It is one of the most common oral conditions that affect the supporting structures of teeth (periodontium) along with gums, including both soft and hard tissues (bone). They can show many symptoms but the common one for which patient seeks professional help is mobile teeth.
This can be caused by various microorganisms that colonize in the plaque (soft deposits on teeth) and/or calculus (hard deposits on teeth). Hence, the predisposing causative factors include:
There are various types of periodontitis (periodontal diseases) based on time period on the onset or how long the condition prevailed, and its association with various factors as follows:
This indicates that the condition had been there for a long time, that is greater than 15 days to one month and can be further divided into localized or generalized. If it involves six or fewer teeth, it is called localized and more than six is called as generalized. This can be seen in adults, more commonly.
Interestingly, this is seen in teenagers and sometimes young adults and is more severe than any other form as it causes rapid destruction of the tissues. Also, plaque and calculus are not the major causative factor. It is mainly attributed to the defective killing property of neutrophils (WBC). Again, they are further divided into localized (incisors and molars, near circumpubertal age) and generalized (three or more teeth other than first molars and incisors, less than 30 years). It is also called early-onset or juvenile periodontitis.
For further details, it is advisable to consult your dentist for a diagnosis of the type of condition you are suffering.
The difference between gingivitis and periodontitis is that gingivitis affects only the gums that surround oral cavity and does not affect bone or other attachment and supporting apparatus of the tooth, whereas, periodontitis affects all the supporting and attachment structures including gums and both hard and soft tissues of the tooth. It can be noted that gingivitis may or may not proceed to periodontitis.
Healthy gums are pale pink in color with firm consistency, surrounding the neck of the tooth, and can have some normal brownish-black melanin pigmentation. When periodontitis is present, you can witness the following symptoms:
A dentist is a trained physician to diagnose and treat this condition. Majority of the patients come with the complaint of bad breath, mobile teeth, sensitivity, stains, and deposits or pain while chewing.
Initially, a detailed history will be recorded of the patient including personal, medical, previous dental, current complaint, and drug histories which will lead to a provisional diagnosis of the condition. Next, the doctor will go for clinical examination, wherein the status of gums will be checked like for gum bleeding, the extent of deposits, depth of the gingival sulcus (pocket between gum and root surface of the tooth), etc., along with hard tissues (teeth). For mobility, a fremitus test is also done to check for the causative factor of mobility. If it is due to defective occlusion, it can be corrected by a different treatment modality.
After all, this, if required, you may be asked to get an X-ray (OPG or IOPA) to check for the extent of bone loss or presence of any other condition. And, once based on all these, the diagnosis is made, the treatment plan is formatted and carried out.
The treatment can be classified into conservative and surgical.
1. The conservative management involves the follows:
2. The surgical management is done for severe defects and for the tooth that has a better prognosis after the surgery and involves:
After the surgery, a gum (gingival) pack is placed on the surgical site for 7 to 10 days to aid in healing and avoid any gum injury or infection
Once the treatment is done, the patient is recalled for further examination and review in a week and then in a month or six months to one year once based on the severity of the condition. During the follow-up, the oral examination is done and once a satisfactory level of healing is achieved, the next step of treating the other conditions like endodontic (root canal treatment), filling, or replacing the missing or extracted tooth (prosthesis), etc., can be done.
It is always better to prevent any condition before it takes up a disease form. To prevent periodontitis, you can do the following:
Since periodontitis is a very common condition, it is necessary to be aware of the same. A minor doubtful change in your oral cavity needs medical attention. You can consult a dentist regarding diagnosis, details, and treatment of any of the condition affecting the periodontium. The sooner the attention, the more high chances to save the tooth and supporting structures.Last reviewed at: 12.Jan.2019