PERIODONTAL DISEASE
No healthy teeth without healthy gums
Periodontal disease is an umbrella term used to cover several diseases that affect the soft tissue and the bone around your teeth. Sometimes, the term “periodontal disease” is used as a synonym for periodontitis, one of two types of periodontal disease. It should not be confused with gingivitis, which is a reversible disease if treated appropriately.
Learn how to distinguish gingivitis from periodontitis
There are two main types of periodontal disease.
On the one hand, there is gingivitis. It is the inflammation of the gum at the neck of the teeth. It often results in discomfort and bleeding, but it is a milder form of gum disease.
On the other hand, periodontitis, commonly referred to as gum disease, is, however, a serious gum infection that damages the soft tissue and the bone around teeth and, without treatment, can result in the permanent loss of teeth. Mild or moderate periodontitis occurs when there are 4-6mm pockets between the teeth and soft tissues, which leads to the growth of bacteria. Advanced periodontitis occurs when the pockets have exceeded 6 mm, and this can result in significant bone loss and shifting of the teeth. Periodontitis is the most common cause of tooth loss among adults. Missing teeth is a sign of significant bone loss, and therefore advanced treatments are used to assist in improving the attachment of teeth to the jawbone and restoring their function.
In any case, it is strongly advised to book an appointment with a periodontist as soon as you notice the first symptoms of a periodontal disease, as doing so will greatly limit the likelihood of any further damage to your teeth and gum.
What are the symptoms of a periodontal disease?
Numerous signs indicate you might be suffering from periodontal disease. These include bleeding when brushing/ flossing, redness, inflammation of the gum, bad taste in the mouth or bad breath, abscesses,
loose or moving teeth, shifting teeth, tooth loss, etc.
What are the causes of a periodontal disease?
Periodontal disease is the result of bacteria in your mouth infecting the tissue surrounding the tooth. They will colonise that space and create a biofilm called plaque if allowed to stay there long enough, which will eventually harden into tartar (sometimes called calculus). In response to these bacteria, your immune system will create inflammation. The accumulation of tartar will make cleaning much more difficult, and bacteria will thus have further space to thrive under the gum line. This cycle is the reason why you experience swollen and/ or bleeding gums along with the other signs of gum disease.
There are various predisposing factors that may make a patient more susceptible. These include diabetes, a weakened immune system, smoking, and genetics. For example, patients that smoke are up to six times more likely to experience periodontitis in comparison to a non-smoker.
Besides being the main culprit for tooth loss among adults, numerous studies have demonstrated that periodontal disease is a risk factor in the aggravation of several systemic conditions. These include diabetes, chronic respiratory disease, and osteoporosis. It may also increase the likelihood of heart disease as well as problematic pregnancies (premature deliveries and low birth weights).
How can a periodontal disease be treated? Can it be prevented?
There are various things you can do to prevent periodontal diseases from happening. The most important is to gently brush your teeth twice daily for at least 2 minutes. It is also important to floss regularly to remove plaque from places your toothbrush cannot reach. Finally, go to your dentist regularly for a check-up and professional cleaning.
However, if you believe you may be suffering from a periodontal disease, it is best to book an appointment as soon as possible with your periodontist. They will identify your condition and suggest the most appropriate treatment option. Treatment can vary depending on the severity of the disease. For milder forms, deep cleaning techniques, such as scaling and root planing, and medications will often prove to be enough.
More serious infections may require surgical treatments. This can include flap surgery and bone and tissue grafts.
Periodontal disease will only worsen if left untreated, so book an appointment right away if you believe you are suffering from this condition. Keeping up with your oral health is an important part of maintaining your overall health; don’t ignore the warning signs.
Do I need a referral?
The short answer is no, a referral is not necessary for a periodontal consultation.
If you feel that you experience any signs and symptoms of periodontal problems, it is important that you schedule an appointment with a periodontist without delay.
DON’T IGNORE THE SIGNS
5 reasons to take periodontal disease(s) seriously
A serious threat to diabetic patients
Patients suffering from diabetes have an increased risk of periodontitis, and it is estimated to be two to three-fold. They also tend to have more severe symptoms. It’s also been proven that it works the other way around: an untreated periodontitis can negatively affect glycemic control in diabetic patients.
