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Periodontal disease: how do I know if I have it?

Periodontal disease is characterized by the formation of a space between the gum and the tooth, a periodontal pocket, which helps to accumulate food debris and bacteria. It is the main cause of tooth loss in adults. As in all cases, only a dentist can determine with certainty the patient’s condition and what treatment should be carried out.

Periodontal disease self-examination

But people can find out more quickly at home what their problem is. In the case of periodontal disease, the most characteristic sign is bleeding gums. In addition, changes in the position of the teeth, swollen gums, tooth mobility, receding gums, bad breath and food retention are signs that the disease may already be present.

Periodontal disease is caused by bacterial plaque adhering to the tooth. Bacterial activity in this area releases toxins that initially cause the gums to loosen, making room for infection inside. This infection leads to the progressive deterioration of the supporting tissues of the teeth and in advanced cases, they become soft and fall out.

However, changes in the gums can also be associated with emotional causes, medication or low immunity. That’s why it’s important to have a consultation to assess the causes.

periodontal disease stages

Treatments for inflamed gums

For treatment, the patient must go to the dentist who will remove the plaque by scraping and smoothing the roots of the teeth. Surgery may be indicated if the aforementioned procedures do not reach the entire area of the compromised root. Even with proper treatment, there may be sequelae such as displacement in the position of the tooth, bone loss and gum recession. Surgical and prosthetic procedures are available to reduce these effects.

If you’re noticing any of these symptoms of periodontal disease, make sure you schedule an appointment to start proper treatment as soon as possible, and thus avoid more serious problems such as tooth loss.

Periodontal disease – causes

Periodontal disease is a set of inflammatory manifestations caused by bacteria that affect the supporting tissues of the teeth, which in advanced cases leads to tooth loss. Periodontal disease is the main cause of tooth loss in adults. Bacterial action in these structures begins with the accumulation of plaque on the tooth surface.

Why gum disease occurs

The accumulation of bacterial plaque occurs mainly due to poor oral hygiene, poorly performed or hampered by the shape of the teeth (crooked teeth or teeth that are too close together) and long periods without visits to the dentist’s office for preventive treatment.

In early cases, the toxins released by the bacteria inflame the gums, which then become red, swollen and bleed easily. In moderate cases, the gums lose their attachment and form pockets, called periodontal pockets.

This condition is very worrying because when the gums lose their adherence it opens a door for bacterial activity below the gum line, meaning that tartar can build up on the surface of the tooth root and inflammation of the bone tissue and all the supporting structures of the teeth can occur.

Without proper control, inflammation leads to gradual bone loss and teeth become soft, fall out or need to be extracted. Look at your teeth and gums: some conditions can be signs of periodontal disease:

  • Plaque and tartar adhered to the teeth, mainly on the line between the gums and teeth. Plaque is colorless and viscous. Tartar is when the accumulated plaque calcifies and is yellowish or whitish in color;
  • Gums that are swollen, red or bleed easily when brushing, flossing or involuntarily;
  • Retracted gums, sagging or separated from the tooth;
  • Tooth sensitivity;
  • Part of the tooth root exposed;
  • Changes in the position or mobility of the teeth;
  • Tooth loss;

Periodontal disease: causes

Accumulation of plaque and tartar

Plaque is a viscous, transparent film that forms on the teeth near the gum line. The toxins released by the bacteria inflame and irritate the gums, which can turn red and bleed. Tartar is when this plaque becomes hardened (yellowish or whitish calculus) and can only be removed by a professional. When the gum becomes loose, it exposes the root and calculus can build up in this area. Bacterial activity in this area leads to the gradual deterioration of the bone around the tooth.

Medicines

Some medications can interfere with oral health and favor the onset of periodontal disease or make it difficult to cure. The main classes of these drugs are: contraceptives, antidepressants, anticonvulsants, antihypertensives, some used to treat cardiovascular problems and drugs to prevent organ rejection in transplant patients. It is important that patients inform their dentist of any medication they are taking.

Low immunity

Patients in this condition, in most cases as a result of AIDS or chemotherapy, find it more difficult to respond to infectious processes and are more susceptible to the progression of periodontal disease.

Diabetes

Diabetes can cause difficulty in healing, changes in blood circulation and a drop in immunity. Diabetics are more likely to suffer from periodontal disease than non-diabetics.

Bad habits and functional conditions

  • Smoking –smoking reduces vascularization and consequently oxygenation of the cells. This makes it difficult for the body to respond to any infection. It also hinders healing processes and reduces salivation (which is essential for removing and fighting bacteria on the teeth). Read more about the harmful effects of smoking on oral health.
  • Poor nutrition – a lack of intake of various nutrients, such as vitamin C, can reduce immune resistance and promote oral infections.
  • Poor oral hygiene – proper brushing is the best way to remove food residue that may stick to the teeth and gums. The accumulation of this waste serves as “food” for bacteria. In addition to brushing properly, flossing and antiseptic rinses are recommended.
  • Failing to visit the dental practice regularly – visits are essential for identifying problems at an early stage and for carrying out prophylactic professional cleanings.
  • Bruxism – the habit of grinding and clenching teeth can accelerate the process of destruction of bone and gum structures with active periodontal disease. Read more about treating and controlling bruxism.
  • Malocclusion and crooked teeth – conditions that can encourage food residue to accumulate on the teeth and make it difficult to remove.

Emotional causes

  • Stress – Stressed individuals may have an altered immune response to infectious conditions. Tension can also encourage bruxism.

Genetic factors

There are people who are genetically predisposed to periodontal disease, even if they maintain good oral hygiene habits and visit the dentist regularly. A test can be carried out to find the genetic marker that influences periodontal disease.

