Periodontal disease is caused by bacteria which are always present in saliva. The bacteria attach to the tooth surface around the gum margin and form dental plaque. This is the sticky white substance which can be scraped away with a fingernail. If the plaque is not removed effectively every twelve hours it can harden into tartar (calculus). The bacteria will cause irritation (inflammation) in the gums.
Tobacco use, diabetes, stress and our genes all increase the chances of developing gum disease and can make it worse.
The increase in blood sugar level, which occurs in diabetes, can cause damage to nerves, blood vessels, the heart, the kidneys, the eyes and the feet. In the same way, the gums can also be affected.
Evidence also shows that severe periodontal disease can increase blood sugar levels in people with diabetes and also in those who do not have diabetes. In other words, periodontal disease and diabetes are linked in both directions.
The early symptoms are bleeding during tooth cleaning or eating, redness and swelling of the gums, and bad breath. If these symptoms are not treated, the disease progresses to involve the deeper tissues and results in bone destruction. Recession of the gums may occur and the teeth appear longer. Also gaps can appear between the teeth and the teeth may start to drift apart and, as the disease progresses, become loose. It is rare that the disease is painful.
Yes, it can be prevented by having good plaque removal techniques, including tooth-brushing and cleaning in between the teeth. Having a healthy lifestyle, including not smoking, eating a healthy balanced diet and taking regular exercise, can help to prevent periodontal disease.
People with diabetes can reduce the risk of getting periodontal disease by maintaining good blood sugar control.
Sometimes, the symptoms of periodontal disease go unnoticed, particularly in people who smoke, and this is why it is very important to visit the dentist regularly for check ups.
It can be successfully treated, especially if caught early. Management includes improving daily plaque removal techniques and by having an intensive course of treatment, in which the teeth are thoroughly cleaned by a dentist and/or dental hygienist. It is important to understand that the treatment of periodontal disease is a partnership between the patient and the clinicians who care for the patient. Achieving and maintaining good plaque removal and attending regular dental appointments are a lifelong commitment.
Treatment also involves stopping smoking and having a healthy lifestyle. People who smoke respond less well to treatment than non-smokers.
Successful treatment results in clean plaque-free teeth, no bleeding, pale pink gums and fresh breath. If a patient has the severe form of the disease with receding gums and bone destruction, the bone cannot, in most cases, be replaced. However, the good news is that the condition can be stabilised and the teeth, if they were loose, should feel firmer. The patient can maintain the teeth for much longer than without treatment, hopefully for life.
The treatment of periodontal disease in people with diabetes, who have good control of blood sugar, can be just as successful as in patients who do not have diabetes. Improving blood sugar control can improve the outcome of periodontal treatment in people with diabetes. Also there is evidence that treatment of periodontal disease can result in improvement in blood sugar control in people with poorly controlled diabetes and reduce the risk of the other complications of diabetes.