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What is periodontitis/ periodontal disease?

Periodontitis, or gum disease, is a common infection that damages the soft tissue and bone supporting the tooth. Without treatment, the alveolar bone around the teeth is slowly and progressively lost.

The name “periodontitis” means “means inflammation around the tooth.” Microorganisms, such as bacteria, stick to the surface of the tooth and in the pockets surrounding the tooth, and they multiply. As the immune system reacts and toxins are released, inflammation occurs.

Untreated periodontitis will eventually result in tooth loss. It may increase the risk of stroke, heart attack, and other health problems.

Bacterial plaque, a sticky, colorless membrane that develops over the surface of teeth, is the most common cause of periodontal disease. If plaque it not removed, it can harden to form tartar, or calculus.

Most cases of periodontitis are preventable through good dental hygiene.


Periodontitis Facts:

  • Periodontitis, or gum disease, affects the area around the tooth, including the bone and the gum.

  • It happens when bacteria and plaque build up around the tooth, and the immune system launches a reaction.

  • Good oral hygiene is part of both treatment and prevention, but sometimes surgery is necessary too.

  • Smoking increases the risk of gum disease and of treatment not working.

  • There appears to be a link between gum disease and conditions elsewhere in the body, such as heart disease.


Periodontitis Treatment:

The main aim of treatment is to clean out bacteria from the pockets around the teeth and prevent further destruction of bone and tissue.

Good oral hygiene:

Good oral hygiene should be followed daily, even if the teeth and gums are healthy, to prevent infection.

Proper dental care involves brushing teeth at least twice a day and flossing once a day. If there is enough space between the teeth, an interdental brush is recommended.

Soft-picks can be used when the space between the teeth is smaller. Patients with arthritis and others with dexterity problems may find that using an electric toothbrush is better for a thorough cleaning.

Periodontitis is a chronic, or long-term, inflammatory disease. If good oral hygiene is not maintained, it will recur.

Scaling and cleaning:

It is important to remove plaque and calculus to restore periodontal health.

A healthcare professional will carry out scaling and debridement to clean below the gum-line. This may be done using hand tools or an ultrasonic device that breaks up the plaque and calculus. Root Planing is done to smooth rough areas on the roots of the teeth. Bacteria can lodge within the rough patches, increasing the risk of gum disease.

Depending on how much plaque and calculus there is, this may take one or two visits.

Cleaning is normally recommended twice a year, and possibly more often, depending on how much plaque accumulates.

Periodontal Medication:

A number of medicated mouthwashes and other treatments are available.

Prescription antimicrobial mouth rinse, such as chlorhexidine: This is used to control bacteria when treating gum disease and after surgery. Patients use it as they would a regular mouthwash.

Antiseptic chip: This is a small piece of gelatin that is filled with chlorhexidine. It controls bacteria and reduces periodontal pocket size. It is placed in the pockets after root planing. The medication is slowly resealed over time.

Antibiotic gel: This gel contains doxycycline, an antibiotic. It helps control bacteria and shrink periodontal pockets. It is placed in the pockets after scaling and root planing. It is a slow-release medication.

Antibiotic microspheres: Very small particles containing minocycline, an antibiotic, are placed into pockets after scaling and root planing. This slow-release medication is also used to control bacteria and reduce periodontal pocket size.

Enzyme suppressant: This keeps destructive enzymes in check with a low-dose of doxycycline. Some enzymes can break down gum tissue, but this medication can delay the body’s enzyme response. It is taken orally, as a pill, and it is used with scaling and root planing.

Oral antibiotics: Available in capsule or tablet form, these are taken orally. They are used short-term for the treatment of acute or locally persistent periodontal infection.

Advanced periodontitis:

If good oral hygiene and non-surgical treatments are not effective, surgical intervention may be needed.

Options include:

  • Flap surgery: The healthcare professional performs flap surgery to remove calculus in deep pockets, or to reduce the pocket so that keeping it clean is easier. The gums are lifted back, and the tarter is removed. The gums are then sutured back into place, so they fit closely to the tooth. After surgery, the gums will heal and fit tightly around the tooth. In some cases, the teeth may appear longer than before.

  • Bone and tissue grafts: This procedure helps regenerate bone or gum tissue that has been destroyed. New natural or synthetic bone is placed where the bone was lost, promoting bone growth.

  • Guided tissue regeneration (GTR) is a surgical procedure that uses barrier membranes to direct growth of new bone and gum tissue at sites where one or both of these are lacking. It aim to regenerate tissue and repair defects that have resulted from periodontitis.

In this procedure, a small piece of mesh-like material is inserted between the gum tissue and bone. This stops the gum from growing into bone space, giving the bone and connective tissue a chance to regrow. The dentist may also use special proteins, or growth factors, that help the body regrow bone naturally.

The dental professional may suggest a soft tissue graft. This involves taking tissue from another part of the mouth, or using synthetic material to cover exposed tooth roots.

Success depends on how advanced the disease is, how well the patient adheres to a good oral hygiene program, and other factors, such as smoking status.

Remedies for Periodontal Disease:

The effects of periodontitis can be stopped through regular checkups and treatment and continued good oral hygiene. This is also a part of treatment once an infection occurs.

It is important to:

  • Brush the teeth with a suitable toothbrush and toothpaste at least twice a day, carefully cleaning the chewing surfaces and the sides of the teeth.

  • Use floss or an interdental brush every day to clean between the teeth, in the spaces that the brush cannot reach. Dental floss can clean small gaps, but a dental brush is useful for a larger space.