May increase the risk for heart disease
Bacteria responsible for periodontal disease can travel in your blood and colonate around your heart or accumulate in your arteries. Over a lifetime, the cumulative exposure of these pathogens may augment the risk of atherosclerosis and thrombosis and further aggravate the likelihood of heart disease.
Is associated with osteoporosis
There is increasing evidence to support that osteoporosis is associated with periodontal disease and tooth loss. In both cases there is a characteristic loss of bone mass.
Explanations include an underlying low bone density in the oral cavity, an inflammatory response to infection or a genetic predisposition.
Can affect pregnancy
Untreated periodontal disease may increase the risk of premature birth and low birthweight. Early treatment before or during pregnancy is thought to diminish by a factor of 5 the incidence of such complications.
A breeding ground for respiratory diseases
Periodontal diseases create a favorable environment for bacteria to grow in your mouth. They are then more susceptible to travel in your respiratory system and cause other infections elsewhere. Dealing with the problem at its core and treating your periodontal disease is therefore an important step in maintaining your overall health.
Besides being the main culprit for tooth loss among adults, numerous studies have demonstrated that periodontal disease is a risk factor in the aggravation of several systemic conditions. These include diabetes, chronic respiratory disease, and osteoporosis. It may also increase the likelihood of heart disease as well as problematic pregnancies (premature deliveries and low birth weights). If you think you are experiencing symptoms consistent with a periodontal disease, a consultation with a periodontist should be considered without delay. A referral is not necessary for a periodontal consultation with our specialist.
Dr. Romina Perri
DMD, Cert Perio, MS(Paro), FRCD(C), Diplomate ABP
YOUR FIRST VISIT
What to expect?
Our periodontist will help educate you about your treatment options, so you can fully understand the process.
01
Review
During your first visit, your doctor will review your complete medical and dental histories. They will need to know about any medications being taken or if you currently have any conditions that could affect your periodontal treatment, including pregnancy, diabetes, and heart disease.
02
Examination
Our professionals will examine your gums to assess the probing depths around your teeth, gum line height, jawbone alignment, and if you have any loose or missing teeth.
03
X-rays
We make every effort to collaborate with your dentist’s office to obtain recent and pertinent X-rays. Should we not be able to obtain recent radiographs, or if they are not helpful in diagnosing your problem, our specialist will take digital X-rays to assess your oral health under your gum line. These are essential to help determine the appropriate treatment for your condition.
01
Review
During your first visit, our professionals will review your complete medical and dental histories with you. They will need to know about any medication you are taking or if you currently have any condition(s) that could affect your periodontal treatment, including pregnancy, diabetes, and heart disease.
02
Examination
Our professionals will then examine your teeth and gums to determine the correct diagnosis of your problem. This may include an assessment of the pocket depths around your teeth, gum line recession, jawbone alignment, and if you have any loose or missing teeth.
03
X-rays
We make every effort to collaborate with your dentist’s office to obtain recent and pertinent X-rays. Should we not be able to obtain recent radiographs, or if they are not helpful in diagnosing your problem, our specialist will take digital X-rays, either 2D or 3D, to assess your oral health under your gum line or within the jaw. These are essential to help determine the appropriate treatment for your condition.
Medication
If analgesics (pain relief medication) have been prescribed, it is usually best to take the first dose one hour before the procedure. All medications (including antibiotics) should be taken strictly as prescribed. Variations can affect healing and the outcome of your surgery. Let your periodontist know of any change.
Bleeding
You may notice slight bleeding from the wound. This is completely normal and should be expected for 1 to 2 days post-op. If you notice excessive bleeding (more than a slight ooze) apply firm pressure to the area with folded gauze or a moist tea bag for at least 30 minutes. If it persists, notify your doctor at once.
Swelling
Some slight swelling is not unusual and may begin right after the surgery, reaching its peak at day 3 or 4. During the first day and immediately after surgery, place an ice pack wrapped in a clean towel over your face (apply 10 minutes on, 10 minutes off).
