Pinnacle Dental Solutions
Interdisciplinary Periodontics & Implant Dentistry
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Pinnacle Dental Solutions
Interdisciplinary Periodontics & Implant Dentistry
Block A, Office No. 112A, 1st floor, Sun South Street, Nr. Aarvi156, Behind Safal Parisar1, Opp. Bopal Fire Station, South Bopal, Ahmedabad, Gujarat, India – 380058.
What is gum disease?
Gum disease begins with gingivitis, an inflammation caused by the build-up of bacterial plaque along the gum line. The plaque is more dangerous than calculus or tartar for sustaining a tooth at its natural position. If left untreated, it progresses to periodontal disease (periodontitis), where the inflammation spreads, damaging the bones that support your teeth. This can further lead to tooth loss.
For optimal oral health, early treatment is the key!
What is periodontitis?
Periodontitis is a chronic gum disease triggered by bacterial microorganisms. It causes severe inflammation, destroying the tissues that support teeth, often resulting in tooth loss. It begins as gingivitis, where gums become red, swollen, and bleed when brushing or eating. If untreated, the inflammation spreads below the gums, damaging the bone and periodontal ligaments. Over time, teeth may loosen, causing difficulty chewing, speaking, and aesthetic concerns. Early detection and treatment can stop the disease and restore gum health. Periodontitis accounts for around 80% of adult tooth loss.
The good news is that – if detected and treated – the process can be halted and gum health can be restored.
The word “periodontitis” comes from “periodontium”, which means “surrounding (peri) the tooth (odont)”. The periodontium includes all the components that hold the tooth in the jawbone: the gum (gingiva), the bone, the anchoring fibers, and the anchoring structure on the surface of the root (cementum). In a healthy tooth, the periodontium surrounds the entire root.
What are the symptoms of periodontitis?
- Increased bleeding from the gums, may be provoked by tooth-brushing or eating, or may be even spontaneous.
- Bad breath.
- Changes in the positioning of the teeth in the jaws.
- Teeth appear “longer” (receding gums).
- Gradual Loosening of teeth.
- Pus discharge from the gums and around the teeth.
- Increased gap/spacing between the teeth.
What are the probable causes of periodontitis?
The simple message is that periodontitis is always caused by the build-up of bacteria in the form of dental plaque.
A healthy mouth is colonized by more than 700 different species of bacteria, most of which are completely harmless and live in harmony with their “host”. But when we do not clean our teeth thoroughly enough, bacterial deposits build up next to the gums, forming a “plaque” – and this creates the conditions for more dangerous bacteria to flourish. The natural defenses of the body are also compromised as a result.
If this soft bacterial plaque is not removed by brushing, minerals are deposited within it and a hard deposit on the tooth called tartar (or calculus) is formed. The presence of tartar encourages the growth of bacterial plaque towards the roots of the teeth. This leads to a weakening of the attachment of the root to the gum and the creation of a gap – called a periodontal pocket – between tooth and gum. This pocket is an ideal place for harmful bacteria to gather and multiply, which drives disease forward as the bacteria release toxins that further trigger the body’s defense mechanisms.
The severity and speed with which periodontitis progresses depends on factors including:
- the number and type of bacteria present.
- the strength of an individual’s defenses.
- the presence or absence of risk factors (e.g. smoking, diabetes).
- genetic factors.
- certain types of medication.
For example, the more aggressive the bacteria and the weaker the immune response of the patient, the more active will be the disease. And if the patient is a smoker or has diabetes, the body’s defenses may be weakened which can speed up the disease process. Some drugs – such as antihypertensive or vasodilating agents and immunotherapy – can affect the inflammatory response to plaque and make patients more susceptible to gingivitis.
However, it is very important to remember that without the accumulation of bacterial plaque, periodontitis will not occur.
What are the consequences of periodontal disease?
Tooth loss: If the progress of periodontal inflammation is not halted, the supporting structures of the teeth – including the surrounding bone – are destroyed. The teeth eventually loosen and are either lost or need to be extracted. Among adults, it is estimated that around 70% of tooth loss is caused by periodontitis.
Problems with eating: Periodontitis weakens the structures that hold the teeth in place. Wobbly teeth can cause problems when chewing. People affected can to some extent adapt and switch their chewing habits to the teeth that can still be used. But if the damage continues – and especially if teeth are lost – people can end up able to eat only soft foods.
