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What is Periodontal Disease ?

Periodontal disease is commonly referred to as “Gum Disease”. The word “periodontal” can be split into meaning surrounding the tooth. PD is disease of the surrounding structures of the tooth i.e. the bone, the gums and the fibres that attach the tooth to the bone. PD comes in a few different varieties and it may effect one or multiple teeth in the mouth. Periodontal disease usually manifests in a progressive manner. It can be broadly classified into the following stages.

Gingivitis This is the first stage of periodontal disease in which only the superficial gums at the border of the teeth get affected. The gums get red, puffy and tend to bleed at the slightest provocation. This is a totally reversible stage of the disease and generally can be completed cured with simple procedures.

Early Periodontitits: Gingivitis if untreated will more often than not progress into Early Periodontitis. In this form of the disease the plaque and calculus burrow inbetween the gums and the tooth, and create a pocket, thereby weakening the support and making the tooth loose. This stage of the disease generally requires more advanced forms of treatment which may be surgical in nature.

Advanced Periodontitis: This is the most severe form of the disease and a lot of bone damage takes place and the teeth become very mobile. The disease in this stage is quite difficult to treat and requires very advanced treatment modalities.

What Causes Periodontal Disease ?

The prime casueative factor of this disease is PLAQUE, which is a sticky film composed of bacteria and its byproducts which constantly forms around your teeth. If not regularly removed PLAQUE turns into a hard calcified substance called Calculus which can only be removed in a dental clinic with special instruments. The bacteria in the Plaque produce toxins which cause differing grades of infection leading to destruction of the periodontal structures. Other factors might aggravate PD if sufficient quantities of Plaque is present. These factors are Smoking, Tobacco, Preganancy and Puberty, Medications like Phenytoin & Nifidepine, uncontrolled Diabetes and a few other less occuring systemic diseases.

How Do you Know if You have Periodontal Disease ?

The most common symptoms of periodontal disease are

Bleeding gums, especially during brushing
Red and puuffy gums
Persistent bad breath
Gums separated from the teeth
Pus like discharge from the gums
Mobile and drifting teeth with discomfort in the bite of the teeth

"It might still be possible that you have periodontal disease and none of the above symptosm. Above all, the larger number of patients with Periodontal Disease experience almost no pain till the tooth has reached its last almost untreatable stage"

What is the treatment for Periodontal Disease?

Early forms of the disease are usually treated by a general dentist. For managing a patient with advanced stages of the disese you will require the services of a Periodontist. A periodontist is a specialist in the diagnosis, prevention and treatment of PD. Periodontists examine your teeth with a small measuring instrument called the Periodontal probe and generally require X-rays to asses the amount of destruction taken place.

Depending on the extent of the disease the treatment will vary from scaling procedures to surgical therapy. In some cases you will be suggested some kind of Tissue Regenerative therapy. Scaling is the removal of all visible plaque & calculus. Contrary to the belief, there is no harmful effect of scaling on the teeth. Patients are generally advised to get their teeth scaled once a year. Advanced treatment involves surgical correction to arrest the disease process and also repair and regenerate the lost structures.

What are the means for preventing Periodontal Disease ?

Once PD Disease is treated , all patients will require what is known as Supportive Periodontal Treatment. During SPT your periodontist will evaluate your periodontal health, exmaine and remove any new formation of plaque and calculus and trap the disease process, if it recurs, in its initial stages. Periodontal treatment only addresses 50% of the problem, it will arrest the disease process and possibly repair some of the damage. The balance 50% is to be able to maintain the state of health in what is now a slightly compromised dentition.

It is important to understand that PD is a chornic disease and often tends to recur without ongoing supportive therapy. Keep in mind the following rules for supportive therapy. Get a regular checkup and scaling done once every six months. Brush regularly twice a day. See your dentist the moment any of the disease symptoms appear

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