Archive for the ‘Dentistry’ Category

What is Periodontitis?

Posted by admin in Dentistry on January 19th, 2009

Periodontitis, or Pyorrhea, is a disease involving inflammation of the gums, often persisting unnoticed for years or decades in a patient, that results in loss of bone around teeth. This differs from gingivitis, where there is inflammation of the gingiva but without bone loss; it is the loss of bone around the teeth that differentiates between these two oral inflammatory diseases.
In most cases this disease is linked to poor oral hygiene. In particular, patients must regularly clean underneath their gumline in order to help disrupt the build-up of plaque and inflammation-generating toxins below the gumline. Some people, however, can have a genetic pre-disposition to the disease. Once initiated, the disease can progress more rapidly in people who have diabetes, especially if the diabetes is poorly controlled. Smoking is a strong risk factor for periodontal disease as it contains chemicals that can exacerbate existing inflammation, enhance bacterial growth, and prevent the synthesis of collagen, an important factor in healing damaged gingival tissue.

Symptoms may include the following:

occasional redness or bleeding of gums while brushing teeth, using dental floss or biting into hard food (e.g. apples)
occasional gum swellings that recur
halitosis or bad breath
persistent bad taste in the mouth
recession of gums resulting in apparent lengthening of teeth. This may also be caused by heavy handed brushing using a hard tooth brush.
pockets between the teeth and the gums (Pockets are sites where the jaw bone has been destroyed gradually or by repeated swellings)).
loose shaky teeth in later stages

Patients should realize that the gingival inflammation and bone destruction are largely painless. Hence people may wrongly assume that painless bleeding after teeth cleaning is unimportant, although this may be a symptom of periodontitis progressing in that patient.

Measures to prevent periodontal disease include:

brushing properly on a regular basis (2 times a day), with the patient attempting to direct the toothbrush bristles underneath the gum-line, so as to help disrupt the bacterial and plaque growth that may occur there.
flossing daily and using interdental brushes if there is sufficient space between teeth and behind the last tooth in each quarter.
using an antiseptic mouthwash. Listerine and its generic formulations, as well as Hydrogen Peroxide, may help prevent gingivitis, although they cannot reverse any bone loss due to periodontitis.
regular dental check-ups and professional teeth cleaning as required. Dental check-ups serve to monitor the person’s oral hygiene methods and levels of bone around teeth, identify any early signs of periodontitis, and monitor if it has responded to treatment.

Dentists use special instruments to clean teeth below the gumline and disrupt any plaque growing below the gumline. This is a standard treatment to to prevent any further progress of established periodontitis. Studies show that after such a professional cleaning, bacteria and plaque tend to grow back to pre-cleaning levels after about 3-4 months. Hence, in theory, cleanings every 3-4 months might be expected to also prevent the initial onset of periodontitis. However analysis of published research has reported little evidence either to support this or the intervals at which this should occur. Instead it is advocated that the interval between dental check-ups should be determined specifically for each patient between every 3 to 24 months.

Nonetheless, the continued stabilization of a patient’s periodontal state depends largely, if not primarily, on the patient’s home care. Without good technique and habits at home, periodontal disease will not be overcome, especially if the patient has a history of extensive periodontal disease.