Problems with speaking: the loose teeth caused by periodontitis can make it difficult to speak clearly. If the visible front teeth in the upper jaw are forced apart because of periodontitis, the gaps that arise can cause problems in speaking (for example, sibilant sounds like “S” may not be pronounced clearly). Singers and musicians who play wind instruments can also have problems if teeth start to move apart as a result of periodontitis.
Problems with appearance: People with periodontitis can have problems with their appearance (aesthetic problems). Gums are dark red because of inflammation, teeth look longer because of receding gums, and the roots (which are darker than the crowns of teeth) become visible – all of which can look unattractive. As teeth loosen, they can move apart leaving dark spaces (black triangles) between them, and if teeth are lost as a result of periodontitis there can be unattractive gaps.
Bad breath: The bacteria that cause the inflammation involved in periodontitis can also cause bad breath (halitosis). The kinds of bacteria that cause periodontitis thrive in gum pockets and produce foul-smelling volatile sulfur compounds. Bad breath needs to be treated by professional teeth cleaning and good oral hygiene at home.
Negative effects on general health: It is now known that untreated periodontal disease can have serious consequences for general health. Periodontitis means an increased risk of suffering diabetes, heart disease, cerebrovascular disease, and complications in pregnancy (pre-eclampsia, premature birth, and low birth weight). Periodontitis has been linked with more than fifty diseases and conditions, including chronic kidney disease, Alzheimer’s Disease, rheumatoid arthritis, and certain types of cancer.
What are the risk factors for periodontitis?
Several factors increase your chance of developing periodontitis and make the disease more likely to progress. Among the common risk factors are:
Smoking
- Smokers are much more likely to develop periodontitis than non-smokers.
- Periodontitis progresses much more quickly – and with more rapid loss of teeth – in smokers than in non-smokers.
- Even with good oral hygiene at home, smokers experience greater bone loss and are more likely to develop gum pockets that house a greater number of harmful bacteria.
- Periodontal treatments (e.g. implants and gum or bone grafts) are less successful in smokers than non-smokers because healing is generally poorer.
- About 90% of cases where periodontitis does not respond to treatment involve smokers.
- In ex-smokers, the condition of the gums can improve within a few years and with good professional care. Just one year after quitting, former smokers respond better to treatment than patients who still smoke.
- Quitting smoking is strongly advised.
Genetics
- Some people may have more of a genetic predisposition to suffering gum disease than others.
- The way the immune system reacts to harmful bacteria can differ from person to person because of genetic differences. As a result, people do not all develop the same symptoms of periodontitis.
Age
- Periodontitis can start at the age of 18 in rare cases, and in very rare cases even in adolescence.
- But most cases develop after the age of 35.
- Because the disease usually progresses slowly, those affected do not detect the first problems until much later – sometimes when it is already too late.
- In old age, the consequences of periodontitis can be more serious, in terms of greater bone loss and more tooth loss.
Type-2 diabetes
- Diabetics whose blood sugar is not managed have a higher risk of developing periodontitis.
- Periodontitis and diabetes have a two-way effect on each other. Diabetics whose blood sugar is not managed have a higher risk of developing periodontitis. And patients with periodontitis have a higher risk of suffering diabetes.
- Diabetics with well-managed blood-sugar levels do not have a higher risk for periodontitis.
- The treatment of one disease has a positive effect on the treatment of the other.
- It is important that people with diabetes are examined by a dentist to see if they have periodontitis and patients with periodontitis should be tested for diabetes by their doctor.
Poor diet
- An unhealthy diet – one high in processed foods and refined carbohydrates – increases the tendency for gums to become inflamed.
- In both gingivitis and periodontitis, this can lead to more swelling at the gum line and increased damage to the tooth-supporting structures.
- An unhealthy diet also increases the risk of diabetes, which can further exacerbate periodontitis.
Stress
- Mental and emotional stress can weaken the immune system and lower the resistance of the gums to harmful bacteria.
- People with a weakened immune system may be more susceptible to gum disease.
- The resulting greater bacterial load adds to the unfavorable effect on an already compromised immune system.
- Individuals suffering from stress or depression may spend less time on their daily oral hygiene at home.
What can I do to prevent periodontal disease?
Inflammation of the gums is neither normal nor inevitable. Gum diseases –gingivitis and periodontitis – can be prevented by looking after your teeth and gums. This means adopting good habits in oral hygiene and getting regular professional check-ups (at least once a year).