Hormonal factors

  • Pregnancy – During pregnancy there are intense hormonal changes and the woman’s body can be slow to respond to infectious conditions. In addition, there are studies that show that periodontal disease can influence premature birth.
  • Puberty and menopause – As with pregnancy, puberty and menopause are phases of intense hormonal changes that can certainly make the body more susceptible to infections.
stages of periodontal disease

How can periodontal disease be prevented?

  • Maintain proper and regular oral hygiene. Spend more time brushing. Don’t forget the inside. People tend not to brush the less visible areas of their teeth properly and it is precisely in these areas that plaque and tartar can build up;
  • Visit the dentist regularly for professional prophylactic cleaning (scraping off plaque and smoothing the tooth surface);
  • Avoid excessive consumption of sugar and refined foods (the bacteria present in plaque feed on these sugars).

Even if you don’t notice these signs, regular visits to the dentist should not be abandoned. A professional eye can identify problems in time to treat them. Preventive care is certainly very important. They prevent problems in the future and can save you time and money.

Replacing teeth with periodontal disease with implants

When extractions are unavoidable due to periodontal disease, it is likely that teeth will need to be replaced with dental implants. However, dental implants can only be placed immediately after periodontitis has been treated. If the disease is not well controlled, the success of rehabilitation with dental implants will be compromised.

Periodontal disease (periodontitis) without proper treatment can lead to tooth loss. This is because the bacterial infection gradually destroys the structures that support the teeth. As a result, the teeth soften and, depending on the case, are unable to be maintained.

This is what is known as peri-implantitis, i.e. infection around the implants. Peri-implantitis hinders osseointegration (a phenomenon necessary for implant fixation) and can lead to implant loss.

*Learnall about dental implants: Dental implants: Learn all about dental implants in this guide

Control of periodontitis

Immediately after tooth extractions, the surgeon assesses whether the bone and gum structures are compromised through clinical and radiographic examinations. He may perform minor surgery to clean the area and administer antibiotics to control the infection. The patient is instructed to maintain proper oral hygiene. In the meantime, the patient can wear a temporary prosthesis. The recovery time for periodontitis is not established, as it depends on each case.

PROTESE PROTOCOLO
Replacement of problematic teeth with implants,in this case protocol prosthesis

Replacing teeth with dental implants

If the bone loss after periodontitis is reasonable, dental implants can even be immediately loaded (in selected cases). If bone loss is severe, it may be necessary to perform a bone graft to rebuild the structure before placing the implants.

Unfortunately, this process is not so quick, as it is primarily necessary to wait for complete healing (from 3 to 6 months on average). After dental implants have been placed, clinical follow-up is particularly important in these cases, in order to prevent periodontitis from returning.

Dental visits should be more frequent for patients with a history of periodontal disease than in cases where tooth loss has occurred for other reasons. The surgeon may order additional imaging tests to monitor the osseointegration of the implant. Care should be taken with oral hygiene at home.

This treatment, when carried out by a specialized team and together with the patient’s valuable collaboration in terms of oral hygiene, correct use of medication, regular visits to the clinic and the patience to wait for the results, has a high chance of success.

The ImplArt Dental Clinic specializes in replacing teeth with implants after periodontal disease. Its team is made up of serious periodontists and implant dentists, trained at the country’s leading universities.

*Readmore about the risks of dental implants: 5 major risks for those who have dental implants

Practice at Clinica Dentaria ImplArt

Dr Roberto Markarian, implant dentist, is the creator and director of the ImplArt Dental Clinic. The ImplArt Dental Clinic is certainly one of the main centers of technology in aesthetic oral rehabilitation and implantology in Brazil. As a result of its know-how and high technology, the ImplArt dental clinic receives patients from all over the world who are looking for high technology and knowledge to carry out their dental implant treatment.

Our clinical director holds a doctorate in implant dentistry, a master’s degree in prosthodontics, and two specializations in dental implants and prosthodontics. In addition, he has completed several training courses in the field of dentistry, not only in Brazil, but also abroad.

Dr. Roberto Markarian is enthusiastic and knowledgeable about the most advanced technologies applied to digital dentistry, such as computerized CAD/CAM systems, high-performance and aesthetic ceramics, state-of-the-art dental implants, 3D dental printers, as well as digital scanners for computerized molding. For this reason, since 2011 the Clinic has had computerized scanners and machines in its in-house laboratory to meet patient demand.

Get to know the structure of the ImplArt Dental Clinic. Make an appointment now.

Dr. Roberto Markarian, implant dentist

Text written by DR. ROBERTO MARKARIAN – CRO-SP 73.583
Founder and Director of the ImplArt Dental ClinicDr. Roberto’s Linkedin profile

Dr. Roberto Markarian implant dentist
Replacing teeth with periodontal disease with implants

Dr. Roberto Markarian is a reference in dental implants and computerized dental prostheses in Brazil. As well as having more than 10,000 implants installed, he is a researcher who produces knowledge that is published worldwide in renowned scientific journals in the field of dentistry. He is responsible for promoting knowledge and high technology applied in all the treatments offered by the ImplArt Clinic.

  • Post-Doctorate in Implant Dentistry – Univ SL Mandic (Campinas-SP) – 2020
  • PhD in Implant Dentistry – Doctor of Implant Dentistry, Univ SL Mandic – 2017
  • Dr. Roberto Markarian Specialist in Dental Implants at USP (Implant Dentist) – 2008
  • Specialist in Prosthodontics (Prosthodontist ) by the CFO – 2006
  • Master in Prosthodontics, USP – 2005
  • Graduated as a Dental Surgeon from USP (São Paulo) – 2001
  • Member of the Clinical Staff of Hospital Alemão Oswaldo Cruz

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como é feito um implante dentario
Replacing teeth with periodontal disease with implants

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