The name “periodontitis” means ‘inflammation around the tooth.” Micro-organisms, such as bacteria, stick to the surface of the tooth and in the pockets surrounding the tooth, and they multiply. As the immune system reacts and toxins are released, inflammation occurs.
Periodontitis disease, also called gum disease, is a serious gum infection that damages the soft tissue and, without treatment, can destroy the bone that supports your teeth. Periodontitis can cause teeth to loosen or lead to tooth loss, and although common is largely preventable as It’s usually the result of poor oral hygiene. Brushing at least twice a day, flossing daily and getting regular dental checkups can greatly improve your chances of successful treatment for periodontitis and can also reduce your chance of developing it.
Chronic periodontitis represents a major health problem in the UK with surveys show that more than 50% of the population currently experience some degree of damage to bone or the soft tissues supporting the teeth.
Approximately 10-15% of the population losing a significant number of teeth as a result of chronic periodontitis: the more susceptible the patient, the more rapidly the bone loss progresses. In addition, around 1% of the population is susceptible to the aggressive forms of periodontitis. These patients can present with advanced levels of attachment (bone) loss and pocketing in their twenties or thirties.
Although many patients do not immediately link their symptoms with gum disease, other patients report concerns with bleeding gums, drifting or loose teeth, a lack of mouth freshness or discomfort when eating, all of which are associated with periodontitis. Early diagnosis is important for periodontitis in order both to simplify treatment and improve prognosis.
Aggressive periodontal disease
Aggressive periodontal disease is much less common than chronic periodontitis and generally affects younger patients. This form of periodontal disease can be split into two categories; localised aggressive periodontal disease and generalised aggressive periodontal disease. The progression of this form of the disease is much more rapid and patients often display a different pattern of bone loss compared to this suffering from chronic periodontitis. Treatment for aggressive periodontal disease largely involves early mechanical therapy from dentists and the use of antibiotics. Whilst excellent oral hygiene can treat and stop the progression of chronic periodontitis, given the nature of aggressive periodontitis, more invasive treatment is required to halt the progression of the disease
Treatment for chronic periodontitis
Treatment of chronic periodontitis is highly successful in keeping teeth and improving both comfort and confidence. Non-surgical therapy is the foundation of periodontal care and this can also be successful when the disease is thought to be unresponsive or refractory. Effective self-care oral hygiene is the main key in combatting this disease. In addition, meticulous instrumentation of the root surface (deep scaling or root planing) will lead to substantial improvements in periodontal health. Depending on the severity and degree of bony involvement, effective self-care oral hygiene may minimise or eliminate the need for surgical intervention.
Several risk factors have well established associations with both periodontal and systemic diseases, such as diabetes, smoking, stress, immunodeficiency, medications, obesity, hormones and nutrition. For optimal treatment results, systemic risk factors must be modified or eliminated. Some are under the patient’s control (including smoking, stress, obesity and nutrition), and may, therefore, require lifestyle changes to achieve significant modification.
Supportive periodontal therapy (SPT) begins when active treatment is complete. SPT maintains the health improvements achieved by the patient and is the long-term continuation of care. Most patients with periodontitis benefit from regular SPT, typically every three months, although this recall is dependent on health status and risk factors. SPT involves helping patients to maintain an effective daily plaque control routine and to overcome barriers which prevent the routine being effective. Monitoring of periodontal health is also an integral aspect together with removal of bacterial deposits and re-instrumentation of developing pockets.
If treated early, periodontal disease may be arrested, bringing the gums back to a state of health preventing additional bone loss and tooth loss. For further information on chronic periodontitis please contact us here.