Periodontitis: Treatment, home remedies, and symptoms

Periodontitis, or gum disease, is a common infection that damages the soft tissue and bone supporting the tooth. Without treatment, the alveolar bone around ... Whatisperiodontitis?MedicallyreviewedbyChristineFrank,DDS—WrittenbyYvetteBrazieronJanuary18,2018TreatmentHomeremediesSymptomsPeriodontitisvsgingivitisCausesRiskfactorsDiagnosisComplicationsWeincludeproductswethinkareusefulforourreaders.Ifyoubuythroughlinksonthispage,wemayearnasmallcommission.Here’sourprocess.Periodontitis,orgumdisease,isacommoninfectionthatdamagesthesofttissueandbonesupportingthetooth.Withouttreatment,thealveolarbonearoundtheteethisslowlyandprogressivelylost.Thename“periodontitis”means“meansinflammationaroundthetooth.”Microorganisms,suchasbacteria,sticktothesurfaceofthetoothandinthepocketssurroundingthetooth,andtheymultiply.Astheimmunesystemreactsandtoxinsarereleased,inflammationoccurs.Untreatedperiodontitiswilleventuallyresultintoothloss.Itmayincreasetheriskofstroke,heartattack,andotherhealthproblems.Bacterialplaque,asticky,colorlessmembranethatdevelopsoverthesurfaceofteeth,isthemostcommoncauseofperiodontaldisease.Ifplaqueitnotremoved,itcanhardentoformtartar,orcalculus.Mostcasesofperiodontitisarepreventablethroughgooddentalhygiene.TreatmentThemainaimoftreatmentistocleanoutbacteriafromthepocketsaroundtheteethandpreventfurtherdestructionofboneandtissue.GoodoralhygieneShareonPinterestRegularbrushingwithasoftbrushandfluoridetoothpastecanhelppreventgumdisease.Goodoralhygieneshouldbefolloweddaily,eveniftheteethandgumsarehealthy,topreventinfection.Properdentalcareinvolvesbrushingteethatleasttwiceadayandflossingonceaday.Ifthereisenoughspacebetweentheteeth,aninterdentalbrushisrecommended.Soft-pickscanbeusedwhenthespacebetweentheteethissmaller.Patientswitharthritisandotherswithdexterityproblemsmayfindthatusinganelectrictoothbrushisbetterforathoroughcleaning.Periodontitisisachronic,orlong-term,inflammatorydisease.Ifgoodoralhygieneisnotmaintained,itwillrecur.Arangeoforalhygieneproductsisavailableforpurchaseonline:Shopforelectrictoothbrushes.Shopforinterdentalbrushes.Shopforsoft-picks.Shopfordentalfloss.ScalingandcleaningItisimportanttoremoveplaqueandcalculustorestoreperiodontalhealth.Ahealthcareprofessionalwillcarryoutscalinganddebridementtocleanbelowthegumline.Thismaybedoneusinghandtoolsoranultrasonicdevicethatbreaksuptheplaqueandcalculus.Rootplaningisdonetosmootheroughareasontherootsoftheteeth.Bacteriacanlodgewithintheroughpatches,increasingtheriskofgumdisease.Dependingonhowmuchplaqueandcalculusthereis,thismaytakeoneortwovisits.Cleaningisnormallyrecommendedtwiceayear,andpossiblymoreoften,dependingonhowmuchplaqueaccumulates.MedicationsAnumberofmedicatedmouthwashesandothertreatmentsareavailable.Prescriptionantimicrobialmouthrinse,suchaschlorhexidine:Thisisusedtocontrolbacteriawhentreatinggumdiseaseandaftersurgery.Patientsuseitastheywouldaregularmouthwash.Antisepticchip:Thisisasmallpieceofgelatinthatisfilledwithchlorhexidine.Itcontrolsbacteriaandreducesperiodontalpocketsize.Itisplacedinthepocketsafterrootplaning.Themedicationisslowlyresealedovertime.Antibioticgel:Thisgelcontainsdoxycycline,anantibiotic.Ithelpscontrolbacteriaandshrinkperiodontalpockets.Itisplacedinthepocketsafterscalingandrootplaning.Itisaslow-releasemedication.Antibioticmicrospheres:Verysmallparticlescontainingminocycline,anantibiotic,areplacedintopocketsafterscalingandrootplaning.Thisslow-releasemedicationisalsousedtocontrolbacteriaandreduceperiodontalpocketsize.Enzymesuppressant:Thiskeepsdestructiveenzymesincheckwithalow-doseofdoxycycline.Someenzymescanbreakdowngumtissue,butthismedicationcandelaythebody’senzymeresponse.Itistakenorally,asapill,anditisusedwithscalingandrootplaning.Oralantibiotics:Availableincapsuleortabletform,thesearetakenorally.Theyareusedshort-termforthetreatmentofacuteorlocallypersistentperiodontalinfection.AdvancedperiodontitisIfgoodoralhygieneandnon-surgicaltreatmentsarenoteffective,surgicalinterventionmaybeneeded.Optionsinclude:Flapsurgery:Thehealthcareprofessionalperformsflapsurgerytoremovecalculusindeeppockets,ortoreducethepocketsothatkeepingitcleaniseasier.Thegumsareliftedback,andthetarterisremoved.Thegumsarethensuturedbackintoplace,sotheyfitcloselytothetooth.Aftersurgery,thegumswillhealandfittightlyaroundthetooth.Insomecases,theteethmayappearlongerthanbefore.Boneandtissuegrafts:Thisprocedurehelpsregenerateboneorgumtissuethathasbeendestroyed.Newnaturalorsyntheticboneisplacedwherethebonewaslost,promotingbonegrowth.Guidedtissueregeneration(GTR)isasurgicalprocedurethatusesbarriermembranestodirectgrowthofnewboneandgumtissueatsiteswhereoneorbothofthesearelacking.Itaimtoregeneratetissueandrepairdefectsthathaveresultedfromperiodontitis.Inthisprocedure,asmallpieceofmesh-likematerialisinsertedbetweenthegumtissueandbone.Thisstopsthegumfromgrowingintobonespace,givingtheboneandconnectivetissueachancetoregrow.Thedentistmayalsousespecialproteins,orgrowthfactors,thathelpthebodyregrowbonenaturally.Thedentalprofessionalmaysuggestasofttissuegraft.Thisinvolvestakingtissuefromanotherpartofthemouth,orusingsyntheticmaterialtocoverexposedtoothroots.Successdependsonhowadvancedthediseaseis,howwellthepatientadherestoagoodoralhygieneprogram,andotherfactors,suchassmokingstatus.HomeremediesTheeffectsofperiodontitiscanbestoppedthroughregularcheckupsandtreatmentandcontinuedgoodoralhygiene.Thisisalsoapartoftreatmentonceaninfectionoccurs.Itisimportantto:Brushtheteethwithasuitabletoothbrushandtoothpasteatleasttwiceaday,carefullycleaningthechewingsurfacesandthesidesoftheteeth.Useflossoraninterdentalbrusheverydaytocleanbetweentheteeth,inthespacesthatthebrushcannotreach.Dentalflosscancleansmallgaps,butadentalbrushisusefulforalargerspace.Takeextracarewhencleaningaroundunevensurfaces,forexample,closely-packedteeth,crookedteeth,crowns,dentures,fillings,andsoon.Afterbrushing,useanantibacterialmouthwashtohelppreventbacteriafromgrowingandtoreduceanyinflammatoryreactioninthemouth.AccordingtotheAmericanDentalAssociation(ADA),itisbestto:brushtheteethfor2minutes,twiceadaywitheitheramanualorelectrictoothbrushthathassoftbristlesuseafluoridetoothpasterinsethebrushwellafteruseandstoreuprightreplacethetoothbrushevery3to4months,moreifthebristlesaremattedorfrayedchooseabrushwiththeADAsealofacceptanceBrushesshouldnotbeshared,asbacteriacanpassfrompersontopersoninthisway.SymptomsThesignsandsymptomsofperiodontitisinclude:ShareonPinterestAsthegumsrecede,theteethlooklonger.Gapscanalsoappearbetweentheteeth.inflamedorswollengumsandrecurrentswellinginthegumsbrightred,sometimespurplegumspainwhenthegumsaretouchedrecedinggums,whichmaketheteethlooklongerextraspacesappearingbetweentheteethpusbetweentheteethandgumsbleedingwhenbrushingteethorflossingametallictasteinthemouthhalitosis,orbadbreathlooseteethThepersonmaysaytheir“bite”feelsdifferentbecausetheteethdonotfitastheydidbefore.PeriodontitisvsgingivitisGingivitisoccursbeforeperiodontitis.Itusuallyreferstoguminflammation,whileperiodontitisreferstogumdiseaseandthedestructionoftissue,bone,orboth.Gingivitis:Bacterialplaqueaccumulatesonthesurfaceofthetooth,causingthegumstobecomeredandinflamed.Theteethmaybleedduringbrushing.Thegumsareirritatedandbothersome,buttheteetharenotloose.Thereisnoirreversibledamagetoboneorsurroundingtissue.Untreatedgingivitiscanprogresstoperiodontitis.Periodontitis:Thegumandbonepullawayfromtheteeth,forminglargepockets.Debriscollectsinthespacesbetweenthegumsandteethandinfectsthearea.Theimmunesystemattacksbacteriaastheplaquespreadsbelowthegumlineintothepockets.Boneandconnectivetissuethatholdthetoothstarttobreakdown,becauseoftoxinsproducedbythebacteria.Teethbecomelooseandcanfallout.Thechangesmaybeirreversible.CausesDentalplaqueisapaleyellowbioformthatcollectsonteethaspartofanaturalprocess.Itisformedbybacteriathattrytoattachthemselvestothetooth’ssmoothsurface.Brushingteethgetsridofplaque,butafteradayorso,itwillbuildupagain.Ifitisnotremoved,ithardensintotartar,alsoknownascalculus.Tartarishardertoremovethanplaque,anditcannotbedoneathome.Itrequiresprofessionaltreatment.Plaquecangraduallyandprogressivelydamageteethandsurroundingtissue.Atfirst,gingivitismaydevelop.Thisisaninflammationofthegumaroundthebaseoftheteeth.Ifgingivitispersists,pocketscandevelopbetweentheteethandgums.Thesepocketsfillupwithbacteria.Togetherwiththeimmunesystem’sresponsetoinfection,bacterialtoxinsstartdestroyingtheboneandconnectivetissuethatholdteethinplace.Eventually,theteethstartbecomingloose,andtheymayfallout.Belowisa3-Dmodelofperiodontaldisease,whichisfullyinteractive.Explorethemodelusingyourmousepadortouchscreentounderstandmoreaboutperiodontaldisease.RiskfactorsGumdiseaseismorelikelytobecomesevereiftherearehighlevelsofaggressivebacteria,andiftheperson’simmunesystemisweakened.Thefollowingriskfactorsarelinkedtoahigherriskofperiodontitis:Smoking:Regularsmokersaremorelikelytodevelopgumproblems.Smokingalsounderminestheefficacyoftreatment.Ninetypercentofcasesthatdonotrespondtotreatmentareinsmokers.Hormonalchangesinfemales:Hormonalchangesoccurduringpuberty,pregnancy,andmenopause.Thesechangesincreasetheriskofdevelopinggumdisease.Diabetes:Thoselivingwithdiabeteshaveahigherincidenceofgumdiseasethanotherindividualsofthesameage.AIDS:GumdiseaseismorecommoninpeoplewithAIDS.Cancer:Cancerandsomecancertreatmentscanincreasethechanceofgumdisease.Drugs:Medicationssuchasantihypertensivedrugsorvasodilatingagents—whichrelaxanddilatethebloodvessels—immunotherapydrugs,andmedicationsthatreducesalivacanallincreasethechanceofgumdisease.Geneticfactors:Somepeoplearemoresusceptibletogumdiseaseduetogeneticfactors.DiagnosisAdentistcannormallydiagnoseperiodontitisbylookingatthesignsandsymptomsandcarryingoutaphysicalexamination.Thedentistwillprobablyinsertaperiodontalprobenexttothetooth,underthegumline.Ifthetoothishealthy,theprobeshouldnotslidefarbelowthegumline.Incasesofperiodontitis,theprobewillreachdeeperunderthegumline.Thedentistwillmeasurehowfaritreaches.AnX-raymayhelpassesstheconditionofthejawboneandteeth.ComplicationsThemostcommoncomplicationisthelossofteeth,butperiodontitismayimpactaperson’soverallhealthinotherways.Ithasbeenlinkedtoahigherriskofarangeofotherdiseases,includingrespiratoryproblems,stroke,andcoronaryarterydisease,althoughhowtheyarelinkedremainsunclear.Onestudyofpeoplewithchroniccoronaryarterydisease,lasting3.7years,foundthatforeveryfiveteethlost,therewasa17-percenthigherriskofcardiovasculardeath,a16-percenthigherriskofall-causedeath,anda14-percenthigherriskofstroke.Scientistsarenotyetcertainwhythishappens.Itmaybethatbacteriafromperiodontitisinfectsthecoronaryarteries,thattheperiodontalbacteriatriggeranoverallimmuneresponsethataffectsthecardiovascularsystem,ortheremaybeanotherlink.Itremainsunclearwhethergumdiseaseleadstoheartdiseaseortheotherwayround.Thereisnoevidenceasyetthatbetteroralcarewillleadtobettercardiovascularhealth.Duringpregnancy,ifabacterialinfectioncausesmoderate-to-severeperiodontaldisease,thereisahigherriskofpretermbirth.Periodontitishasalsobeenlinkedtolowbirthweightandpre-eclampsia.Postmenopausalwomenwithperiodontaldiseasearemorelikelytodevelopbreastcancer,accordingtoresearchpublishedinCancerEpidemiology,BiomarkersPrevention.Thosewithahistoryofsmokingareparticularlyaffected.Periodontitiscanalsomakeitharderforpatientswithdiabetestocontrolbloodsugar.LastmedicallyreviewedonJanuary18,2018DentistryFEEDBACK:MedicallyreviewedbyChristineFrank,DDS—WrittenbyYvetteBrazieronJanuary18,2018LatestnewsLessthanhalfoftransgenderpeoplefeelsupportedbyfamilydoctorCOPDinnumbers:Howmanypeoplehaveit,who'smoreatrisk?Doanti-inflammatorydietsreallywork?HowdoOmicron-targetedvaccinescomparetotheoriginalones?COVID-19:BrainareaslinkedtosmellmayshrinkafterinfectioninsomeRelatedCoverageFoureffectivegingivitishomeremediesMedicallyreviewedbyChristineFrank,DDSGingivitisisaconditionthataffectsthegums.Learnaboutfourhomeremediesforgingivitis,howtotakethemsafely,andhowtopreventgingivitis.READMOREHowtotreatatoothacheathomeMedicallyreviewedbyChristineFrank,DDSToothacheisapainfulconditionthatcanresultfromabrokentooth,aninfection,orrecedinggums.Anumberofhomeremediescanhelp,fromchewing…READMOREBeyondtoothdecay:whygooddentalhygieneisimportantWelookatsomelesswell-knownandseriousconditionsthathavebeenlinkedtopoordentalhygieneinrecentyears:Alzheimer'sdisease,pancreatic…READMOREPeriodontitismaybeanearlysignoftype2diabetesNewresearchsuggestspeoplewithseveregumdisease-alsoknownasperiodontitis-mayhaveundiagnoseddiabetesandprediabetes.READMORE