What is Periodontal Disease?

Periodontal disease, also known as gum disease, is a chronic inflammatory condition that causes loss of the bone supporting the teeth.  Periodontal disease is caused by bacterial plaque and calculus deposits on root surfaces and within gum pockets, triggering an inflammatory immune response that leads to bone loss and tooth mobility.

Periodontal diseases are common infections affecting 20-40% globally. In Australia, 25% of individuals aged 35-54 have periodontitis, with prevalence rising to over 40% for those aged 55-74, and around 60% for those aged 75 and older.

Gingivitis, the mildest form, is reversible but can progress to periodontitis, which destroys supporting bone and may lead to tooth loss. Periodontitis is chronic, requiring long-term maintenance to prevent further bone loss.

Risk factors:

  • Smoking
  • Genetic susceptibility
  • Medical conditions and medications
  • Hormonal changes (e.g., pregnancy, menopause)
  • Lifestyle factors

Common signs and symptoms:

  • Bleeding gums and persistent bad breath
  • Sensitivity and tender, swollen gums
  • Discomfort when chewing and frequent food impaction
  • Loose teeth and teeth appearing longer
  • Migration of teeth

Treatment, Prevention, and Maintenance

Prevention: Control plaque build-up by brushing twice daily and flossing. Regular professional cleanings are essential. Good daily care and lifestyle changes, like quitting smoking, are crucial.

Treatment Options:

  1. Deep Cleaning (root surface debridement): Removes plaque and tartar below the gumline, often done using local anaesthetic.
  2. Surgical Treatment: Gum flap surgery to remove deep deposits and reduce pocket depths.
  3. Bone and Tissue Grafts: Regenerate lost bone or tissue using natural or synthetic bone, or cover exposed roots with soft tissue grafts.
  4. Medications: Antimicrobial rinses, gels, or antibiotics to control bacteria.
  5. Regenerative Treatment: In certain cases, growth factors or bone substitutes to help regenerate lost bone and tissue. Products like Emdogain™ can encourage bone regrowth.

Maintenance: On-going maintenance is needed to prevent recurrence. Regular check-ups with your periodontist and excellent plaque control are essential. Lifestyle factors like smoking, and certain health conditions, such as poorly controlled diabetes can affect treatment outcomes.