What are gingivitis and periodontitis?
Our mouths are full of bacteria. These bacteria, along with mucus and other particles, constantly form a sticky, colorless plaque on teeth. Plaque is a sticky material made of bacteria, mucus, and food debris that build upon the exposed parts of the teeth. It is also a major cause of tooth decay.
Brushing and flossing help get rid of plaque. Plaque that is not removed can harden and form “tartar” that brushing doesn’t clean. Only a professional cleaning by a dentist or dental hygienist can remove tartar.
Periodontitis always begins with inflammation of the gums, known as gingivitis. This inflammation – usually involving reddened or swollen gums and bleeding when brushing teeth or biting on food – is the body’s response to bacteria that have been allowed to accumulate on the teeth.
What is periodontitis?
Also called gum disease, periodontitis is a serious gum infection that damages the soft tissue and can destroy the bone that supports your teeth if left untreated. Periodontitis can cause teeth to loosen or lead to tooth loss. If periodontitis is treated early and proper oral hygiene is maintained, the damage can be stopped.
Symptoms of gingivitis and periodontitis
Although gingivitis and periodontitis have some overlapping symptoms, it’s important to understand the differences.
Symptoms of gingivitis
Symptoms of gingivitis include:
- Bleeding gums (when brushing or flossing)
- Bright red or reddish-purple gums
- Gums that are tender when touched, but otherwise painless
- Mouth sores
- Swollen gums
- Shiny appearance to gums
- Bad breath
Symptoms of periodontitis
- Gums that bleed when you brush or floss your teeth
- Bad breath
- Changes in the position of your teeth or loose teeth
- Receding gums
- Red, tender, or swollen gums
- A buildup of plaque or tartar on your teeth
- Pain when chewing
- Tooth loss
- Foul taste in your mouth
- Inflammation throughout your body
Symptoms in the early stages of periodontitis are often not very noticeable. Your dentist will likely be the first to point them out.
Causes of gingivitis and periodontitis
Causes of gingivitis
The following raise your risk for gingivitis:
- Certain infections and body-wide (systemic) diseases
- Poor dental hygiene
- Pregnancy (hormonal changes increase the sensitivity of the gums)
- Uncontrolled diabetes
- Misaligned teeth, rough edges of fillings, and ill-fitting or unclean mouth appliances (such as braces, dentures, bridges, and crowns)
- Use of certain medicines, including phenytoin, bismuth, and some birth control pill
Causes of periodontitis
Many of the factors that put you at risk for gingivitis also contribute to periodontitis. Additional factors that increase your risk for periodontitis, include:
Diagnosis of gingivitis and periodontitis
Gingivitis is commonly diagnosed with a dental exam. Your dentist will look for inflammation of the gums and plaque or tartar at the base of the teeth. Using a probe, your dentist will determine the severity of your gum disease by measuring pockets in your gums and decide if further tests are required. Occasionally, your dentist may order dental x-rays to determine whether your gum disease has begun to impact the bones that support your teeth.
Your dentist will be able to detect signs of periodontitis at an early stage during a routine dental examination. They can monitor your periodontal status overtime to make sure it doesn’t get any worse. This is why it’s important that you visit a dentist on a regular basis for screening.
Similar to a gingivitis exam, your dentist will use a probe to diagnose the severity of your periodontitis by measuring pockets in your gums. In a healthy mouth, the depth of these pockets is usually between 1 and 3 millimeters.
This test is usually painless, but you may experience discomfort if your gums are especially tender. Your dentist will also ask about your medical history to identify conditions or risk factors that may contribute to gum disease.
Treatments for gingivitis and periodontitis
Daily habits are one of the best ways to treat and prevent gingivitis. Here are a few tips for keeping your teeth healthy:
- Brush your teeth twice a day and floss regularly
- Visit your dentist at least twice a year for professional cleaning.
- Use antibacterial rinses.
- Seek out orthodontic treatment for misaligned teeth.
Depending upon the severity of your periodontitis, your dentist may recommend the following non-invasive procedures:
- Scaling, a procedure that removes buildup on your teeth and below your gum line. This may be done with tools, lasers, or ultrasonic devices.
- Root planing, a procedure that discourages plaque buildup by smoothing out the surface of the roots of your teeth.
In some cases, your dentist will prescribe antibiotics to help with persistent gum infections that haven’t responded to cleanings. The antibiotic might be in the form of a mouthwash, gel, or an oral tablet or capsule.
If inflammation persists in sites that are inaccessible to brushing and flossing, your dentist may recommend a surgical procedure called flap surgery to clean deposits under your gums. Under anesthesia, your gums are lifted away and the roots of your teeth cleaned. Your gums are then stitched back into place.
If you’ve had any bone loss, a procedure known as bone grafting may be done at the same time as flap surgery to regenerate the lost bone.
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NCH Healthcare System: "Periodontitis."
Mount Sinai: "Gingivitis."
InformedHealth.org: "Gingivitis and periodontitis: Overview."
American Dental Association: "Gum Disease."
European Federation of Periodontology: "What is periodontitis?"
National Institute of Dental and Craniofacial Research: "Periodontal (Gum) Disease."