Periodontal Disease – Part 2

Periodontitis is the last topic in periodontal disease. Periodontitis is a serious gum infection (I will not cover this under infections) that damages the soft tissue and destroys the bone that supports your teeth. Periodontitis can cause tooth loss or worse, an increased risk of heart attack or stroke and other serious health problems.

Periodontitis is usually the result of poor oral hygiene. Brushing at least twice a day, flossing daily, and getting regular dental checkups can greatly reduce your chance of developing periodontitis. It is also preventable by using the above oral hygiene.

Signs and symptoms of periodontitis can include:

• Swollen gums
• Bright red or purplish gums
• Gums that feel tender when touched
• Gums that pull away from your teeth (recede), making your teeth look longer than normal
• New spaces developing between your teeth
• Pus between your teeth and gums
• Bad breath
• Bad taste in your mouth
• Loose teeth
• A change in the way your teeth fit together when you bite

There are different types, or classes, of periodontitis. Chronic periodontitis is the most common class, affecting mostly adults, though children can be affected, too. Aggressive periodontitis usually begins in childhood or early adulthood and affects only a small number of people.

Factors that can increase your risk of periodontitis include:

• Gingivitis
• Heredity
• Poor oral health habits
• Tobacco use
• Diabetes
• Older age
• Decreased immunity, such as that occurring with leukemia, HIV/AIDS or chemotherapy
• Poor nutrition
• Certain medications
• Hormonal changes, such as those related to pregnancy or menopause
• Substance abuse
• Poor-fitting dental restorations
• Problems with the way your teeth fit together when biting

Some complications associated with gum disease include:

• Tooth loss
• Coronary artery disease
• Stroke
• Premature, low birth weight babies
• Poorly controlled diabetes
• Respiratory problems
• Rheumatoid arthritis
• Asthma

If your gums are puffy, dusky red and bleed easily, or show other signs or symptoms of periodontitis, see your dentist soon. The sooner you seek care, the better your chances of reversing damage from periodontitis, potentially preventing other serious health problems.

It is believed that periodontitis begins with plaque, a sticky film composed mainly of bacteria. Plaque forms on your teeth when starches and sugars in food interact with bacteria normally found in your mouth. Brushing and flossing your teeth removes plaque. Plaque re-forms quickly, usually within 24 hours.

Plaque that stays on your teeth longer than two or three days can harden under your gum line into tartar (calculus). Tartar also may form because of the mineral content of your saliva. Tartar makes plaque more difficult to remove and acts as a reservoir for bacteria. You can't get rid of tartar by brushing and flossing, you need a professional dental cleaning to remove it.

The longer you allow plaque and tartar to remain on your teeth, the more damage they can do. Initially, they may simply irritate and inflame the gingiva, the part of your gum around the base of your teeth. This is called gingivitis, the mildest form of periodontal disease.

The continuing inflammation eventually causes pockets to develop between your gums and teeth that fill with plaque, tartar, and bacteria. Bacteria deposit endotoxin, a byproduct of their own metabolism, which is responsible for much of the inflammation around teeth. In time, these pockets become deeper and more bacteria accumulate, eventually advancing under your gum tissue. These deep infections cause a loss of tissue and bone. If too much bone is destroyed, you may lose one or more teeth.

Some research suggests that the bacteria responsible for periodontitis can enter your bloodstream through your gum tissue, affecting your lungs, heart, and other organs of your body. For instance, bacteria may travel to the arteries in your heart, where they might trigger a cycle of inflammation and arterial narrowing that contributes to heart attacks.