Periodontal disease, bleeding gums

Periodontal disease, bleeding gums

1. What is periodontitis?

Periodontitis, also known as Periodontal disease is an inflammatory condition with an infectious etiology of the periodontium – the tissues supporting the teeth. Periodontitis involves progressive loss of alveolar bone and if left untreated leads to loosening of the teeth and their subsequent loss.

Periodontitis has two main forms – chronic periodontitis and less commonly Rapidly progressive periodontitis. Much less common are juvenile and prepubertal periodontitis.

2. What are the symptoms of periodontitis?

In many people, early symptoms resemble Gingivitis or go unnoticed for a long time.

These include persistent bad breath, bleeding gums after brushing or eating hard food (this can also be seen in gingivitis); red, swollen and painful to the touch gums; gingival recession – receding gums from the crown of the teeth; deep pockets between the gums and teeth; “wobbling” of the teeth in a more advanced stage.

Inflammation of the gums and bone loss are usually painless, so bleeding after brushing the teeth should not be left unattended.

3. What are the complications of periodontitis?

Left unchecked, periodontitis can progress and affect other tissues and organs in the body. The organs most often affected, due to their proximity to the focus of the infectious process, are the jaws(osteomyelitis), soft tissue abscess in the mouth, dental abscesses, painful bacterial infection with ulcerations (ulcerations) of the gums. It is possible for the causative agent to enter the bloodstream and cause sepsis – a dangerous condition with high fever, chills, palpitations and rapid breathing.

4. What causes periodontitis?

Periodontitis occurs when Low oral hygiene has led to a heavy accumulation of dental plaque. Microorganisms inhabiting the oral cavity form a biofilm on the teeth, the thickness of which is regulated by regular brushing. Prolonged not brushing the teeth leads to the formation of permanent deposits on the teeth – tartar that cannot be washed away. The gums become inflamed, and if this is not treated in time, the inflammatory process covers the tissues surrounding the teeth. Plaque, rich in myrmic organisms, accumulates around the neck of the teeth, where pockets filled with anaerobic bacteria and decaying matter form. The swelling of the gingival tissue when inflamed traps their contents and makes self-cleaning of the pockets impossible. The metabolic activity of microorganisms separates the gum from the tooth, in which the characteristic clinical picture of periodontitis is formed.

Smoking also contributes to the development of periodontitis and makes it more difficult to treat.

Diabetes mellitus has also been associated with an increased risk of periodontitis.

5. How is the diagnosis made?

The diagnosis is made by dentist, and usually an examination is sufficient for this purpose.
The typical clinical picture is observed – swollen, red gums; dental plaque and tartar; loose teeth.

On an X-ray, the loss of underlying bone and, possibly, the presence of Deposits under the gums.

6. What is the treatment for periodontitis?

Any treatment starts first with maintaining good oral hygiene. In addition to regular brushing, this includes using interdental brushes to remove fine food debris between teeth that regular brushes usually can’t reach, and professional teeth cleaning to remove tartar and plaque – at least twice a year.

The initial removal of plaque requires, in addition to a thorough cleaning of the teeth, its removal from the subgingival pockets. This is done using special curettes and may require the administration of a local anaesthetic. It is necessary to periodically evaluate the treatment. In pockets shallower than 4 – 5 mm, this usually results in therapeutic success. The presence of bleeding pockets, deeper than 5 – 6 mm, after the initial therapy, is an indicator of the presence of active inflammatory process and is a prognostic marker of continued bone loss.

Advanced periodontitis may require surgical treatment to open and clean deep pockets, replace lost bone where possible, extract one or more teeth to limit the disease process.

Prophylactic check-ups after treatment is completed are absolutely essential to monitor the affected teeth and provide timely treatment, if the disease recurs.

7. What is the prevention of periodontitis?

First and foremost is maintaining high oral hygiene. This includes regular brushing, cleaning the interdental space using dental floss or interdental brushes, using a mouthwash that contains antiseptic ingredients that prevent the oral microbiome from developing excessively.

Regular checkups at the dentist are a must.

8. What is the incidence of periodontitis?

According to the World Health Organization, between Between 5 and 15% of the population  in theobserved countries between 35 and 44 years of age suffer from a serious form of periodontitis and are at risk of losing teeth due to it. Juvenile periodontitis affects 2% of adolescents.

Statistics show that in developed countries Smoking  is aserious risk factor for the development of periodontitis and is responsible for half of the cases in these countries. The risk decreases with smoking cessation. The prevalence of periodontitis is declining in countries where there is a trend towards reduced tobacco use.


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