Gingivitis and periodontitis
Gingivitis is an early inflammation limited to the gums and still completely curable. Healthy gums adhere firmly to the tooth and stop bacteria from reaching the root. With gingivitis this attachment is still intact; with periodontitis it has already been destroyed – and it cannot be regenerated. Periodontitis is therefore irreversible and can at best be stabilised.
Because gingivitis can turn slowly and often unnoticed into periodontitis, it pays to act early. Periodontitis itself damages the supporting tissues gradually before anything is visible; it often takes years or decades before a moderate or severe form with impending tooth loss develops.
Signs and symptoms
Take these signs seriously and have them checked – early treatment eases the inflammation and prevents further complications.
- Bleeding gums when brushing or flossing – healthy gums do not normally bleed, so even occasional bleeding deserves attention
- Bad breath (halitosis): bacteria associated with gum disease produce unpleasant odours as they break down food residue
- Red, swollen or changed gums instead of pink and firm ones
- Receding gums: teeth look longer, a notch forms at the gum line and teeth become sensitive
Causes
The usual cause is a build-up of plaque – a colourless to pale yellow deposit colonised by bacteria whose toxins damage the gums. The most common reason is inadequate oral hygiene: not flossing and brushing irregularly encourages bacteria. Smoking, certain medications and genetic factors can also cause gingivitis.
During pregnancy, hormonal changes can encourage plaque growth and increase the risk of periodontitis. Regular brushing and professional cleaning then protect the health of mother and child.
Effects on the whole body
Unlike gingivitis, which is a local process, periodontitis affects the whole body. Links between untreated periodontitis and arteriosclerosis, as well as a higher risk of heart attack and stroke, have been scientifically demonstrated. Loose teeth and pus-filled pockets indicate an advanced stage. Treatment of periodontitis therefore also takes the body's own defences into account – for example through nutrition, orthomolecular therapy and stress reduction.
Treatment
We treat gingivitis with professional cleaning: we remove all deposits, clean between the teeth, polish the teeth smooth so that bacteria adhere less easily, and clean and disinfect any gum pockets.
If a check-up reveals gum pockets at least four millimetres deep, the periodontitis needs treatment. Thanks to modern technology, therapy at our practice is low in pain to painless, depending on how advanced the disease is.
- Preparation: professional cleaning above the gum line, cleaning between the teeth, smoothing and polishing
- Diagnosis: recording and documenting the gum status, taking X-rays
- Therapy: cleaning the hidden areas below the gum line, smoothing the root surfaces, rinsing the pockets with a disinfectant solution
- Finish: a protective fluoride varnish or a fluoride-free calcium phosphate preparation
Bacterial test
Aggressive forms of periodontitis involve bacteria that conventional treatment cannot remove sufficiently; an antibiotic is then needed. To choose the right one, we identify the bacteria responsible with a molecular genetic test (bacterial DNA test): we take a sample from the gum pockets and have the germs identified in the laboratory. In the subsequent therapy we can then target the bacteria specifically.