Periodontal Diseases

Gingival disease is an important health problem which is as common as tooth decay and can cause tooth loss.

Periodontal fibers support teeth, gums, jaw bone and allows the teeth to be attached to the jaw bone.

Gingivitis occurs when the gums are inflamed. If the disease progresses, affects other tissues and bone resorption occurs, it is then called Periodontitis (commonly known as pyorrhoea).

What are the symptoms?

The symptoms of this disease are often difficult to notice. Healthy gum is pale pink in color, matte, its surface is orange-peel-like, protruding and stiff.

The symptoms include:

• Bleeding gums (spontaneously or when brushing, eating something hard)
• Change in the color and surface properties of the gingiva (red, glossy, flat surface)
• Dental calculus formation
• Gum growth
• Gum recession or teeth looks longer than usual
• Displacement and spaces between the teeth
• Loose teeth
• Bad taste and halitosis

What are the causes?

The most important cause of gum disease is “microbial dental plaque”, which consists of millions of microbes that build up on the surfaces of the teeth, and spaces between the teeth and gums, caused by poor oral hygiene.  The microbes in this layer and the harmful substances they produce cause periodontal disease. The plaque is soft and easily cleaned with toothbrush and dental floss.

If the plaque is not cleaned, it becomes calcified and a tartar is formed. The rough surface of the tartar leads to more and faster plaque build-up. Again, soft and sticky foods increase plaque formation. Poor overall health, poor immune system, nutritional deficiency, adolescence and hormonal changes in pregnancy facilitate the formation of the disease in the presence of plaque. Inherited factors can also lead to more susceptibility to these diseases?

Is there a treatment for these diseases?

Yes. The sooner the treatment begins, the more successful the result is. Periodontal treatment achieved with the patients and dentist cooperation. As the primary cause of the disease is the plaque, cleaning the plaque, (i.e. the patient’s own oral care) forms the basis of treatment. The lifelong results achieved from the treatment of the physician depends on the oral care. The teeth and gums should be brushed after breakfast and before going to bed at night, dental floss and inter- surface brush should also be used for cleaning the teeth.

With oral and radiographic examinations, the dentist will determine the degree of your condition and arrange a treatment plan.

The first stage of treatment is removing the plaque, tartar and stains from the tooth surfaces. Dental surface cleaning is done in two to three sessions. Periodontal operations constitute the second stage of the treatment in patients with advanced disease.

What is Periodontal operation?

Periodontal operation is performed under local anesthesia when the gums are inflamed and enlarged, when it is difficult to perform a proper oral care and when there is bone resorption. If the disease is only in the gums and there is inflammation or swelling despite initial treatment, this gum is cut off and the wound surface is protected by pat for one week.

If the disease is at the advanced stage (i.e. bone resorption), the gums are removed, the inflamed tissues are cleared, the bone is corrected. The gingival bone is then stitched and covered. Stitches are taken out a week after.

What are the benefits of treatment?

Gingivitis is completely cured.  However, the lost tissues in periodontitis cannot be usually restored. The disease is treated when the tissues are cured. Given the appropriate conditions, bone-stimulating substances are placed for bone reformation. This way, the patient can easily clean the teeth and have a healthy mouth. This treatment may last from three weeks to six months depending on the severity of the disease. After treatment, you should regularly check with your physician every three to six months.

A healthy person has a smiling face, a healthy mouth and shining teeth.

The Effects of Gum Diseases on Systemic Diseases

Chronic infections that occur around the teeth and its surrounding tissues are called gingival diseases. These diseases are usually caused by bacteria that accumulate in the tooth surfaces and in areas where teeth and gums meet. If the disease only affects the gums, it is gingivitis, however, if it affects the periodontal fibers that allow the tooth to adhere to the jaw bone, then it is periodontitis.

The disease is not noticed in the early stages because it exhibits very few symptoms and is painless. However, an early diagnosis can be made when you visit the dentist after experiencing bleeding of gums, bad breath and loose teeth (when the disease progress es). Since this disease is dangerous, it can result in teeth loss. The inflammation in the gum does not affect the mouth only, the blood circulation in the whole body, including the teeth, is in direct contact with the immune system and can cause more disease or may exacerbate existing diseases.

Gum diseases are considered as one of the risk factors involved in the formation of systemic diseases. It is known to trigger or exacerbate systemic diseases. By treating gingival diseases, your dentists will not only keep your teeth and mouth healthy but also eliminate some risk factor for the development of fatal systemic diseases. Thus, dental and gingival health is vital for a healthy life.

Today, studies show that there may be a relationship between gum diseases and heart diseases, diabetes, stroke, rheumatic diseases, preterm birth and low infant birth weight.

Pregnancy and Periodontitis

Premature birth or low birth weight (<2500g) are some of the problems related to pregnancy. The common causes of these conditions include smoking, consuming alcohol, diabetes, and mother’s poor nutrition. And the fact that 25% of the cases are uncertain, it can suggest that chronic infections in the body causes such problems. It is assumed that bacteria from these infections enter the uterus causing inflammation. The inflammation stimulates muscles and begins to contract, hence, premature birth.

Studies revealed that the risk of experiencing the problems mentioned above in pregnant women with treated periodontitis are lower than the women with untreated periodontitis.  

How does it affect your heart?

Bacteria around the teeth pass through the ulcerative areas of the inner surface of the gums, mixing with the blood, and circulates through the body via blood vessels. The immune system activates white blood cells to fight these bacteria in the bloodstream. Chemical substances secreted by the white blood cells for defense purposes, to fight the toxins released by bacteria, initiates the inflammatory response. Hence, increasing the number of cells and clotting factors in the blood.

All this can lead to atherosclerosis, vascular stiffness, vascular occlusion, and ultimately impaired blood flow. Decreased blood flow to the heart can lead to cardiovascular diseases that can be fatal.

In a study, individuals with gum disease under 50 years of age were 70% more susceptible for heart diseases or hospitalization than those with healthy teeth.

Diabetes and Periodontitis

Type II diabetes is a progressive disease like periodontitis, and cannot be diagnosed in many years, especially in elderly patients. Diabetes can be diagnosed by a dentist with the following symptoms: burning sensation in the mouth, slow wound healing, reduced saliva production, inflammation of the gums and frequent abscess formation.

The relationship between diabetes and gum disease is bidirectional. One can cause harm to the other, and vice versa. Damage caused by diabetes in the veins can cause inflammation of the gums. In gum disease, chemicals secreted against the toxins produced by bacteria can lead to the development of insulin resistance. This leads to an increase in blood sugar, making it difficult to control diabetes.