Periodontitis

What is periodontitis?

Periodontitis (pronounced “peh-ree-uh-don-TIE-tus”) is a form of gum disease. It’s a bacterial infection that causes your gums to bleed and swell. Eventually, it can damage the bone that supports your teeth, leading to wiggly teeth and tooth loss.

Periodontitis is more likely to happen as you age. It’s most common in people over 30. Still, it can affect anyone with poor oral hygiene. Some people are also more genetically prone to periodontitis than others. If your biological parents or grandparents have a history of gum disease, you’re more likely to develop it as well.

Healthcare providers classify periodontitis as mild, moderate or severe. They base this on how much bone you’ve lost around each tooth and on how much inflammation you have in your gums. There are surgical and nonsurgical treatments that can help treat this oral infection and keep your gums healthy.

What are the symptoms of periodontitis?

Periodontitis symptoms include:

• Bad breath
• Bite changes
• Bleeding gums
• Gum recession
• Loose teeth
• Pain when chewing
• Pus (infection) around your gum line
• Reddish or purplish gums
• Swollen gums

Often, periodontal disease doesn’t hurt, so you may have no idea that you have the disease. Catching periodontitis early helps prevent complications. See a dentist as soon as possible if you have these symptoms, and even if you don’t have any symptoms.

What causes periodontitis?

The main cause of periodontitis is poor oral hygiene. Bacteria create plaque and tartar that cling to your teeth surfaces. If you don’t clean your teeth as well or as often as you should, bacteria travel down beneath your gum line, where your toothbrush and floss can’t reach. These harmful bacteria wear away the tissues that support your teeth, leading to infection, bone loss and tooth loss.

Risk factors

The following risk factors can increase your chances of developing periodontitis:

• A family history of gum disease
• Hormonal changes
• Inflammatory diseases like diabetes and high blood pressure
• Infrequent visits to the dentist
• Poor oral hygiene
• Smoking and vaping

What are the complications of periodontitis?

Left untreated, periodontitis could lead to complications like:

• Gum or tooth abscesses
• Gum pain
• Gum recession
• Loose teeth
• Tooth loss

How is periodontitis diagnosed?

Dentists typically diagnose periodontitis during routine examinations. During your appointment, they’ll likely:

• Ask about your symptoms, medical history and smoking history.
• Examine your gums for signs of inflammation.
• Take dental X-rays to check for bone loss.
• Use a periodontal probe, which is like a tiny ruler, to measure areas of bone loss (periodontal pockets) around your teeth.

How is periodontitis treated?

Periodontitis treatment depends on the severity of the condition. Options include nonsurgical and surgical procedures. Your dentist should refer you to a gum specialist (periodontist) unless your disease is mild.

Nonsurgical periodontitis treatments

Healthcare providers may treat milder cases with nonsurgical procedures or lifestyle changes. These include:

• Antibiotics. Your dentist may prescribe oral antibiotics to fight infection. Or they may place topical antibiotics under your gums to target the affected area.
• Oral hygiene instructions. Your dentist and hygienist will review the tools, products and techniques you use to clean your teeth.
• Scaling and root planing. Your dentist or hygienist will numb your mouth with local anesthesia and clean deep beneath your gums.

Surgical periodontitis treatments

Severe periodontitis usually requires surgery. These treatments include:

• Osseous surgery. A periodontist makes a cut (incision) along your gum line and temporarily lifts your gums. This allows them to see your teeth roots easily and clean them thoroughly. Your periodontist can smooth your bone to stabilize the periodontal disease.
• Dental bone grafts. These materials help rebuild your jawbone in areas where you’ve lost bone density.
• Guided tissue regeneration. A surgeon places a tissue-friendly (biocompatible) membrane between your jawbone and tooth. This membrane keeps unwanted tissue from growing into the area and encourages bone to grow back instead.
• Gum grafts. This procedure addresses gum recession, which often happens in combination with periodontitis. Gum recession is when you can see too much of your teeth roots.
• Platelet-rich plasma (PRP). This treatment helps rebuild lost bone or gum tissue. Healthcare providers obtain platelet-rich plasma from a sample of your own blood.

Can periodontitis be prevented?

The best way to prevent periodontitis is to see a dentist regularly and practice good oral hygiene at home. People who are prone to periodontitis may need more frequent cleanings than people without gum disease. Ask your dentist how often you should have cleanings to maintain healthy teeth and gums.

What’s the outlook for periodontitis?

Your outlook depends on the severity of your condition and how soon you begin treatment. When you treat periodontitis early, you reduce your risk for long-term damage to your teeth and gums. Severe or untreated periodontitis can lead to bite changes, tooth loss and a host of other oral health problems.

If you already have missing teeth due to periodontitis, talk to your dentist about replacement options. Dental implants or bridges can restore your smile and your oral health.

Can periodontitis be cured?

You can’t cure periodontitis, but you can manage it with treatment. Talk to your dentist or periodontist about a personalized plan.

When should I see my healthcare provider?

If you develop sore, swollen or bleeding gums, schedule an appointment with a dentist right away. Early intervention is key to getting your oral health back on track.

The longer you wait, the worse the disease may get. As a result, you might need more extensive (and more costly) treatment. For example, you may be able to treat early-stage periodontitis with a deep dental cleaning. But late-stage periodontitis usually requires surgery, which is more expensive and invasive.

What questions should I ask my doctor?

If you have periodontitis, here are a few questions you may want to ask your dentist:

• What stage of gum disease do I have?
• Do I have bone loss?
• What are my treatment options?
• How long will treatment take?
• How long will my recovery take?
• How often should I have my teeth cleaned to maintain my results?

Can periodontitis kill you?

No, periodontitis doesn’t directly cause death. But it’s associated with many other health conditions like rheumatoid arthritis, cardiac disease, low birth weight babies, Alzheimer’s disease and even some cancers. Some scientists believe that bacteria in your mouth can travel throughout your body via your bloodstream.