Periodontal means “around the tooth”, and periodontal disease is a common chronic bacterial infection. Untreated gingivitis (inflammation or infection of the gums) will develop into periodontal disease. This happens when the gums pull away from the teeth and infection becomes spreading. The term pyorrhoea describes advance an periodontal disease. The disease usually doesn’t cause any pain until the teeth become loose enough to move when chewing or talking, or until an abscess (a collection of pus) forms. There are three stages of periodontitis: Early, Moderate and Advanced.
When a patient suffers from periodontitis, the teeth can become loose, the gums swell (or bleed) and the breath smells bad. This often occurs due to the plaque and tartar build up between the teeth and gums which spreads to the bone under the teeth. An x-ray is usually taken to measure the depth of the pockets in the gums. This helps determine which stage of periodontitis the patient is at.
Early Periodontitis. At this stage, the plaque begins to build up around and under the edges of the gums. This build-up causes swelling of the edges of the gums, causing them to pull away from the tooth and allowing bacteria to grow in this “pocket”.
Moderate Periodontitis. Results when Early Periodontitis gets to the point where the connective tissue periodontal ligament (this is what attaches the tooth to the bone) and 30-50% of the bone is damaged and lost. The bacteria and toxins will start eating the bone away. This causes the gums to spread down beyond the top of the bone. Moderate periodontitis does not require surgery.
Advanced Periodontitis is slightly more complicated than moderate periodontitis. At this stage, the teeth start to get very loose and may start to shift positions. Patients may experience pain when biting or chewing their food. Because teeth and bone are connected so loosely, pushing on the gums could produce pus. This pus is a sign of an infection, and the pockets at this stage can be as large as 7 millimeters and more.
Other than very good oral hygiene, the main treatment methods are scaling and gum surgery. Scaling can take several appointments. Before undergoing scaling, gums will be numbed with an injection of local anesthetic. After the procedure, the dentist or hygienist will monitor the size of the pockets to ensure that the treatment has been successful and the periodontitis is not getting worse. The dental hygienist can do deep scaling and root surface debridement. Whereas dentist can perform periodontal treatments if needed. When deep pockets are present, a surgeon will take over. The surgery involves making incisions in the gum tissue to pull it back. This allows the dentist or periodontist to look into the bottom of the deepest pockets, and to clean it much more effectively.
Also, read – Oral Hygiene Instruction