Last Updated on January 13, 2022 by Dr Gustavo Assatourians DDS
PERIODONTITIS IN THE EARLY STAGE
Periodontitis is a serious and irreversible infection of the gums, characterized by the progressive inflammation, bleeding and destruction of the soft tissue surrounding the tooth which, if not treated in time, can destroy the bone in which the tooth lodges, causing loosening and possible loss.
This disease is common and affects between 15% and 20% of adults between 35 and 44 years old, according to the World Health Organization.
Periodontitis is the main reason for tooth decay in adults. This disorder is not common in children, but its presence increases during adolescence.
WHAT IS PERIODONTITIS IN THE EARLY STAGE?
The development of periodontal disease is always preceded by a phase of inflammation of the gums, caused by the presence of bacterial plaque. If this inflammation is prolonged and the accumulation of plaque and the attack of bacteria persists, the irritation and chronic inflammation will produce the destruction, generally irreversible, of the bone that supports the tooth. This is especially the case in people who have some kind of genetic susceptibility or predisposition.
At this stage, periodontal pockets appear and the gum retracts, making the teeth appear longer. Your gums will be swollen and tender to the touch, and they may have turned paler as blood supply is reduced. The plaque around the teeth will begin to harden into a tougher and more damaging material called dental tartar; this will accelerate the damage. At this stage, the bony structures that hold the teeth to the jaw may begin to weaken. Prompt professional treatment is necessary to reduce the risk of tooth loss.
SIGNS AND SYMPTOMS OF PERIODONTITIS IN THE EARLY STAGE
In its initial phase, the symptoms of periodontitis are usually few and in many cases can be reversed if they are diagnosed and treated early; hence the importance of visiting a dentist regularly.
Once periodontitis has started, the most important sign is the loss of bone tissue, which is evaluated by a specialist through periodontal probing. The condition, which characterizes the transition from gingivitis to periodontitis, is confirmed by radiographs that confirm whether or not the bone has been destroyed.
In the early stages of periodontitis, the gums recede or separate from the teeth and small pockets form between the gums and teeth, called periodontal pockets. These bags harbor harmful bacteria. The immune system tries to fight the infection and the gum tissue begins to regress. There will also be some bleeding during brushing and flossing, and possibly some bone loss. Dental tartar is present, generally on the palatal and lingual surfaces of the incisors and molars.
CAUSES OF PERIODONTITIS
Healthy people normally have hundreds of different types of bacteria in their mouths. Most are completely harmless. When there is not a proper daily cleaning of the teeth, bacteria can grow and accumulate on the teeth. Periodontitis is generally caused by poor dental hygiene. When you don’t brush your teeth and clean hard-to-reach places in your mouth, the following happens:
Bacteria in the mouth multiply and form a substance known as dental plaque. If you don’t brush off this plaque, bacteria deposit minerals inside the plaque over time. This mineral deposit is known as tartar, which will encourage further bacterial growth toward the root of the tooth.
The body’s immune response to this bacterial growth causes inflammation of the gums. The attachment of the gum to the root of a tooth is broken over time, and a periodontal pocket (space) can form between the gum and the root. Harmful bacteria colonize this periodontal pocket and multiply, releasing toxins that can damage the gums, teeth, and supporting bone structures.
Additionally, certain factors put you at a higher risk for periodontitis:
- Smoking, one of the biggest risk factors for periodontitis
- Type 2 diabetes
- Hormonal changes in women (such as menstruation, pregnancy, or menopause), which can make the gums more sensitive
- Conditions that affect the immune system, such as HIV or leukemia
- Medications that reduce the flow of saliva in the mouth
- Poor nutrition, including a vitamin C deficiency
TREATMENT OF PERIODONTITIS IN THE EARLY STAGE
Early treatment of periodontal disease is very important to intercept the evolution of the disease, especially in people susceptible to developing it. The treatment must aim to remove plaque and bacterial deposits on the teeth and gums.
Oral hygiene practices
Your dental care team will instruct you how to reduce the amount of bacteria in your mouth, which involves keeping your teeth and gums clean.
Scraping and root planing
When you already have initial periodontitis or are in the maintenance phase, you need the treatment of scraping and smoothing the root of the tooth, which consists of the elimination of all bacteria from the root surface with local anesthesia.
In some cases, it will be necessary to supplement treatment with antibiotics to help with persistent gum infections that have not responded to cleanings. The antibiotic may come as a mouthwash, gel, or tablet or oral capsule.
The dentist will encourage a follow up after a few weeks, then about every three to six months after to assess your progress. If there are still periodontal pockets, the dentist may recommend other treatment options, such as surgery.
If inflammation persists in places inaccessible to brushing and flossing, your dentist may recommend a surgical procedure, called flap surgery, to clean the deposits under the gums. Under anesthesia, the gums are lifted and the roots of the teeth are cleaned. The gums are then stitched back into place.
It is essential to become aware of the need for frequent check-ups and lifelong maintenance visits to avoid the recurrence of the disease and ensure its inactivity.
If you have periodontitis, regular check-ups with a dentist are essential to make sure the disease doesn’t progress.
PERIODONTITIS IN THE EARLY STAGE PERIODONTITIS IN THE EARLY STAGE