Gingivitis and periodontitis can be considered one disease complex, with gingivitis leading to periodontitis in some cases. Gingivitis often goes unnoticed in the early stages and may cause no symptoms until it is fairly advanced.
When gingivitis is advanced, it spreads to the bony tissues, which lie under the gums and support the teeth. This is called periodontitis which is much more serious than gingivitis.
In later stages of periodontitis, the teeth can become loose and severely infected with pus oozing from around the sockets. In very advanced periodontitis, the teeth can actually fall out or may have to be removed because of infection. Gum disease is the major cause of premature tooth loss.
Gingivitis and periodontitis are caused by bacteria, which are incorporated into a substance called dental plaque. Plaque begins as a soft and sticky substance, which forms constantly on all areas of the teeth. This soft material gets into every area in the mouth. It is especially harmful in areas where it is hard to see and hard to remove, such as between the teeth, and in the crevices between the gum and the tooth surface.
The longer this material is allowed to set, the more difficult it is to remove. At some point, this plaque hardens and has to be scraped off the teeth. In the early stages, it can be brushed and flossed off the teeth but once it has set and formed tartar or calculus, it must be removed by a dentist or dental hygienist.
The bacteria in this plaque material is the primary cause of the problem. The bacteria in plaque or tartar produces irritating substances that cause gingivitis and periodontitis.
There are no symptoms in the early stages of gingivitis. Symptoms of gingivitis and periodontitis include: blood on the tooth brush when brushing the teethswelling of the gumsredness of the gumstenderness when the gums are touchedtenderness when chewingpus around the teethbad taste in the mouthchange in the bitevisible deposits of tartar or calculus on the teeth
If untreated, periodontitis can lead to the loss of teeth. It is the biggest single factor in tooth loss in adults. If treated early in the gingivitis stage, loss of teeth is usually preventable.
Gingivitis and periodontitis are preventable diseases. Simple attention to everyday oral hygiene and regular visits to the dentist and hygienist are all that is necessary to prevent this disease process.
Specific oral hygiene measures are: Brush with a soft toothbrush at least twice a day.Change toothbrushes whenever the bristles begin to wear out.Use a fluoride toothpaste.Use floss at least once a day to clean between the teeth.Use special tips or devices to clean between the teeth or around bridges as suggested by a dentist or hygienist. Keep removable denture appliances just as clean as the teeth.Clean around orthodontic appliances or retainers.Stay on a common-sense diet to keep oral tissues healthy. A diet high in sugars and starches has been shown to support higher levels of bacterial growth.Have teeth cleaned and examined every six months unless instructed otherwise by a healthcare professional.
A dentist or hygienist will make the diagnosis of gingivitis or periodontitis by examination, gum probing, and dental X-rays.
If untreated, gingivitis and periodontitis can lead to the loss of the teeth. With preventive care, there is no reason that the teeth should not last a lifetime. This disease process is almost always preventable or controllable if simple oral hygiene and regular dental checkups are followed.
Also, periodontitis has now been found to be associated with heart disease and problems in pregnancy.
The infection of advanced periodontal disease can spread to other parts of the body, including the heart and other organs. This can happen without warning and can be avoided by simple prevention or early treatment.
A dental healthcare professional is responsible for recommending appropriate treatment, which may vary considerably from person to person. Full patient cooperation is essential and will be stressed by the dentist or hygienist. Treatment without good oral hygiene practices at home will not be successful.
Depending on the stage of the disease, treatment can range anywhere from simple cleaning, called prophylaxis, and home care to complex periodontal surgery. In advanced cases, some or all the teeth may have to be extracted.
Since dental plaque will continue to form after treatment, good home care is needed to prevent relapse of this disease.
Regular dental checkups must continue to detect relapse or resumption of this disease, which can happen at any time.