Frequently asked questions
Frequently asked questions about periodontitis and our answers.
The bacterial plaque on the teeth leads to inflammation of the gum line (gingivitis), that can spread to the entire structure that holds the teeth in the jawbone (periodontitis). Due to bone loss, what are called gum pockets can develop at the gum margins and the teeth can become loose and even be lost.
Gingivitis is an inflammation that is limited to the gum line, while periodontitis can also cause loss of jawbone substance. The difference between gingivitis and periodontitis is that in gingivitis, there is still no loss of the structures holding the teeth in place. With gingivitis, good oral hygiene at home can restore healthy gums again. With periodontitis, it is different: Once inflammation has led to bone loss in the jaw, it cannot be built up again by the body with good oral hygiene at home.
If the onset of periodontitis is not detected, the valuable anchoring structure is lost within a few months. Regular good oral hygiene at home to prevent gingivitis is thus the best and least expensive way to prevent periodontitis.
Not every receding gum is caused by periodontitis. If you have receding gums, two situations may be the cause:
On the one hand, you could have gum recessions. They are caused by brushing your teeth too vigorously. The strong force of the toothbrush repeatedly injures the gum line. When it heals, it draws back further and further until the dental root beneath the gum is exposed. Even if you change your oral hygiene habits and clean your teeth less forcefully, the gum recession will not be reversed.
Periodontitis, on the other hand, is an inflammatory disease that develops due to bacterial plaque. If periodontitis is not treated, the damage to the structures holding the teeth in place beneath the gum line progresses. In periodontitis, the initial damage to the anchoring structure is not visible. The gum line draws back only after advanced periodontitis and you might perceive this as receding gums because the root surfaces of the teeth are also exposed.
Only an examination in the dental practice can give you the correct answer.
Periodontitis is an inflammatory disease that is caused by bacterial plaque. If it is not treated, the damage to the structures holding the teeth in place continues below the gum line, invisible from the outside. This is precisely why you cannot detect periodontitis on your own.
However, you can observe some signs of gum inflammation (gingivitis) yourself, for example, the gum line can be discolored red or dark red and be somewhat swollen and you may also notice bleeding gums when you brush or floss your teeth. For smokers, it is important to know that your gums tend to bleed less, and you may be mistaken in your self-assessment of periodontitis*.
On the other hand, there are the following signs of periodontitis that you can see yourself: Like gingivitis, the gums may also be somewhat swollen and reddened. However, since there has already been bone loss in the jawbone, the teeth may have already shifted somewhat, and open spaces formed between the teeth. In advanced periodontitis, the teeth may become loose the bacterial plaque would cause bad breath.
There are several reasons why you could have periodontitis.
The bacterial coating on your teeth (plaque, biofilm) is the main cause of periodontitis. Some kinds of bacteria can promote the development of periodontitis even more. It could be that you practiced inadequate oral hygiene at home for a long time or that you are affected in particular by the kinds of bacteria that can promote the development of periodontitis.
In addition, risk factors such as smoking, unhealthy diet, unmanaged diabetes, or stress should be considered. Finally, genetic factors can also play a role in the development of periodontitis, because the way the immune system reacts to harmful bacteria can differ from person to person due to genetic differences.
In an initial discussion, the dentist will determine whether you have any risk factors. Known risk factors for periodontitis are inadequate oral hygiene at home, smoking, unhealthy diet, diabetes, or stress.
Then the dentist or dental hygienist will carry out what is called a basic periodontal examination that will take only a few minutes.
With a gum probe (periodontal probe), the penetration depth at the gum line will be measured gently and precisely at selected sites.
After this basic examination, other investigations will be made only if signs of loss of the structures holding the teeth in place were found. These investigations include what is called the periodontal status and additional X-ray images.
While you can become healthy again after periodontitis, your gums will not be restored to their original condition.
Periodontitis is an inflammatory disease that leads to damage to the structures holding the teeth in place. In untreated periodontitis, this damage to the tooth anchoring will continue until the tooth is lost. To be precise, gum treatment can only stem the inflammation or even make it go away. This situation is described as healthy because the signs of inflammation have disappeared on the one hand and further damage to the anchoring structures is stopped.
After gum treatment, long-term success over several years is ensured only if patients practice optimal oral hygiene at home, every day preventing new bacterial plaque from causing gum inflammation again.
For optimal long-term success, it is also important to have continuous professional care by the dental hygienist so any recurring problems can be detected and remedied in time.
According to the latest scientific studies, periodontitis considerably increases the risk of complications with dental implants. In particular, the complications involve the anchoring of the dental implants in the jawbone. As in periodontitis, the bacterial inflammation can also lead to bone loss with a dental implant. This disease is called peri-implantitis. The treatment of peri-implantitis is usually much more difficult than the treatment of periodontitis. Untreated peri-implantitis leads to the loss of the affected implant.
However, there are scientific studies that confirm that after successful gum treatment, the risk of peri-implantitis is much lower.
If you have periodontitis, it is absolutely necessary to complete gum treatment before having the dental implants and also to have regular long-term professional dental care, i.e. appointments with the dental hygienist.
After gum treatment, long-term success over several years is ensured only if patients practice optimal oral hygiene at home, every day preventing new bacterial plaque from causing gum inflammation again.
For optimal long-term success, it is also important to have continuous professional care by the dental hygienist so any recurring problems can be detected and remedied in time.
The intervals for these appointments with the dental hygienist are usually three, four, or six months. The frequency depends on the quality of oral hygiene, the extent of gum inflammation, and the presence of what are termed residual gum pockets.
After a tooth is pulled (extraction), the mucosa in the mouth and the bone beneath it is usually completely healed after a few weeks or months. The gap left when the tooth was extracted generally remains unchanged for a long time.
Only after several months could it happen that the teeth of the opposing jaw –because the opposing tooth is missing – can grow out of their own jawbone (elongation), thus protruding into the opposing gap.
In other cases, due to the gap between the teeth, the teeth behind the gap in the same section of the jaw begin to move (mesialization).
If the ability to chew needs to be restored or improved, gaps with or without implants should be fitted with dental prostheses. The restoration can involve fixed crowns or bridges or removable partial dentures.
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