Periodontitis is an inflammation of the tissues surrounding the teeth and molars. The inflammation usually begins at the gum line but can extend further into the supporting tissue and jawbone around the teeth.
The difficult thing about periodontitis is that it can cause little or no pain for a long time. As a result, the condition can be present without you immediately noticing how serious it is.
Bleeding gums, receding gums, bad breath, or teeth that become loose can be signals. However, periodontitis can only be reliably diagnosed through a dental examination.
In this article, we explain what periodontitis is, how it develops, and which signals are reasons to have your gums checked.
What is periodontitis?
Healthy gums fit snugly around the teeth and molars. When plaque builds up along the gum line, the gums can become inflamed. This is called gingivitis.
In gingivitis, the inflammation is limited to the gums. When the inflammation extends further and the supporting tissue around the teeth and molars is affected, we refer to it as periodontitis.
In this process, the jawbone around the teeth can gradually be lost.
That difference is important: gingivitis can usually recover when the inflammation is properly addressed. Bone and supporting tissue lost due to periodontitis usually do not grow back completely on their own.
The goal of treatment is therefore primarily to get the inflammation under control and to prevent further damage as much as possible.
How does periodontitis develop?
Plaque consists of a layer of bacteria that constantly forms on the teeth. When plaque is insufficiently removed, the gums can become inflamed.
Plaque that remains for a longer period can also calcify into tartar. Tartar has a rough surface on which new plaque can easily adhere and cannot be brushed away with a regular toothbrush.
In periodontitis, the connection between the tooth and the surrounding supporting tissue becomes damaged. This can cause the spaces between the tooth and the gum to become deeper. These deepened spaces are called pockets.
Bacteria can accumulate in these pockets, making it increasingly difficult to keep the area clean yourself.
What is a pocket?
Around every tooth, there is a small space between the tooth and the gum. The dentist or dental hygienist can carefully measure this space with a special measuring instrument.
When the gums are inflamed and the supporting tissue is affected, this space can become deeper.
Such a deepened space is called a pocket.
The depth of these pockets, the bleeding of the gums, and other findings help to assess the condition of the gums.
How do you recognize periodontitis?
Periodontitis does not cause the same symptoms in everyone. Furthermore, the condition can be present without clear pain.
Possible signals include:
- gums that bleed regularly;
- red or swollen gums;
- receding gums;
- teeth that appear to be getting longer;
- persistent bad breath or a bad taste;
- sensitivity around teeth and molars;
- changes in the position of teeth;
- teeth or molars that become loose.
Not every one of these symptoms automatically means you have periodontitis. For example, bleeding gums can also occur with gingivitis.
Therefore, an examination is necessary to determine exactly what is going on.
Does periodontitis hurt?
Often not.
That is one of the reasons why periodontitis is sometimes discovered relatively late. A cavity or an inflamed tooth nerve can cause clear pain, whereas gum inflammation can progress much more gradually.
Therefore, do not wait exclusively for pain before having your gums checked.
Regular check-ups are specifically intended to discover problems before you experience serious symptoms yourself.
Who is more likely to develop periodontitis?
Not everyone with plaque develops periodontitis to the same extent. Various factors can influence the onset and progression of the condition.
Smoking is, for example, a major risk factor. Certain general conditions, including diabetes, can also be associated with an increased risk or a less favorable progression, especially when these are not well controlled.
In addition, oral hygiene, hereditary susceptibility, and the body’s individual response to bacteria play a role.
The risk therefore varies per person.
Why can smoking make periodontitis harder to recognize?
Smoking not only increases the risk of gum problems but can also make certain warning signs less clear.
In smokers, for example, inflamed gums may bleed less easily. As a result, someone may wrongly believe that their gums are healthy.
The absence of bleeding gums in a smoker does not, therefore, automatically mean that no gum inflammation is present.
How does the dentist or dental hygienist diagnose periodontitis?
To assess the health of the gums, the gums around the teeth and molars are examined.
With a thin measuring instrument, the spaces between the tooth and the gum can be measured. This includes looking at the pocket depth and whether the gums bleed during measurement.
When there is reason to do so, additional measurements and X-rays may be necessary to assess, for example, the bone level around the teeth.
Based on the total examination, it can be determined whether there is gingivitis, periodontitis, or another situation.
What happens if periodontitis is not treated?
If active periodontitis persists, more and more supporting tissue around teeth and molars can be lost.
As a result, teeth can eventually become loose, change position, or, in serious situations, be lost.
How quickly this happens varies greatly per person. Periodontitis is therefore not equally serious for everyone and does not always progress at the same speed.
This is precisely why timely diagnosis, treatment, and monitoring are important.
How is periodontitis treated?
The treatment is aimed at reducing the bacterial load and inflammation around the teeth and molars.
An important part of this is good daily oral care. In addition, the teeth, molars, and root surfaces can be professionally cleaned, with special attention to places that are difficult for you to reach yourself.
After a treatment period, it is reassessed how the gums respond and whether the inflammation is sufficiently under control.
In more complex or serious situations, additional treatment or referral to a periodontist may be necessary.
What can you do yourself for healthy gums?
Treatment in the practice is only part of the story. What you do at home every day is at least as important.
Brush your teeth carefully with fluoride toothpaste and pay attention to the gum line. The spaces between teeth and molars can be cleaned, for example, with interdental brushes, depending on your teeth.
The correct size of the interdental brush is important. Your dentist or dental hygienist can help you with this.
Do you smoke? Quitting smoking has, in addition to other health benefits, advantages for the health and treatment of the gums.
Can periodontitis return?
Periodontitis requires ongoing attention even after active treatment has been completed.
If plaque accumulates again for a long period, the inflammation can become active again. Therefore, good daily oral hygiene and check-ups/aftercare are important.
How often professional aftercare is needed varies per patient and is tailored to the condition of the gums and the individual risk.
When should you have your gums checked?
Have your gums assessed if they bleed regularly, remain swollen, or recede. Persistent bad breath, changes in the position of your teeth, or teeth that feel looser are also reasons to make an appointment.
Do not wait until it starts to hurt. After all, periodontitis can cause few symptoms for a long time.
Have gums and periodontitis checked in Leiden
Do you have regularly bleeding gums or are you concerned about the condition of your gums?
At We Smile Tandartsen in Leiden we can examine your teeth and gums and assess what care is needed. If professional dental cleaning or further treatment is required, we will discuss the appropriate next steps with you.
Would you like to have your gums checked? Then make an appointment for a check-up or with our dental hygienist.