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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.

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.