Periodontal Disease (Periodontitis): Can the Teeth Be Saved

What periodontal disease is and why it is confused with periodontitis

The periodontium is the set of tissues that hold a tooth in place: the gum, the ligaments and the bony socket. They work like the foundation of a house. In everyday speech, almost any gum disease with bleeding and loosening of the teeth is called periodontosis. In the clinic we tell these diagnoses apart more precisely.

That is why we make an exact diagnosis only at an examination.

Where the disease comes from

It all starts with plaque. A bacterial film builds up at the gum edge. If you do not remove it morning and evening, it irritates the tissues day after day. In time it hardens and turns into tartar. It starts as gingivitis, inflammation of the gum only. It is reversible: once hygiene is restored, the signs go away. If plaque stays for months, the inflammation goes deeper, to the ligaments and the bone.

In our practice, the risk is raised by:

• smoking: smokers lose more bone and respond worse to treatment;
• diabetes: it intensifies gum inflammation, and inflammation makes it harder to keep blood sugar under control;
• pregnancy and hormonal changes;
• age and heredity;
• poor cleaning between the teeth.

How the disease moves through its stages

The disease develops over years and for a long time hardly hurts. The scale below shows what happens to the tissues at each stage and what we can still save.

Symptoms of periodontal gum disease

The symptoms of periodontal gum disease are easy to dismiss as trivial. For a long time there is no pain, so the disease is noticed late. Check yourself against the list:

In our practice, people most often come when a tooth is already loose, although their gums have bled when brushing for years. Many people treat blood on the toothbrush as a trifle and start brushing that spot more lightly. More plaque is left at the gum edge, and the inflammation only gets worse. That is why we advise you not to wait for pain and to show your gums as soon as blood appears.

If bleeding is so far the only symptom, read our article on when bleeding gums are just irritation and when they are a sign of disease.

Is periodontal disease contagious?

We are asked this question often at consultations, especially when people in the family have already lost teeth to gum disease. Most people have bacteria in the mouth that are linked to gum disease. In total, hundreds of species of microorganisms live in the mouth. But periodontitis is not like a cold that you catch from a neighbour on the bus.

Periodontal disease: can it be cured?

It can be stopped. Can periodontal disease be cured for good? We answer carefully: periodontitis is a chronic disease. Our aim is to remove the active inflammation and stop it coming back. First we check how loose the teeth are and measure the depth of the pockets with a probe, a thin instrument with markings. From the X-rays we assess how much bone is left. We describe the stage and the speed of the disease according to the 2017 international classification.

Smoking and uncontrolled diabetes worsen the outlook. Both factors can be brought under control. Loose teeth are sometimes stabilised by splinting. A tooth with almost no bone has to be extracted so that the infection does not destroy its neighbours. For early and moderate looseness of the teeth we offer gum disease treatment, where all the stages are put together in one plan.

Periodontal disease: can you have dental implants?

Gum disease in the past does not by itself rule out implants. First we treat the inflammation, because active infection in the tissues is a temporary contraindication. According to international studies, periodontitis, smoking and diabetes are linked to peri-implantitis, that is, inflammation around an implant with bone loss. That is why regular check-up visits after implantation are especially important.

Where to go for help

Periodontal disease is not a death sentence for your teeth if you start in time. Begin with a consultation with a periodontist: we will assess the condition of the bone and tell you which teeth can be saved. We do this in our periodontology department at Cristi Dent in Chișinău. Here we draw up a plan of treatment and maintenance visits for your case.