  • Take extra care when cleaning around uneven surfaces, for example, closely-packed teeth, crooked teeth, crowns, dentures, fillings, and so on.

  • After brushing, use an antibacterial mouthwash to help prevent bacteria from growing and to reduce any inflammatory reaction in the mouth.

Home Remedies & Natural Alternatives for Periodontal Disease:

Advanced gum disease can be a sign of poor overall health. Improving your overall health along with a number of natural home remedies can definitely improve your oral health.

The kind of food you eat can greatly affect your dental health in several ways.

A diet low in refined carbohydrates and high on vitamin C, D, Fiber and omega 3 fatty acids is beneficial to lower the inflammation of gums and avert the symptoms. Add plenty of fresh fruits and colored veggies and nuts to maintain your dental health.

5 Effective Home Remedies for Periodontal Disease

Salt Water Gargle

Salt water rinse is the most beneficial home remedies in curing gums inflamed by gingivitis. Salt has natural anti-inflammatory and antiseptic properties that ease swelling and fight bacteria causing infections. Regular salt water gargling can help heal inflamed gums, reduce pain, combat bad breath and remove food deposits

-How To Do

In a glass of lukewarm water add ½ teaspoon of salt and mix well. Swirl the solution in the mouth for a few seconds and spit out the solution. To get respite from gum pain repeat this 2 to 3 times a day

Aloe Vera Gel

Aloe Vera gel works well in treating gum disease owing to its strong anti-inflammatory and antimicrobial properties. It greatly helps in reducing the symptoms associated with gum disease when applied topically or used as a natural mouth floss.

-How To Do

In a bowl add 2-3 tsp. of aloe Vera gel whisk well add little water to get the right consistency. Apply the gel on to the inflamed gums, let it stay for 10 minutes and rinse off with water. You can also use this as a mouth rinse by adding enough water. Repeat this process twice daily to alleviate pain.

Lemongrass Oil

Lemongrass oil known for its astringent property helps in warding off bacteria from the dental cavity and averts the risk of tooth decay and gum disease. While it also exhibits inhibiting effects on the bacteria causing gum disease, prevents plaque formation, making your teeth healthier and strengthens gum.

-How To Do

In a cup of water add 2- 3 drops of lemongrass essential oil and mix well, swirl this solution for up to 50 seconds and spit out. Repeat this process 2-3 times a day for best result.

Turmeric Honey Gel

This natural herb is well-known for its strong anti-inflammatory, antimicrobial and antifungal properties which is valuable in preventing plaque and gingivitis. The active ingredient curcumin in turmeric is a potent antioxidant helps to heal bleeding and reddening of the gums. While honey helps in combatting oral bacteria linked with plaque formation.

-How To Do

Rinse the mouth thoroughly, make a paste of turmeric powder by mixing it with honey, apply the gel on gums, and let it stay for 15 minutes and swirl the water around the mouth and spit it out. Repeat this process twice daily for an instant result.

Coconut Oil Pulling

Coconut oil imbued with vast reserves of lauric acid exhibits potent anti-inflammatory and antimicrobial properties. Regular oil pulling using coconut oil remarkably lessens the plaque formation and improves the symptoms associated with gingivitis.

-How To Do

Take about 2 tsp of coconut oil into your mouth, swish the oil well around the mouth for about 20 minutes and spit the oil out. Rinse your mouth well with water and brush your teeth.

Symptoms of Periodontal Disease:

The signs and symptoms of periodontitis include:

  • Inflamed or swollen gums and recurrent swelling in the gums

  • Bright red, sometimes purple gums

  • Pain when the gums are touched

  • Receding gums, which make the teeth look longer

  • Extra spaces appearing between the teeth

  • Pus between the teeth and gums

  • Bleeding when brushing teeth or flossing

  • A metallic taste in the mouth

  • Halitosis, or bad breath

  • Loose teeth

  • The person may say their “bite” feels different because the teeth do not fit as they did before.

Periodontitis vs gingivitis:

Gingivitis occurs before periodontitis. It usually refers to gum inflammation, while periodontitis refers to gum disease and the destruction of tissue, bone, or both.

Gingivitis: Bacterial plaque accumulates on the surface of the tooth, causing the gums to become red and inflamed. The teeth may bleed during brushing. The gums are irritated and bothersome, but the teeth are not loose. There is no irreversible damage to bone or surrounding tissue.

Untreated gingivitis can progress to periodontitis.

Periodontitis: The gum and bone pull away from the teeth, forming large pockets. Debris collects in the spaces between the gums and teeth and infects the area.

The immune system attacks bacteria as the plaque spreads below the gum line into the pockets. Bone and connective tissue that hold the tooth start to break down, because of toxins produced by the bacteria. Teeth become loose and can fall out. The changes may be irreversible.

Teeth cleaning Vs Periodontal treatment:

As you can tell by now, Periodontal disease is pretty serious and cannot be remedied by a simple cleaning. In fact, if you go to a dentist to have a basic teeth cleaning and they discover Periodontal Disease, they will not perform the cleaning. This is the same reason why a mechanic will not replace your break pads if your rotors are bad. You cant build a strong home on a weak foundation. Very often patients, who have skipped out on their biannual teeth cleanings and checkups, are shocked when their hygienist refuses to perform a simple cleaning and suggests a much more expensive Periodontal Treatment Plan instead. This is one more reason why it is so important to have regular health, dental, vision etc. checkups. Its always easier and cheaper to catch problems before they get worse.

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