Periodontal disease is more commonly known as Gum Disease. There are two main types of gum disease – gingivitis and the more serious, periodontitis.
Gingivitis is inflammation of the gums caused by plaque. Plaque is the sticky, colourless film, made up of a mixture of saliva, bacteria and food, which forms on teeth every day. It's what makes teeth feel 'furry' when they haven't been brushed. If plaque is not routinely removed by an effective daily oral hygiene regime, the gums become red and swollen. Inflamed gums will bleed on blushing or flossing, with blood sometimes being seen on rinsing after brushing.
Long standing gingivitis can turn into periodontitis. The main cause is the continual presence of plaque which eventually hardens into calculus and leads to irreversible damage of the gums, bones and other supporting structures around the teeth. It is impossible to remove calculus by routine brushing etc. As the disease progresses the bone anchoring the teeth within the jaw is lost, causing teeth to become loose. If left untreated such teeth may eventually fall out.
Unfortunately, gum disease progresses slowly and can go unnoticed. However, the first sign of disease is bleeding on brushing, and in some cases on eating. Occasionally when the bacteria is more active abscesses (presenting as pus and/or swelling of the gum) can form. As the disease progresses the gum line may recede, the teeth may move (change position and/or become loose). The longer periodontal disease is present the harder it is to treat.
Some members of the general population are more genetically predisposed to severe periodontal disease than others. However, there are many other factors which can also contribute to the onset and progression of the disease. These include:
Bad breath, sometimes called halitosos, is a common problem and there are many different causes. Persistent bad breath is usually the result of smelly gases released by the bacteria that coat your teeth and gums.
Other causes of halitosis include:
Bits of food that get caught between the teeth and stuck to the soft tissues of the mouth rot and cause an unpleasant smell, so correct and regular brushing is very important to keep your breath smelling fresh.
If left, the bacteria on the teeth and gums can also cause gum disease and dental decay. Attending the dentist regularly helps ensure that your breath stays fresh and prevents the development of gum disease and dental decay, both of which can have serious repercussions on your oral health.
The initial treatment of periodontal disease starts with a consultation and detailed assessment. The information from this assessment is used to make a diagnosis and identify risk factors such as smoking habits, general health and family associated risks. It is important to control or modify any risk factors that can be adjusted.
The initial treatment usually consists of modifying brushing techniques to improve homecare, scaling and debridement under local anaesthetic, which is usually carried on one side of the mouth (upper and lower teeth) over two appointments. This is followed up with a reassessment 2 months after the treatment is completed. If the disease has stabilised, then follow up usually consists of maintenance therapy with the hygienists.
In certain cases further treatment such as repeating the initial phase of treatment or surgical therapy such as surgical debridement and/or bone regeneration may be required. Other periodontal treatments aimed at improving gum recession or correcting tooth lengths can also be carried out.