Periodontitis

Overview

Periodontitis is a serious gum infection that damages the soft tissue and bone that support your teeth. It usually starts with gum disease called gingivitis and can lead to tooth loss if not treated.

Yes, it is very common. According to the World Health Organization, severe periodontitis affects about 10 to 15 percent of adults worldwide.

Periodontitis can affect anyone, but it is more common in adults over 30. People who smoke, have diabetes, or have poor oral hygiene are at higher risk.

Symptoms

Common symptoms

• Red, swollen, or tender gums
• Bleeding gums when brushing or flossing
• Bad breath that won't go away
• Loose or shifting teeth
• Gums that pull away from teeth (receding gums)
• Pain when chewing

Symptoms in children

• Periodontitis is less common in children but can occur. Symptoms may include bleeding gums, bad breath, and loose teeth. Children with certain medical conditions are more at risk.

Symptoms in older adults

• In older adults, symptoms are similar but may be more severe. Gum recession and tooth mobility become more common due to long-term plaque buildup. Older adults are also more likely to have other health conditions that can worsen gum disease.

Causes

Main causes

• Plaque buildup – a sticky film of bacteria on teeth
• Poor oral hygiene – not brushing or flossing regularly
• Smoking or using tobacco products
• Certain medications that reduce saliva flow
• Genetics – some people are more prone to gum disease

Risk factors

• Smoking
• Diabetes
• Poor oral hygiene
• Stress
• Genetics
• Hormonal changes (pregnancy, menopause)
• Certain medications (for example, some antihistamines or antidepressants that dry the mouth)
• Conditions that weaken the immune system (like HIV)

When to see a doctor

See a doctor urgently if:

• If you have severe pain, swelling, or pus in your gums
• If a tooth is suddenly very loose

Book a routine appointment if:

• If you notice bleeding gums when brushing or flossing
• If you have persistent bad breath
• If your gums look red or swollen for more than a week

Diagnosis

Your dentist will examine your gums and measure the spaces between your teeth and gums using a small probe. They may also take X-rays to check for bone loss.

Tests that may be done

• Periodontal probing (measuring pocket depths around teeth)
• Dental X-rays (to see bone loss)
• Sometimes a test for bacteria or other markers

What to expect at your appointment

The dentist or dental hygienist will gently probe your gums to check for deep pockets and bleeding. It may be slightly uncomfortable but is not usually painful. X-rays are quick and painless. They will then discuss the results and treatment options with you.

Treatment

Treatment aims to clean the infected pockets around your teeth and prevent more bone loss. It usually starts with professional cleaning and may include prescription mouth rinses or antibiotics. In advanced cases, surgery may be needed.

Self-care at home

• Brush your teeth twice a day with a fluoride toothpaste
• Floss daily to clean between teeth
• Use an antiseptic mouthwash if your dentist recommends it
• Stop smoking – this is one of the most important things you can do
• Keep up with regular dental check-ups and cleanings

Medical treatments

Professional cleaning (scaling and root planing) removes plaque and tartar from below the gum line. Your dentist may also prescribe an antibiotic gel or oral antibiotics to control infection. In more advanced cases, laser treatment or other therapies may help.

When is surgery considered?

If non-surgical treatments are not enough, your dentist or periodontist may recommend surgery to clean deeper pockets or to rebuild bone and gum tissue. This might include flap surgery or bone grafts.

Living with this condition

Living with periodontitis means taking extra care of your teeth and gums every day. Brush and floss carefully, and see your dentist regularly. Pay attention to changes like bleeding or loose teeth.

Lifestyle tips

• Quit smoking or using tobacco
• Manage other health conditions like diabetes
• Reduce stress – it can affect your immune system and gum health

Diet and exercise

Eat a balanced diet rich in vitamins C and D, which are important for gum health. Limit sugary foods and drinks that feed bacteria. Exercise helps overall health and can reduce inflammation.

Mental health and emotional wellbeing

Periodontitis can affect your self-esteem because of bad breath, tooth loss, or changes in your smile. It is normal to feel worried or self-conscious. Talk to your dentist or a counsellor if you need support.

Prevention

Yes, good oral hygiene and regular dental visits can prevent periodontitis. Brushing twice a day, flossing daily, and seeing your dentist for cleanings are the most effective steps.

Screening programmes

Regular dental check-ups allow your dentist to spot early signs of gum disease before it becomes serious.

Complications

If left untreated

• Tooth loss
• Increased risk of heart disease and stroke
• Worsening of diabetes control
• Respiratory infections (from inhaling bacteria from the mouth)
• Pregnancy complications (like low birth weight)

Long-term outlook

With proper treatment, periodontitis can be managed. While bone loss cannot be reversed, further damage can be stopped. Many people are able to keep their teeth for a lifetime with good care and regular dental visits. Be patient – treatment takes time, but the outlook is hopeful.

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