The basic elements of good oral hygiene are:
- Brush your teeth at least twice a day, for at least two minutes, using a manual or an electric toothbrush.
- Clean between teeth at least once a day using interdental brushes (also known as interproximal brushes) and dental floss if the gaps are too small for brushes. You may need to use differently sized brushes for differently sized gaps. This interdental cleaning should be done before brushing your teeth.
- After brushing your teeth, antiseptic mouthwashes may be used as they can prevent plaque accumulation for up to 12 hours. Chlorhexidine mouthwashes are the most efficient, but have some side effects such as tooth staining, black tongue, change in taste, and sometimes erosion of the mouth’s soft tissues. Chlorhexidine mouthwashes are recommended to be used for a maximum of two weeks. Ask your periodontist whether you should use a mouthwash, and which one would be appropriate to your situation.
Special care should be taken to clean thoroughly around crooked or crowded teeth, and around fillings, crowns, and dentures because plaque builds up easily in these places which might be hard to access.
Optimal oral hygiene can therefore vary widely from person to person. It is important to consult your periodontist or dental hygienist about which are the best techniques in your case and to ask them for instructions.
There are two main toothbrushing techniques. The Bass toothbrushing technique is the most commonly recommended technique both for people with healthy gums and with periodontitis. The Stillman technique is often recommended for patients with gum recessions.
If your cleaning technique is poor, deposits of plaque remain on the teeth and will become “mineralised”, turning into hard deposits known as calculus or tartar, which cannot be removed by a toothbrush. But your dentist or periodontist (a dentist who specialises in periodontal health) can identify these deposits during a regular check-up and remove them as part of professional cleaning. Once the tartar is removed, the teeth are polished (using special cups and pastes) to create a smooth surface that is less likely to accumulate plaque.
Ask your dentist for a basic periodontal examination as part of your regular dental check-up.
Addressing risk factors can also help prevent the onset of periodontitis. So, giving up smoking, avoiding or reducing stress, eating a healthy diet, and exercising can all play a role in supporting good oral hygiene and thus, preventing periodontitis.
What is periodontology?
Periodontology is the study of the specialized system of hard and soft tissues that support your teeth and keep them in their place in the jaw. This apparatus, known as the periodontium, has some very important functions:
- It securely attaches the teeth to the jaws.
- It acts as a shock absorber during biting and chewing, and so helps to prevent damage to the teeth.
- It maintains the teeth in a stable position within the jaws so that that they work together efficiently and comfortably during chewing.
The periodontium is made up of several individual structures that work together:
- The tooth socket: the bony pouch in the jawbone in which the tooth is positioned.
- The cementum: a layer that covers the roots of the teeth.
- The periodontal ligament: a complex arrangement of tiny fibers, between the root cementum and the tooth socket, which holds the tooth in place almost like a sling.
Because the different parts of the periodontium are made from living tissues, they can adapt to changes in our mouths over time, making tiny changes in shape and thickness that keep the position of the teeth stable.
In many ways, the mouth acts as a mirror of the general condition of our bodies. Our periodontal status can often tell us more than simply what is happening locally in our gums. Although periodontitis is always triggered by the accumulation of plaque on the teeth, diseases affecting the rest of the body – known as systemic diseases – can weaken the supporting structures of the teeth.
Also, some serious disorders are known to show themselves in the mouth before they are evident in any other part of the body. Sometimes a trained periodontist is the first person to detect the signs of a general disease, such as diabetes or blood disorders, when examining a patient’s mouth.
Who is a Periodontist?
Periodontists are dental practitioners who specialize in the prevention and treatment of diseases of the tooth-supporting tissues – the periodontium. Although all dentists receive training in the diagnosis and treatment of mild to moderate periodontal disease, severe or complex cases are usually referred to a periodontist, who will have undertaken additional training and acquired special expertise in the area.
Within the field of periodontology, there is also a range of different specialist procedures that focus on specific types of treatment. The treatments a periodontist provides include: non-surgical periodontal therapy, regenerative periodontal therapy, soft-tissue grafting and recession coverage, pre-prosthetic surgery, and bone reconstruction with implant placement or therapy.
Still Have any Questions?
Pinnacle Dental Solutions
Interdisciplinary Periodontics & Implant Dentistry
Consulting Hours
| Day | Time |
|---|---|
| Monday, Wednesday, Friday |
10am – 01pm
02pm – 09pm |
| Tuesday, Thursday, Saturday | 11am – 08pm |
| Sunday* | 09am – 02pm |