16620 Periodontitis

Overview

Periodontitis is a serious gum infection that damages the soft tissue and bone that support your teeth. It usually starts as plaque build-up and, if not treated, can lead to tooth loss.

Yes. Mild gum disease is very common, and periodontitis affects a significant number of adults worldwide.

It can affect anyone, but it is more common in adults over 30, and in people who smoke, have diabetes, or have poor oral hygiene.

Symptoms

Common symptoms

• Bleeding gums when brushing or flossing
• Red, swollen, or tender gums
• Bad breath that does not go away
• Receding gums (teeth look longer)
• Loose or shifting teeth
• Pain when chewing
• A change in the way your teeth fit together

Symptoms in children

• Gum disease is less common in children, but it can happen. Symptoms include bleeding gums, swollen gums, bad breath, and gums that pull away from the teeth.

Symptoms in older adults

• Older adults may notice receding gums, loose teeth, or changes in how dentures fit. The disease can also progress silently, so regular dental visits are important.

Causes

Main causes

• Plaque, a sticky film of bacteria, builds up when brushing and flossing are not thorough. Over time, plaque hardens into tartar, which only a dentist can remove.
• Bacteria in plaque cause the gums to become inflamed (gingivitis). If gingivitis is not treated, the inflammation can spread below the gumline and destroy the tissue and bone that hold teeth in place.

Risk factors

• Smoking or vaping
• Diabetes
• Poor oral hygiene
• Certain medicines that reduce saliva
• Hormonal changes, such as during pregnancy or menopause
• A family history of gum disease
• Stress
• Grinding or clenching your teeth
• Obesity

When to see a doctor

See a doctor urgently if:

• See a dentist as soon as possible if you have a loose tooth, a swollen gum boil, or bleeding that will not stop.

Book a routine appointment if:

• If you have bleeding gums, persistent bad breath, or receding gums, make a dental appointment.

Diagnosis

A dentist or periodontist (gum specialist) will examine your gums, check for bleeding and pockets, and may take X-rays to see how much bone is left around your teeth.

Tests that may be done

• Periodontal probing: a small ruler-like instrument measures the depth of the spaces between your gums and teeth.
• Dental X-rays to check for bone loss.
• A review of your medical history and risk factors.

What to expect at your appointment

The examination is usually painless. You may feel gentle pressure as the dentist measures your gums. Based on the results, they will tell you what stage of gum disease you have and recommend a treatment plan.

Treatment

Treatment for periodontitis focuses on removing bacteria and tartar from the teeth and gum pockets, and keeping the gums healthy so they can reattach to the teeth. The earlier it is treated, the better the outcome.

Self-care at home

• Brush your teeth twice a day with fluoride toothpaste.
• Clean between your teeth daily with floss or interdental brushes.
• Do not smoke or vape.
• Eat a balanced diet low in sugary snacks and drinks.
• Ask your dentist if an antibacterial mouthwash could help you.

Medical treatments

Your dentist may carry out professional cleaning called scaling and root planing to remove plaque and tartar. If you have deep gum pockets, you may need antibiotics – as a gel, rinse, or tablets – but always follow your dentist's advice. In some cases, surgery may be needed to clean the root surfaces. Your dentist will discuss the options with you.

When is surgery considered?

Surgery may be considered if deep pockets or bone loss do not respond to cleanings and medication. Options include flap surgery (lifting the gums to clean the tooth roots) and gum or bone grafts to help support the teeth.

Living with this condition

Once you have had periodontitis, you will need to keep up careful home care and see your dentist regularly – typically every 3 to 4 months – to stop the disease from returning.

Lifestyle tips

• Quit smoking or vaping.
• Brush and floss consistently every day.
• Keep all your dental appointments.
• If you have diabetes, manage your blood sugar.

Diet and exercise

A healthy diet rich in vegetables, fruit, and whole grains helps support your immune system, and regular exercise can help lower inflammation throughout your body.

Mental health and emotional wellbeing

Living with gum disease can be stressful. You may feel embarrassed about your breath or teeth, but treatment can really help. Talk to your dentist or doctor if you are feeling down.

Prevention

Yes, in most cases. Regular brushing, flossing, and professional cleanings are very effective at preventing periodontitis.

Screening programmes

Dentists can check for early gum disease during routine check-ups, so regular dental visits are a form of screening.

Complications

If left untreated

• Tooth loss
• Pain and difficulty eating
• Abscess (pus collection) in the gum or jaw
• Damage to the bone supporting the teeth
• Possible links to heart disease and diabetes (research is ongoing)

Long-term outlook

With treatment and good home care, periodontitis can be controlled. Many people keep their teeth for life. The earlier you get help, the better your chances of preventing serious damage.

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