What’s the Difference Between Gingivitis and Periodontitis?
Gingivitis usually precedes periodontitis. However, it is important to know that not all gingivitis progresses to periodontitis. In the early stage of gingivitis, bacteria in plaque builds up, causing the gums to become inflamed (red and swollen) and prone to bleeding during tooth brushing. When gingivitis is left untreated, it can advance to periodontitis, or gum disease, which in fact, is the leading cause of tooth loss in adults. In a person with periodontitis, the inner layer of the gum pulls away from the teeth and causes bone loss which then causes a pocket to form. These pockets between the teeth and gums collect debris (plaque, tartar and calculus) and can become infected.
As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. When this happens, teeth become mobile, and tooth loss may occur.
What Causes Periodontal Disease?
Plaque is the primary cause of periodontal disease. However, other factors can contribute to gum disease. These include:
- Bad habits such as smoking and tobacco use make it harder for gum tissue to repair itself.
- Poor oral hygiene habits such as not brushing and flossing on a daily basis, make it easier for periodontal disease to develop.
- Family history of dental disease can be a contributing factor for the development of periodontal disease.
What Are the Symptoms of Periodontal Disease?
Periodontal disease may progress painlessly, producing few obvious signs, even in the late stages of the disease. Although the symptoms of periodontal disease often are subtle, the condition is not entirely without warning signs. Certain symptoms may point to some form of the disease. They include:
- Gums that bleed during and after tooth brushing
- Red, swollen, or tender gums
- Persistent bad breath or bad taste in the mouth
- Receding gums
- Formation of deep pockets between teeth and gums
- Loose or shifting teeth
- Changes in the way teeth fit together upon biting down.
Even if you do not notice any symptoms, you may still have some degree of periodontal disease.
How Do We Diagnose Periodontal Disease?
During a periodontal exam, we typically check for these findings:
- Gum bleeding, swelling, firmness, and pocket depth (the space between the gum and tooth; the larger and deeper the pocket, the more severe the disease)
- Tooth movement, sensitivity and proper alignment
- Alveolar bone (jawbone) levels to help detect the breakdown of bone surrounding your teeth
How Is Periodontal Disease Treated?
The goals of periodontal treatment are to:
- Promote reattachment of healthy gums to teeth,
- Reduce gum swelling
- Reduce pocket depths
- Reduce the risk of infection
- Stop disease progression
Treatment options depend on the stage of disease, how you may have responded to earlier treatments, and your overall health. Options range from nonsurgical therapies that control bacterial growth to surgery to restore supportive tissues.
How Can Periodontal Disease Be Prevented?
Periodontal disease prevention starts with plaque control. Proper plaque control consists of professional cleanings at least twice a year combined with daily brushing and flossing. Periodic x-rays and exams are essential to detect early problems. Other health and lifestyle changes that will decrease the risk, severity, and speed of gum disease development include:
- Tobacco Cessation: Smoking and smokeless tobacco use is a significant risk factor for development of periodontitis.
- Maintain a well-balanced diet: Proper nutrition helps your immune system fight infection.
Despite following good oral hygiene practices and making other healthy lifestyle choices, the American Academy of Periodontology states that up to 30% of Americans may be genetically susceptible to periodontal (gum) disease. Those who are genetically predisposed may be up to six times more likely to develop some form of gum disease. If anyone in your family has gum disease, it may mean that you are at greater risk as well. If you are more susceptible to gum disease, we may recommend more frequent check-ups, cleanings, x-rays, and treatments to better manage the condition.
Is Periodontal Disease Linked to Other Health Problems?
According to the Center for Disease Control (CDC), researchers have uncovered potential links between periodontal disease and other serious health conditions. In people with healthy immune systems, the bacteria in the mouth that makes its way into the bloodstream is usually harmless. But under certain circumstances, the CDC says these microorganisms may be associated with health problems such as stroke and heart disease. Diabetes is not only a risk factor for periodontal disease, but periodontal disease may make diabetes worse.