Definition

Periodontitis is an advanced form of gum disease. It can cause destruction of the supportive structures around your teeth and lead to permanent tooth loss.

Untreated periodontitis can be serious and lead to complications such as:

• Increased risk of coronary artery disease (CAD)
• Increased risk of preeclampsia and preterm delivery in pregnant women
• Increased risk of pneumonia
• More difficultly controlling blood sugar in people with diabetes

Causes

Bacteria grow on your teeth and create a filmy coating called plaque. A build up of this plaque causes an inflammation of the gum tissue, known as gingivitis. If gingivitis is left untreated, the plaque can extend under the gum line can create pockets around the teeth. Bacteria can collect in these pockets and cause regular inflammation and destruction known as periodontitis. Over time, this chronic inflammation and bacteria cause destruction of gum tissue, ligaments, and bones that hold your teeth in place.

Risk Factors

Poor oral hygiene including untreated gingivitis increases the risk of periodontitis. It is also more common in older adults.

Other factors that can increase bacteria or plaque in your mouth include:

• Genetics
• Poor dietary habits
• Poorly controlled diabetes
• Metabolic syndrome —A condition marked by elevated blood pressure, cholesterol, blood glucose, and body weight. Excess weight centered around the midsection is of particular concern.
• Suppressed immune system
• Pregnancy
• Smoking or chew tobacco

Symptoms

Periodontitis normally occurs without symptoms. In those that have symptoms, periodontitis may cause:

• Red, swollen, tender, or bleeding gums
• Receding gums that may expose the root of your teeth
• Loose teeth or teeth that fall out
• Persistent bad breath
• Presence of pus between your teeth
• Change in the way your teeth fit together when you bite down
• Swelling of face and jaw
• Weight loss in elderly

Diagnosis

You will be asked about your symptoms and medical history. A complete oral exam will be done. Periodontal disease can be diagnosed during an oral exam. Your dentist may do x-rays to determine how much damage has been done.

Treatment

The goal of treatment is to stop the bacterial invasion. Further course of treatment depends on the severity and progression of the periodontitis.

Talk to your dentist about the best treatment plan for you. Options include:

Prevention

To help reduce your chance of periodontitis:

• Brush your teeth and tongue with fluoride toothpaste at least 2 times per day.
• Use a soft-bristled toothbrush or a powered toothbrush if advised by your dentist.
• Floss your teeth 1 time per day.
• Use a mouthwash after brushing and flossing your teeth.
• If you smoke or chew tobacco, talk to your doctor or dentist about how you can successfully quit.
• See your dentist as recommended for regular cleanings and check-ups.