What is periodontitis or pyorrhea?
Babusahabpalya, Bengaluru Feb 9, 2017
What is periodontitis?
Periodontitis (pyorrhea, trench mouth) is a set of inflammatory diseases affecting the periodontium (the bone and other tissues that hold the teeth). It is probably the second most common disease worldwide, after dental decay. About 30-50% of the population in the USA suffer from periodontitis, and 10% have it severely with a high risk of it causing other diseases or lost teeth. It occurs most frequently in economically disadvantaged populations or regions.
It is usually a slow process, caused by bacteria that colonise on the teeth and in the sulcus (the space between the teeth and gums). These sulcular bacteria create acids, enzymes and toxins that decay and erode the structures that support the teeth (periodontium). Periodontitis also involves gum disease and an overly aggressive immune response to the bacteria (inflammation).
Periodontitis causes a gradual loss of the alveolar bone around the teeth. The roots of the teeth narrow and weaken, and are often exposed by gum recession.
Symptoms of periodontitis
At first, periodontitis has few symptoms. Gum (gingival) inflammation and bone destruction are largely painless. Unfortunately for most individuals the disease has progressed significantly before they seek treatment.
Periodontitis is measured with a probe (measuring stick). The depth of the pockets between the teeth and the gums indicates the progress of the disease. If it is deeper than 3 mm around the tooth professional cleaning and treatment should be sought. At 6-7mm, specialised cleaning, antibiotics or even minor gum surgery may be necessary. At this depth there is a high risk of tooth infection and loss, and risk of other diseases.
Redness or bleeding of the gums after brushing, dental flossing or biting into hard food such as an apple.
Swollen or inflamed gums.
Gingival recession, resulting in apparent lengthening of teeth. Gaps between the base of the teeth.
A persistent metallic taste in the mouth.
Loose teeth. By the time this occurs, the periodontitis has progressed severely.
Consequences of periodontitis
The pathogenic gum bacteria cause inflammation, not only around the gums, but throughout the body (systemic inflammation). This increases the risk of various degenerative diseases, and it is difficult to connect the cause and outcome.
Poor memory and other brain disorders.
Causes of periodontitis
*** Poor oral hygiene.
* Diet. High in sugar and other carbohydrates, especially refined carbohydrates. Low in antioxidants.
Alcohol - high consumption.
Diagnosis of periodontitis
Visual - large gap between the roots of the teeth, more easily seen if there is also gum recession.
Dentist - inspecting the soft gum tissues around the teeth with a measuring probe. X-ray (radiographic examination) will show the amount of bone loss around the teeth. Specialists in the treatment of periodontitis are called periodontists.
Prevention / remedies / treatment for periodontitis
Good dental hygiene with proper brushing and flossing every day.
Diet. Avoid sugar and refined carbohydrates.
Professional dental cleaning using special instruments to remove plaque/calculus/tartar below the gum line. It usually takes about three to four months for microbial plaque to grow back to pre-cleaning levels, but good dental hygiene and diet can markedly slow or prevent the recurrence of these bacteria and plaque. After the initial cleaning a second appointment two months later will show if improved dental hygiene and diet are effective.
If there are any gum pockets with a depth greater than 5 mm which persist, these may need more specialized cleaning or even surgery, or they will likely lead to further bone loss over time.