Head position
Keep your head elevated for the first two nights after surgery by using extra pillows. This will help reduce swelling.
Nutrition
For your own comfort and for best healing, a soft diet is strongly recommended. Avoid, if possible, chewing where the wound is, and avoid hard, fibrous or sharp food (such as chips), as these can irritate the wound and delay healing. You may also want to avoid hot food or drinking through a straw as this may promote bleeding. Drink plenty of liquids. Maintain a diet with a normal calorie level that is high in protein, minerals and vitamins to support the post-operative healing.
Oral hygiene
Rinse with the prescribed oral rinse the day after surgery for 1 weeks. Continue to brush and floss the teeth which were not involved in the surgery. The surgical area should not be disturbed for at least the first week post-op. At your post-operative visits, you will be provided with new oral hygiene instructions.
Smoking
Smoking reduces the blood supply to the surgical site. Refrain from smoking until after your sutures have been removed to ensure the best success of your surgery. Smokers may experience diminished healing, thus increasing the risk of infections and implant failure.
Alcohol
The combination of alcohol and certain pain medications is not recommended. Read the notice before taking any medication and talk to your periodontist.
Physical activities
Avoid strenuous physical activity during your immediate recovery period (2 to 3 days after surgery).
Dentures
Please ask your surgeon if you may wear your denture or temporary prosthesis. They may require an adjustment or relining prior to use. If they are used and put too much pressure on the surgical site, it could interfere with the healing process.
Please let us know of any concern or query you may have. We are always happy to help. Feel free to contact us about anything regarding your after care. A referral is not necessary for a periodontal consultation with our specialists.
Dr Romina Perri
DMD, Cert Paro, MS(Paro), FRCD(C), Diplomate ABP
Bleeding
You may notice slight bleeding from the surgical site. This type of minor bleeding is normal for 1 to 2 days and is not a major concern. If you notice an obvious flow of blood which is more than a slight ooze, apply firm pressure to the area with folded gauze or a moist tea bag for at least 30 minutes. If it persists, notify your doctor at once.
Swelling
Some slight swelling is not unusual and may begin after the surgery, reaching a maximum at 3 to 4 days. During the first day and immediately after surgery, place an ice pack wrapped in a clean towel over your face (apply 15 minutes on, 15 minutes off).
Heading position
Keep your head elevated for the first 2 nights after surgery by using extra pillows. This will help to reduce swelling.
Nutrition
For your comfort and to protect the surgical area, a soft diet is recommended. Avoid chewing in the area of surgery. Avoid hard, fibrous, or sharp foods (such as chips) as these may be uncomfortable and can irritate the surgical site. Avoid hot foods or drinking through a straw as this may promote bleeding. Drink plenty of liquids. Maintain a diet with a normal calorie level that is high in protein, minerals and vitamins to support the post-operative healing.
Oral hygiene
Rinse with the prescribed oral rinse the day after surgery for 2 weeks. Continue to brush and floss the teeth which were not involved in the surgery. The surgical area should not be disturbed for at least the first week post-operatively. At your post-operative visits, you will be provided with new oral hygiene instructions.
Smoking
Smoking reduces the blood supply to the surgical site. Refrain from smoking until after your sutures have been removed to ensure the best success of your surgical procedure. Smokers may experience diminished healing, thus increasing the risk for infections and implant failure.
Alcohol
The combination of alcohol and certain pain medications is not recommended.
Physical activities
Avoid strenuous physical activity during your immediate recovery period (2 to 3 days after surgery).
Dentures
Please ask your surgeon if you may wear your denture or temporary prosthesis. They may require an adjustment or relining prior to use. If they are used and put too much pressure on the surgical site, it could interfere with the healing process.
There are several ways treatment from a periodontist may be sought. If you think you are experiencing symptoms of gingivitis or rapidly progressing periodontal disease, a consultation with a periodontist may be recommended. A referral is not necessary for a periodontal consultation with our specialists.
Dr Romina Perri
DMD Cert Paro MS(Paro) Diplomate ABP FRCD(C)
Swelling
Some slight swelling is not unusual and may begin after the surgery, reaching a maximum at 3 to 4 days. During the first day and immediately after surgery, place an ice pack wrapped in a clean towel over your face (apply 15 minutes on, 15 minutes off).
