Periodontal disease: gingivitis and periodontitis

When we talk about periodontal disease, we mean those conditions of the periodontium, which is the set of tissues and fibres surrounding the tooth, holding and protecting it. It is formed by gums, the periodontal ligament, the root cement and the alveolar bone.

Gums are the tissues that line the arches of the jaws, surrounding the neck of the tooth and joining it through an epithelium that acts as a sealant. They constitute the visible part of the gum. Like the teeth, the gums have been exposed to disease. When these tissues become inflamed and/or infected, they are altered, allowing the passage of bacteria into the gum, which poses a threat to the stability of the teeth and can lead to the loss of said teeth.

Gingivitis

The main enemy of our gums is the bacterial plaque or “biofilm”. It is a thin layer of bacteria that forms on the surface of the teeth and, without proper oral hygiene, calcifies forming tartar on the surface of the tooth and even under the gum. The presence of plaque and tartar can damage the enamel and cause inflammation of the gums. This inflammation is what is known as gingivitis and is the first stage of periodontal (gum) disease.

Symptoms

The main symptom of gingivitis is bleeding gums, as a result of the inflammation and redness. None of these signs usually generate discomfort, so they can go unnoticed by the patient, especially in cases of smokers, since tobacco can mask them. For this reason, periodic reviews or our consultation are so important.

Treatment

Usually, performing a professional oral cleaning (tartar removal procedure) to eliminate calcified deposits and monitoring proper oral hygiene, in line with the instructions provided by our clinical team, are sufficient to reverse gingivitis and prevent it from evolving into the next stage of the disease, “periodontitis”, which involves bone loss and whose consequences may be irreversible.

Periodontitis

Periodontitis, pyorrhoea or periodontal disease is a bacterial disease that causes inflammation of the gums and progressive loss of bone support of the teeth. Without proper treatment, you can end the life of the teeth, which can lead to them falling out. The most noticeable symptoms by the patient are the same as in gingivitis redness and gingival redness and gingival bleeding. In more advanced stages, other symptoms may appear, such as mobility and/or displacement of the teeth, gum, retraction, tooth lengthening and halitosis or bad breath.

Some forms of the disease occur in young patients or only in some areas, so a thorough examination is necessary to assess the degree of involvement and the necessary treatment. The destruction caused by gum and bone periodontitis is irreversible in most cases, so early diagnosis treatment will be the best way to preserve teeth and avoid sequelae.

Symptoms

As with gingivitis, the only initial symptom of periodontitis is bleeding gums and redness inflammation. As the disease progresses, other symptoms may appear such as mobility and displacement of the teeth, gingival retraction and lengthening of the teeth, the appearance of sensitivity to cold or halitosis.

Treatment

The treatment is aimed at eliminating the stone deposits that form on the tooth and below the gums. Usually it is done through deep cleaning sessions, called scraped and root smoothed, although in more advanced stages it may be necessary to make a surgical access to allow better access and subsequent healing or even consider performing regenerative treatments that allow to improve one’s prognosis of one to several teeth. In all cases the maintenance of adequate oral hygiene by the patient and the follow-up of a personalized maintenance program will be essential to stop or slow the progression of the disease.

Risk factors that can affect the health of the gums

  • Poor oral hygiene
  • Crowded, crooked or misaligned teeth that make cleaning interdental spaces difficult
  • Genetic predisposition to have from periodontal disease.
  • Smoking
  • Uncontrolled diabetes.
  • Some medications or treatments such as steroids, antiepileptics, chemotherapy, calcium channel blockers or contraceptives.