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Articles

Periodontitis is a Threat to Healthy Teeth

Research
Research

Periodontitis is a Threat to Healthy Teeth

Maintaining oral hygiene can be a real chore. There’s so much noise out there about how to do it, what kind of toothbrush or toothpaste to use, how often you should floss, and what kind of mouthwash you should use or avoid. Not getting it right can lead to serious oral health issues. One of the most common and serious diseases plaguing the mouths of the average American citizen is a serious form of gum disease called periodontitis. This advanced dental disease can, if left untreated, spell disaster for your mouth and can lead to serious issues like heart conditions, bad breath, and loss of teeth. Understanding periodontitis and how to prevent it is the key to avoiding serious health complications. 

What is Periodontitis?

Periodontitis is the result of bacterial infections causing inflammation in the gum around the tooth. The first stage of this disease is the commonly known gingivitis, which starts as mild inflammation. If allowed to progress, gaps can form between the base of the tooth and the gum. This can lead to teeth loosening and wiggling in their socket, and can destroy the soft tissue around the tooth’s root. The gum recedes and reveals more of the tooth’s root than normal, leading to a visual appearance that has traditionally been called ‘long in the tooth’. Bacteria causes plaque and acidification on the tooth, eroding enamel and causing a buildup of black, hard calcified tartar around the base of the tooth. This tartar can increase the damage to the gum, advancing the disease even further. 

Common symptoms of the disease include bleeding gums, foul breath and taste in your mouth, receding gumline, and loose teeth, but there are many more that are potentially more serious. Oral health is strongly related to the health of the rest of your body, and periodontitis can contribute to serious health problems. The inflammation around your gums can increase inflammation in other parts of the body, including around the heart. People with periodontitis have two to three times more likelihood of developing serious heart disease, including plaque buildup in the arteries. Poor oral hygiene therefore increases risk of heart attack, though the exact mechanism behind this link is not fully understood. 

Prevention Methods

Once the disease has started, it can’t be reversed. Damage to the soft tissue surrounding the root of the tooth is permanent, and can only be fixed through dental surgery – more on that later. The only reliable way to make sure you don’t have to deal with any of that is to engage in robust preventative care. The obvious methods are to brush your teeth twice a day and floss after every meal, but those old chestnuts of advice are vague and unhelpful. More specific advice would be to brush with fluoride toothpaste first thing in the morning and last thing before you go to bed, making sure to hit the areas near the gumline. Flossing is the most neglected kind of oral care, and in the case of gingivitis or periodontitis this can create a self-feeding cycle. Flossing can potentially make your damaged gums bleed, which can make you want to neglect flossing, which makes the situation worse. More information on prevention can be found here.

An often overlooked step is to get regular cleanings from your dentist. Scaling is a procedure wherein the dentist will scrape the hardened, solidified plaque and tartar away from the space below the gumline. Bacteria can get lodged into hard to reach places that brushing and flossing can’t always reach. In the case of mild, beginning stages of the disease, you may be prescribed antibiotics or an antibiotic mouthwash to prevent further damage and advancement. Should the disease advance to more damaging stages, other methods will be required to save your teeth. 

Treatment of Serious Periodontitis

Surgical intervention might be required to treat periodontitis when it causes serious damage to your mouth. As mentioned previously, the damage to your gums is irreversible once the disease progresses. Your dental health professional can perform different procedures to save your teeth and jawbone, both of which are at risk with untreated periodontitis. Flap surgery is common, and involves peeling the skin around your tooth away to perform a deep cleaning and suturing it back in place. In more serious cases, your dentist may create new gums by harvesting skin from the roof of your mouth or your cheeks. Then, they will graft the new skin into place around the base of your teeth, creating new gums entirely. Combined with regular cleanings and ongoing hygiene, these methods can maintain the teeth you already have. 

Sometimes, there’s no saving a tooth or teeth affected by periodontitis. In those cases, it becomes a matter not of saving the tooth, but of replacing it. Dental implants are the way to go in the most serious cases where tooth loss is unavoidable. Implants are precisely what they sound like: artificial teeth surgically installed into the jawbone. The procedure takes one of two forms, either subperiosteal or endosteal. Subperiosteal implants are installed below the gumline but not directly into the jaw, where endosteal implants are drilled into the jawbone directly. Of the two, endosteal is the stronger and more permanent of the two. 

Dental implants come in different kinds, and what kind of implant you need depends on the specific damage you’ve suffered. You can learn more about dental implants, including their maintenance, at https://www.nuviasmiles.com/blog/does-food-get-under-dental-implants. For a single missing tooth, you’ll need the obviously named single tooth implant. For a few adjacent teeth missing, a dental bridge might be what you need. Bridges are drilled into your jaw at the ends of the gap, which hold the other artificial teeth in place between them. Implant supported dentures are good if you already have dentures and want to upgrade to something better. They snap into and out of place through metal stubs, and are removable for cleaning and maintenance, and sport a stronger bite and more secure connection to your mouth. Finally, in the case of missing many teeth, you might consider a full arch to replace an entire set of teeth.