Heading position
Keep your head elevated for the first 2 nights after surgery by using extra pillows. This will help to reduce swelling.
Nutrition
For your comfort and to protect the surgical area, a soft diet is recommended. Avoid chewing in the area of surgery. Avoid hard, fibrous, or sharp foods (such as chips) as these may be uncomfortable and can irritate the surgical site. Avoid hot foods or drinking through a straw as this may promote bleeding. Drink plenty of liquids. Maintain a diet with a normal calorie level that is high in protein, minerals and vitamins to support the post-operative healing.
Oral hygiene
Rinse with the prescribed oral rinse the day after surgery for 2 weeks. Continue to brush and floss the teeth which were not involved in the surgery. The surgical area should not be disturbed for at least the first week post-operatively. At your post-operative visits, you will be provided with new oral hygiene instructions.
Smoking
Smoking reduces the blood supply to the surgical site. Refrain from smoking until after your sutures have been removed to ensure the best success of your surgical procedure. Smokers may experience diminished healing, thus increasing the risk for infections and implant failure.
Alcohol
The combination of alcohol and certain pain medications is not recommended.
Physical activities
Avoid strenuous physical activity during your immediate recovery period (2 to 3 days after surgery).
Dentures
Please ask your surgeon if you may wear your denture or temporary prosthesis. They may require an adjustment or relining prior to use. If they are used and put too much pressure on the surgical site, it could interfere with the healing process.
There are several ways treatment from a periodontist may be sought. If you think you are experiencing symptoms of gingivitis or rapidly progressing periodontal disease, a consultation with a periodontist may be recommended. A referral is not necessary for a periodontal consultation with our specialists.
Dr Romina Perri
DMD Cert Paro MS(Paro) Diplomate ABP FRCD(C)
Oral hygiene
Rinse with the prescribed oral rinse the day after surgery for 2 weeks. Continue to brush and floss the teeth which were not involved in the surgery. The surgical area should not be disturbed for at least the first week post-operatively. At your post-operative visits, you will be provided with new oral hygiene instructions.
Medication
If analgesics (pain relief medication) have been prescribed, it is usually best to take the first dose while the surgical site is still anesthetized (numb). All medications (including antibiotics) should be taken strictly as prescribed. Variation from the prescribed regimen can affect the healing and success of your procedure.
Bleeding
You may notice slight bleeding from the surgical site. This type of minor bleeding is normal for 1 to 2 days and is not a major concern. If you notice an obvious flow of blood which is more than a slight ooze, apply firm pressure to the area with folded gauze or a moist tea bag for at least 30 minutes. If it persists, notify your doctor at once.
Swelling
Some slight swelling is not unusual and may begin after the surgery, reaching a maximum at 3 to 4 days. During the first day and immediately after surgery, place an ice pack wrapped in a clean towel over your face (apply 15 minutes on, 15 minutes off).
Heading position
Keep your head elevated for the first 2 nights after surgery by using extra pillows. This will help to reduce swelling.
Nutrition
For your comfort and to protect the surgical area, a soft diet is recommended. Avoid chewing in the area of surgery. Avoid hard, fibrous, or sharp foods (such as chips) as these may be uncomfortable and can irritate the surgical site. Avoid hot foods or drinking through a straw as this may promote bleeding. Drink plenty of liquids. Maintain a diet with a normal calorie level that is high in protein, minerals and vitamins to support the post-operative healing.
Smoking
Smoking reduces the blood supply to the surgical site. Refrain from smoking until after your sutures have been removed to ensure the best success of your surgical procedure. Smokers may experience diminished healing, thus increasing the risk for infections and implant failure.
Alcohol
The combination of alcohol and certain pain medications is not recommended.
Physical activities
Avoid strenuous physical activity during your immediate recovery period (2 to 3 days after surgery).
Dentures
Please ask your surgeon if you may wear your denture or temporary prosthesis. They may require an adjustment or relining prior to use. If they are used and put too much pressure on the surgical site, it could interfere with the healing process.