Periodontal Disease
What is a Periodontal Disease?
The main periodontal diseases are gingivitis and periodontitis. Gingivitis is the inflammation of the gums around the teeth. The irritation begins with dental plaque that accumulates on the teeth daily. If this plaque is not removed by brushing and regular flossing, it hardens and over time forms tartar. You can’t remove tartar by yourself. You then need a professional descaling. Your dental hygienist will descale your teeth with special instruments designed to scrape tartar above and under your gums.
At this first stage of periodontal disease, gingivitis, gums seem normal but they can also be red, swollen and bleed easily when brushing your teeth or flossing. It is also possible that you have bad breath. Fortunately, gingivitis is reversible and can be treated as follows:
- Tutious hygiene care at home including regular brushing 2x day and the use of floss at least 1x day.
- Rinsings with salt water or a solution recommended by your dentist such as Chlorhexidine
- Dental cleaning every 6 months or more regularly as needed to remove tartar
- Stop smoking
The stages of periodontitis
If gingivitis persists and especially is not treated, it will then spread to the bone that supports the teeth, it will then become an inflammation called periodontitis. This is classified into 3 main stages according to its severity:
Stage 1: Early periodontitis
Bacterial infection spreads from the gums to the bone. The bacteria then cause the formation of small spaces or gaps between the gums and teeth called pockets. Normal gaps are 1 to 3 mm deep. The bacteria contained in the pockets destroy the bone that supports the teeth. As the pocket enlarges and the bacteria proliferate, a recession of the gums occurs which further increases the depth of the pocket. Your dentist and hygienist measures the depth of this pocket with an instrument called a periodontal probe to better track it’s progress.
Stage 2: Moderate periodontitis
When the gum recede exposing the tooth’s root, it is called moderate periodontitis. At this point, up to a third of the bone is lost.
Stage 3: Advanced periodontitis
Periodontitis is advanced when half or more of the bone that holds the teeth has been lost and the pockets are very deep. The tooth may seem longer because the root is bare, it will have more or less mobility and it may even end up falling out on it’s own like a baby tooth.
Signs and symptoms of periodontitis
About 3 out of 4 people suffer from periodontal disease at some point in their lives. For adults, it is estimated that 70% of lost teeth are lost due to periodontitis. Most often, however, the disease progresses slowly. If the disease is not already too advanced, treatment is simple and the risk of recurrence remains low provided that the patient maintains excellent hygiene. Most people combine dental problems and pain, “if it hurts, it goes wrong”. However, in adults, gum infection develops slowly and without pain. It can be treated if detected in time. The dentist seeks first and foremost to stop the progression of the disease, thus stabilizing the periodontal state. On the other hand, the bone that is lost will be lost. Therefore, an important point is that untreated periodontitis can lead to to tooth loss.
Here are some symptoms to watch for to prevent advancement of periodontitis:
- A discoloration of the gum
- Bleeding of the gums during brushing or flossing
- A chronic bad breath
- A taste of metal in the mouth
- A redness of the gums at the base of the teeth
- A purplish or painful gum
Gum infection usually begins in one or two places at a time rather than everywhere in the mouth. Examine your gums carefully. If you see anything unusual, do not hesitate to contact us.
How to treat periodontitis
The first step is a complete periodontal examination, which allows us to accurately assess, using X-rays and instruments, the quality of your gum, the depth of your pockets and the condition of your bone. It is from this data that we can suggest the most appropriate treatment. Then, we will be able to start your treatments. Periodontitis can be treated by different treatments depending on the case:
- Closed curettage: it is a non-surgical procedure that consists of descaling and cleaning in depth. You will need local anesthesia for the duration of the treatment and will thus be comfortable during the procedure. Curettage removes all the tartar above and under the gums. The goal will also be to make the tooth smooth of any bacterial debris and diseased tissues.
- Open curettage:it is a surgical procedure that requires the opening of the gum before curetting it, then closing it after the operation using stitches. It will also be practiced with local anesthesia. Sometimes an antibacterial agent is placed under the gums to help with the healing. This procedure is only recommended if periodontitis is very advanced or if other non-surgical treatments have not cured the disease. Antibiotics may be necessary. Open curettage can be done either by your dentist or by a gum specialist, a periodontist.
- Gum graft: This procedure aims to strengthen a gum that is thin. It can also help the gum if there is a gum recession (root exposure). Graft treatments are done with local anesthesia by your dentist or periodontist. You can consult our section on gum grafts to learn more about this treatment.
For the treatment of severe cases, for cases of rapidly evolving periodontitis or for any other cases that require more specific treatments, your dentist will take care to refer you to a specialized periodontist.
