Periodontal diseases

Periodontal diseases

Periodontal treatment (gum disease)

There are a number of different warning signs that indicate the onset of periodontal (gum) disease. Consult a dentist if you are experiencing one or more of the following symptoms:

  • Persistent bad breath
  • Sensitive gums
  • Bleeding gums when brushing teeth or using dental floss
  • Inflamed or swollen gums
  • Loose teeth
  • Loss of one or more teeth
  • Rapid change of position of one or more teeth

Periodontal diseases are the leading cause of adult tooth loss. Nearly 75% of adults will suffer from gum problems, to varying degrees, during their lifetime.

Paying attention to your gums

Swollen and bleeding gums are the first signs of an infection caused by bacteria. If these symptoms are ignored, the infection can spread and destroy tissues and bone that support teeth. Teeth may eventually fall out if they lose their bone support.

What is periodontal disease?

“Peri” means around, and “odontal” refers to teeth. Periodontal diseases are infections of the structures that surround the teeth, i.e. the gums, periodontal ligament and alveolar bone. In the early stages of periodontal disease (gingivitis), infection affects only the gums, but in the most serious forms of the disease, all supporting tissues are involved.

Some bacteria in dental plaque cause this infection of the gums. This disease can also affect your overall health because it is associated with other health problems such as heart disease and respiratory infections.

Periodontitis is common but can be easily prevented. It is usually the result of poor oral hygiene. Toothbrushing at least twice a day, flossing daily and regular dental examinations can significantly reduce the risk of developing periodontal disease.

Symptoms to watch out for

Signs and symptoms of periodontitis may include:

  • Swollen, red, puffy and/or sensitive gums;
  • Gingival recession (receding gums);
  • New gaps between your teeth;
  • Presence of pus at the gum margin;
  • Bad breath;
  • Bad taste in the mouth;
  • Loose teeth;
  • Changes in the position of the teeth when the jaws are closed (occlusion problems)

When to see your dentist?

Healthy gums are firm and pale pink. If your gums show signs or symptoms of periodontitis (red, swollen and tender gums), see your dentist as soon as possible. The sooner you consult a dentist, the better your chances to repair damage caused by periodontitis and prevent even more serious health problems.

Causes of periodontal disease

Periodontal disease begins with the accumulation of dental plaque – a sticky film composed mainly of bacteria that forms on your teeth when food debris interact with bacteria present in the mouth. You can remove plaque by brushing and flossing your teeth but it reforms quickly (within 24 hours).

When dental plaque stays on your teeth more than two or three days, it may harden and turn into tartar and accumulate near the gumline. As you cannot get rid of tartar with a toothbrush or with dental floss, you will need to undergo a dental cleaning at the dentist’s office.

The longer that plaque and tartar stay on your teeth, the more chances you have to develop a more serious form of periodontal disease. At the beginning, the presence of tartar will cause gingivitis, an irritation and inflammation of the gums.

Inflammation causes “pockets” to form between the gums and teeth

Over time, inflammation causes “pockets” to form between the gums and teeth. These spaces fill up with plaque, tartar and bacteria. The bacteria produce endotoxin (a by-product of their own metabolism) that is largely responsible for the inflammation around teeth. Over time, these pockets filled with bacteria become deeper and eventually progress under the gums. This causes deep infections that have the potential to lead to a loss of bone and tissue, ultimately leading to tooth loss.

Risk factors

Here is a list of the various factors that may increase your risk of periodontal disease:

  • Gingivitis
  • Smoking
  • Heredity
  • Poor oral health habits;
  • Aging
  • Decrease in immunity (caused for example by leukemia, HIV / AIDS or chemotherapy);
  • Poor eating habits
  • Diabetes
  • Use of certain medications
  • Defective dental restorations
  • Hormonal changes (such as those related to pregnancy or menopause);
  • Drug addiction
  • Occlusal problems (problems with the position of the teeth when the jaws are closed)


The treatment of periodontal disease is designed to clean the “pockets” around the teeth and prevent damage to the bone that supports the teeth. Treatments can be carried out by periodontists, dentists or hygienists and must be accompanied by an exemplary daily oral hygiene routine.

Non-surgical treatments

In early stages of periodontitis, treatment may include less invasive procedures:

  • Scaling: To eliminate tartar and bacteria on the surface of the teeth and under the gumline. Can be achieved using an ultrasonic device.
  • Root planing: To smooth rough surfaces on the roots of the teeth and limit the accumulation of tartar and bacterial endotoxin.
  • Antibiotics: Topical (mouth rinses or gel applied on the gums) or oral antibiotics can help control bacterial infection.

Surgical treatments

In case of advanced periodontal disease, non-surgical treatments and good oral hygiene will not be sufficient.

One or more of the following surgical treatments may be necessary:

Periodontal pocket reduction procedure:

This is a cleaning of the surface of the tooth roots (under the gum) to restore the health of the gingiva and bone. As periodontitis often causes bone loss, the underlying bone can also be recontoured during this procedure. After healing, it is easier to clean these areas and keep the gum tissue healthy.

Soft tissue grafting:

To counter gingival recession, a small amount of tissue from the palate is removed and grafted to the affected site. This procedure allows to cover exposed roots and give your teeth a better look

Bone grafting:

Performed when periodontitis has destroyed the bone surrounding the root of your tooth, it uses small fragments of your own bone, synthetic bone or bone from a donor. Bone graft prevents tooth loss by solidifying their anchorage point in the jaw.

Guided tissue regeneration:

This allows the regeneration of the bone that was destroyed by the bacteria. Your dentist places a piece of biocompatible membrane between the existing bone and your tooth to prevent unwanted tissues from entering the area of healing, allowing the bone to regenerate.

Enamel matrix derivatives:

with this technique, the dentist applies a gel to the tooth root which stimulates bone and tissue growth.