to bacteria that have accumulated on the teeth. One of the most determining factors in the development of periodontitis is the tartar that accumulates at the base of the teeth.
If left untreated, the inflammation spreads to the ligament and bone supporting the teeth (periodontitis). As periodontitis progresses, a change in the position of the teeth and the appearance of mobility can be observed. In more advanced stages, abscesses, suppuration, pain and, finally, loss of teeth may occur.
See How to solve the problem of a tooth that turns black
In people with dental implants, when the gums around the implants become inflamed, they may be suffering from peri-implant disease. This can take two forms: peri-implant mucositis (affecting the mucous membrane around the implant) and the more serious condition of peri-implantitis (where there is bone loss around the implant).
The most negative consequence of periodontitis is a possible loss of teeth.
See What to do if your implant moves
Signs of a gum problem
Bleeding is the quickest warning sign of gum problems, whether spontaneous or upon brushing (as long as you are not a smoker, since tobacco masks it). Redness, swelling or gum loss (or recession), bad breath or bad taste in the mouth and thermal hypersensitivity are also symptoms of gum disease.
See What is gingivitis and how is it cured?
Healthy gums do not bleed. A bleeding gum can present a gingivitis (which is a mild problem, reversible and that is solved in most cases with hygienic measures) or a periodontitis (which is a more serious problem since it leaves irreversible sequelae and requires a more or less complex specific treatment depending on the degree of affectation).
Occasionally, there is an increased tendency to gum bleeding, as occurs at certain times in a woman’s life (menstruation, pregnancy, etc.).
Halitosis is a common symptom of periodontitis. In cases of untreated periodontitis, some of the bacteria related to this disease produce, during their metabolism, substances called volatile sulfur compounds, which are mainly responsible for bad breath.
And it is also common for people with periodontitis to experience some tooth mobility. Normally, the teeth do not move. Periodontal disease is not the only cause of tooth mobility, but it is the most frequent. This mobility shows that support or anchorage of the tooth to the maxillary bone has been lost and is greater the more advanced the disease is.
This is a late sign and when it appears it reflects a terminal situation that will therefore require more complex treatments and in which the prognosis is worse.
How periodontitis is treated
Although it is a serious disease, the progression of periodontitis can be completely stopped. The key to success is to eliminate the bacterial plaque that triggers the disease process and establish good oral hygiene practices.
1º Professional cleaning. We remove all bacterial deposits (plaque and tartar) from the accessible areas of the teeth, and then the teeth are polished and treated with fluoride. If necessary, the dentist will also remove all bacterial deposits and tartar from the root and gum surfaces. For patients with advanced periodontitis, several dental cleaning appointments are necessary.
2º Antibiotics. In some cases, antibiotics are prescribed to treat active or persistent gum infections that have not responded to oral hygiene measures.
3rd Re-evaluation. After six to eight weeks, your dentist or periodontist performs a complete evaluation of your gums to check the progress of your treatment.A special instrument called a periodontal probe is used to record the depth of the periodontal pockets and check for bleeding gums. If periodontal pockets larger than 3 mm are still present, additional treatment options, including corrective surgical therapy, may be suggested.
4º Corrective surgical therapy. In situations with very advanced periodontitis, the remaining deeper gingival pockets can usually be successfully reduced with surgical treatment alone.
Under local anesthesia, the gum is lifted and the root surfaces are cleaned to ensure that all tartar and plaque accumulations are removed. Sometimes in these cases it is also necessary to remodel the bone or use proteins or grafts to reconstruct the bone that has been lost so that the gingiva can adapt properly to the root surface.
Finally, the gums are sutured around the teeth and the stitches are usually left in place for one to two weeks before being removed.
Periodontitis and orthodontics.
One of the worst complications resulting from periodontitis is the loss of teeth and the consequent dental migration, which translates into bad dental positions, flaring of the anterior teeth, … causing functional and esthetic problems that can be improved with orthodontics and different types of esthetic restorations.
Think that crowding or bad dental positions can lead to the appearance of blind spaces in our mouth that prevent access to brushing and, therefore, lead to a greater accumulation of plaque and a possible appearance of problems in the gums.
The treatment of orthodontics allows to place the teeth in an ideal position in order to facilitate a correct access to the different instruments (brushes, floss, etc…) to remove the plaque in an efficient way, reducing the risk of relapses or worsening of the periodontal situation of the patient’s mouth.
Furthermore, placing the teeth in a stable position with orthodontics will contribute to the long-term maintenance of the teeth, as it provides stability and at the same time reduces the risk of continued trauma that can influence the progression of periodontitis, but above all can contribute to tooth loss.
This stability and correct distribution of the spaces will also ensure, if necessary, that the placement of dental implants to replace missing teeth will be in the most appropriate position for future restorations.
But before starting orthodontic treatment we must remember to evaluate the health of the patient’s gums to identify any signs of disease. Adequately treat those problems present and implement secondary prevention measures, both on the part of the patient (hygiene techniques at home) and on the part of the professional (with periodontal maintenance therapy on a regular basis).
As you can see, it is very important to treat any problems in your gums in time to prevent them from developing into periodontitis. A disease whose treatment requires considerable time and visits to the dentist and in the worst case, involves the extraction of teeth, with all that this entails.
See Gingivitis and Periodontitis Treatment
So our advice is that as soon as you notice swollen or bleeding gums, go to your trusted dentist. With a few simple instructions or at most a scraping, you will avoid many problems. Some of them, as you have seen, are very serious.
If you have any doubts about periodontitis, you can call us at + (34) 669 154 020 and we will give you an appointment at one of our dental clinics in Barcelona, where our periodontists will check the state of your gums and offer you the most effective treatment for your case.
En julio de 2019 realizé un programa avanzado en Odontología Integral en la Universidad de Nueva York. Este programa me dió la oportunidad de ampliar mis conocimientos en odontología general en un ambiente multicultural y publicar trabajos de investigación en revistas americanas, así como hacer voluntariado en un país subdesarrollado para tratar la sonrisa de los pacientes.
Aparte de la odontología, mis aficiones son el yoga, la cocina y viajar para descubrir nuevas culturas
