A Dentist checks teeth under UV light

What is Periodontal Disease (Gum Disease)

What is Periodontal Disease (Gum Disease)

What Is Periodontal Disease?

Periodontal disease is more commonly referred to as “gum disease”. It is a bacterial infection that destroys the gums and supporting structures of the teeth. Periodontal disease, or periodontitis, is a more serious form of gum disease than gingivitis, which is far more common.

Left untreated, the infection damages the soft tissue and destroys the bone that supports the teeth and can cause the teeth to loosen. In extreme cases, this can lead to tooth loss.

Some preliminary studies have also suggested that there may be a link between gum disease and other major health concerns. Researchers have hypothesised that the bacteria responsible for periodontitis can enter your bloodstream through gum tissue, possibly affecting your heart, lungs and other parts of your body. For example, periodontitis may be linked with respiratory disease, rheumatoid arthritis, coronary artery disease or stroke.

Tooth loss remains a major public health problem in the UK, where 15% of 65-74-year olds and over 30% of 75+ year olds have lost all their natural teeth.

How Does Periodontal Disease Occur?

Our mouths are full of bacteria. These bacteria form a sticky, colourless ‘plaque’ on teeth when starches and sugars in food and other molecules interact with these bacteria. Brushing your teeth twice a day and flossing once a day removes plaque, but it re-forms quickly.

Plaque can cause gingivitis, the mildest form of periodontal disease. Gingivitis is irritation and inflammation of the part of your gum around the base of your teeth. This can be reversed with professional treatment and good home oral care.

Plaque that is not removed can harden and form ‘tartar’ that brushing doesn’t clean and must be removed by a dental professional. The longer plaque and tartar remain on your teeth, the more damage they can do.

Ongoing gum inflammation can cause pockets to develop between your gums and teeth that fill with plaque, tartar and bacteria. In time, these pockets become deeper, filling with more bacteria. If not treated, these deep infections cause a loss of tissue and bone, and ultimately you may lose one or more teeth.

The build-up of plaque on the teeth is the main cause of periodontal disease. Poor oral hygiene can contribute to the progression of gum disease, but there are a variety of other factors that can also impact your risk. For instance, stress, poor diet, and even genetics, can also play a role in the health of your gums. Other risk factors include diabetes, hormonal changes in girls and women, certain medications, and other illnesses that affect the immune system, such as AIDS.

Smoking is the most significant risk factor for gum disease and can also mask the signs of gum disease and make treatment less successful. Male smokers are up to 3.6 times more likely to lose their teeth than non-smokers, whereas female smokers were found to be 2.5 times more likely.

What are the Signs of Periodontal Disease?

Gum disease is not always painful, and you may be unaware you have it, so it is important to look for subtle signs of health issues in your gums. The initial symptoms of gum disease, also known as gingivitis, can include:

  • Red and swollen gums
  • Redness at the gum line
  • Bleeding gums after brushing or flossing your teeth

If gingivitis is untreated, the infection can progress and tissues and bone that support the teeth may also become affected. This is known as periodontitis, or periodontal disease.

Symptoms of periodontal disease can include;

  • Chronic bad breath (Halitosis)
  • An unpleasant taste in your mouth
  • Collections of pus that develop under your gums or teeth (gum or periodontal abscesses)
  • Spaces developing or widening between your teeth
  • Painful chewing
  • Sensitivity in the teeth
  • Gums that have pulled away (recessed) from the teeth
  • Changes in how your teeth fit together when you bite
  • Sores in your mouth
  • A change in the fit of partial dentures
  • Loose teeth

Smoking can mask the signs of gum disease, so it is especially important to pay attention to the more subtle signs of gum disease.

How is Periodontal Disease Diagnosed?

If you think you may have symptoms of gum disease, make an appointment with your dentist as soon as possible.

To determine if you have periodontal disease, your dentist may;

  • Examine your gums and note any signs of inflammation.
  • Use a tiny ruler called a “probe” to check for and measure any pockets around the teeth. In a healthy mouth, the depth of these pockets is usually between 1 and 3 millimetres.
  • Ask about your medical history to identify conditions or risk factors that may contribute to gum disease.
  • Take an x-ray to see whether there is any bone loss.

Early detection is crucial, if your dentist fails to diagnose periodontal disease, the infection can continue to develop and attack the gum and jaw bone. Without treatment, the disease can lead to the loss of bone in the jaw which holds the teeth in place and result in tooth loss. Furthermore, as periodontal disease often affects areas in the mouth rather than individual teeth, several teeth can be lost at once as a result of the failure to appropriately diagnose and treat the condition.

Delays in diagnosis allow the disease to progress; a few months can make the difference between losing and retaining teeth.

Different Types of Periodontal Disease

Chronic periodontitis

This is the most common type of periodontal disease, affecting mostly adults, though children can sometimes be affected, too. This type is caused by plaque build-up and involves slow deterioration that may improve and get worse over time but causes destruction in the gums and bone and loss of teeth if not treated.

Aggressive periodontitis

This form of periodontal disease usually begins in childhood or early adulthood and affects only a small number of people. It tends to affect families and causes rapid progression of bone and tooth loss if untreated.

Necrotizing periodontal disease

This is characterized by the death of gum tissue, tooth ligaments and supporting bone caused by lack of blood supply (necrosis), resulting in severe infection. This type generally occurs in people with a suppressed immune system — such as from HIV infection, cancer treatment or other causes — and malnutrition.

How Is Periodontal Disease Treated?

Periodontal disease is the more advanced form of gum disease. It cannot be treated as easily as gingivitis.

While periodontitis can still be treated, your dental professional may have to use more invasive techniques, these can include:

  • Scaling and deep cleaning of the surfaces of your teeth or removing germs and bacteria from beneath your gumline
  • More frequent visits to the dental hygienist
  • More frequent visits to the dentist for monitoring of the condition
  • Referral to a periodontal disease specialist for advice and specialist treatment

Get in touch with our experts if you think your dentist has missed the signs of periodontal disease or failed to provide appropriate treatment which has led to tooth loss or injury. Our experts might be able to help you claim compensation to give you access to the necessary treatment to either prevent any further damage or to replace teeth lost by negligence (such as by bridges or dental implants).