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Periodontitis, better known as gum disease, is a severe bacterial infection that destroys the alveolar bone and soft tissues that support teeth.
Without treatment, periodontal disease can cause severe bone loss in many areas of the mouth, leading to mobile teeth, infection, and tooth loss.
Symptoms of periodontitis include:
Gingivitis is an early, less severe form of gum disease. Untreated gingivitis can progress to periodontitis. Generally, people with gingivitis feel little to no discomfort, though the gums may be red, inflamed, and bleed easily.
Unlike gingivitis, periodontitis is not reversible. But treatment from a dental healthcare professional and good at-home hygiene can help slow the progression of and prevent gum disease.
The term periodontitis translates to “inflammation around the teeth.”
Periodontitis begins when bacteria, mucus, and other substances create a film on the teeth called dental plaque. Brushing the teeth removes plaque. But plaque left on teeth can harden over time and form tartar. Only a dental healthcare professional can remove tartar.
Toxins released by bacteria in plaque and tartar irritate gum tissue and create air pockets between the gum and teeth. If these periodontal pockets become infected, the immune system sparks an inflammatory response that can destroy supportive gum tissue and bones.
Several factors increase the chances of developing periodontitis, including:
The best treatment for periodontitis or periodontal disease depends on the stage of gum disease or how extensive the condition is. A dental hygienist or dentist will treat minor periodontitis. A periodontist, a gum disease specialist,, will often treat severe cases of gum disease or those involving bone loss.
Non-invasive treatments help treat mild cases of periodontitis or periodontal disease. These treatments do not involve surgery and help treat external parts of the teeth or gums.
Scaling is a deep cleaning that removes bacteria and tartar from teeth surfaces and beneath the gums. A dental professional performs scaling by using handheld tools, or an ultrasonic device that breaks up tartar.
Root planing involves a deep cleaning to remove damaged or diseased tissues, plaque and tartar, and toxins that cause inflammation. A dentist then smooths the root surfaces of teeth, to prevent tartar and bacterial build-up.
Many people with mild gum disease who undergo scaling and root planing do not require additional treatment.
A laser device may help break down tartar and build-up on teeth and gums to prepare it for removal. Current research shows laser treatments are about as effective as scaling and root planing procedures.
An experienced dental professional certified by the American Dental Association (ADA) should perform laser treatments. Using the wrong wavelength or power level can damage healthy tissues.
Several medications can help treat gum disease and periodontitis. They typically destroy bacteria or encourage regeneration.
Medications for periodontitis include:
Antibiotic pills taken orally can help destroy bacteria. One common antibiotic regimen involves taking 500 mg of the antibiotic amoxicillin three times daily for 10 days.
Antibiotic gels help destroy bacteria and shrink pockets. A dental professional will put topical antibiotics, often those containing the medication doxycycline, into impacted gum pockets.
In some cases, a dental professional may place microspheres into the gum pockets. These are tiny, sphere-shaped molecules that contain the antibiotic minocycline.
The body reabsorbs topical antibiotics after about 2 weeks.
A doctor may prescribe mouth rinses or swabs that contain medications like chlorhexidine that help destroy bacteria. Use medicated mouth rinses or swabs like you would regular rinses or swabs.
Special gels applied to diseased teeth roots can stimulate healthy tissue and bone growth. These gels contain proteins involved in developing tooth enamel. Tooth enamel is the strong, outer protective layer of teeth.
Severe or complicated cases of gum disease typically require invasive treatments, like surgery. People with more advanced periodontal disease might require more than one treatment.
Gum grafts are necessary when you lose gum tissue and the gums recede from the teeth. It reinforces damaged tissues, prevents additional recession, and covers exposed tooth roots.
During a gum graft, a periodontist removes a bit of tissue from the roof of the mouth and attaches it to the impacted area. Gum grafts may also involve the use of donor tissues.
Bone grafts are performed when periodontitis causes bone loss. It helps hold the tooth in place and prevents tooth loss. It may also encourage bone to regrow.
During bone grafts, a small piece of your bone or bits of synthetic or donor bone is attached to the impacted area.
Crown lengthening surgically adjusts the level of the gum and bone to expose more of a tooth. This makes it easier to clean the area and restore teeth.
During this procedure, a periodontist reshapes excess gums and bones around teeth. It may be performed on one tooth, several teeth, or to even the gum line.
A periodontal pocket procedure helps expose teeth roots to make scaling or root planing treatments easier. It also makes it easier to clean these areas at home once you heal.
During a pocket procedure, a periodontist makes small cuts in the gum tissues and lifts back a small section.
The doctor can then remove tartar, bacteria, and other debris once the tooth's roots are exposed. The periodontist might reshape or smooth underlying bones or splint loose teeth before suturing the gum back in place. They may also surgically remove gum pockets.
This procedure is also called flap surgery, pocket elimination surgery, or pocket reduction surgery.
Guided tissue regeneration allows destroyed bone to regrow.
In one method, a periodontist puts biocompatible mesh between the impacted tooth and existing bone. This fabric allows bones to properly regrow by preventing the growth of unwanted tissues during healing.
When periodontitis is advanced, a dentist or periodontist may need to perform surgery to remove diseased teeth. You will likely need to take antibiotics to control bacterial infections before surgery.
There are several ways you can prevent periodontitis and periodontal disease or stop it from progressing.
Common tips to prevent gum disease include:
Left untreated, advanced periodontitis can have serious health consequences. Treating gum disease quickly with good oral hygiene and/or professional treatments helps prevent complications.
The most common complication of periodontitis is tooth loss. Some people who lose their teeth may require dental implants or dentures to eat properly.
In cases of untreated periodontitis, bacteria can enter the bloodstream, spread to other regions of the body, and result in infections and inflammation that can cause:
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