Periodontal (gum) disease treatment aims to reduce infection and rebuild damaged tissues, typically performed by periodontists. The condition begins with plaque and tartar buildup, irritating gums and leading to redness, swelling, tenderness, and bleeding. Early intervention offers the best chance for long-term oral health, as initial gingivitis is reversible, while later periodontitis can cause significant damage and tooth loss. The severity dictates treatment, ranging from deep cleaning (scaling and root planing) for gingivitis to surgical options like flap surgery, bone/gum grafts, and implants for advanced periodontitis.

Fighting gum disease: Let’s identify “enemy”

Gingivitis is a common and mild form of gum disease caused by a build up of bacterial plaque on the teeth and at the gum line. Plaque is a colorless, sticky film of bacteria that forms on the teeth after eating, which, if not properly removed, can harden into tartar. This plaque and tartar build up irritates the gums, causing inflammation. Unlike the more severe form of gum disease, periodontitis, gingivitis does not involve the loss of the bone and connective tissue supporting the teeth and is reversible with proper treatment.

Symptoms: Gingivitis often does not cause pain, so many people are unaware they have it. However, common signs include:

• Red, swollen, or puffy gums
• Gums that bleed easily, especially when brushing or flossing
• Tender gums
• Bad breath

Causes and risk factors: The primary cause is poor oral hygiene, but other factors can increase the risk, including:

Smoking or chewing tobacco: Significantly increases the risk of gum disease.

Hormonal changes: Events like pregnancy, puberty, and menstruation can make gums more sensitive.

Certain medications: Some drugs, such as calcium channel blockers and phenytoin, can cause gum overgrowth.

Medical conditions: Diabetes, cancer, and HIV can lower immunity and make individuals more susceptible.

Poor nutrition: A vitamin C deficiency can increase risk.

Dry mouth: Lack of saliva can increase plaque build up.

Treatment and prevention

The key to treating and preventing gingivitis is consistent oral hygiene.
Professional dental cleaning: A dentist or dental hygienist can perform a deep cleaning (scaling and root planing) to remove hardened tartar below the gum line.
Improved home care: Brushing twice daily for two minutes with a soft-bristle toothbrush and flossing at least once daily are crucial.
Lifestyle changes: Avoiding tobacco and maintaining a healthy diet also help support gum health.

With proper care, the inflammation from gingivitis can be resolved, and healthy gums can be restored within a couple of weeks

Periodontitis, or advanced gum disease, is a severe bacterial infection of the gums that damages the soft tissue and the bone supporting the teeth. While the initial, milder stage (gingivitis) is reversible with proper oral hygiene, periodontitis is not. Instead, it is a progressive and irreversible condition that must be managed to prevent further destruction and eventual tooth loss.

Progression of the disease

Periodontitis develops when the bacteria in plaque and tartar, which build up on teeth, cause a deepening infection that spreads below the gum line.

Pocket formation: As the infection progresses, the gums pull away from the teeth, forming pockets that trap more bacteria, plaque, and tartar.

Bone and tissue loss: The body’s inflammatory response, triggered by the bacterial infection, breaks down the bone and connective tissues that anchor the teeth in place.

Tooth loss: As the supporting structures are destroyed, teeth can become loose, shift, and may eventually fall out or require extraction.

Symptoms

Symptoms of periodontitis can be subtle at first, with pain often occurring only during acute flare-ups.

• Red, swollen, or tender gums
• Gums that bleed easily when brushing or flossing
• Receding gums, which make teeth appear longer
• Persistent bad breath
• Pus between your teeth and gums
• Loose or shifting teeth
• Pain when chewing

Risk factors

While poor oral hygiene is the primary cause, other factors can significantly increase the risk of periodontitis:

• Smoking: This is the most significant modifiable risk factor and can also make treatment less successful.
• Diabetes: Impaired wound healing in people with diabetes can worsen the disease.
• Genetics: Some people are more prone to periodontitis due to their genetic makeup.
• Stress: Chronic stress can weaken the immune system’s ability to fight infection.

Treatment and prevention

Treatment for periodontitis depends on its severity.

• Non-surgical: Scaling and root planing is a deep-cleaning procedure to remove tartar and bacteria below the gum line and smooth the root surfaces. Antibiotics may also be used to control the infection.
• Surgical: For more advanced cases, procedures like flap surgery, bone grafting, or guided tissue regeneration may be necessary to remove deep infection and rebuild damaged tissue.

Prevention is key to avoiding the condition altogether and relies on consistent, effective oral hygiene habits and regular dental visits.