Causes, Treatment, Symptoms & Risks

What is periodontitis?

Doctors call periodontitis an inflammatory disease of the periodontium (periodontium). This is the region in our mouth that connects the tooth to the jaw. The disease is triggered by a bacterial infection, which is usually deposited as stubborn plaque. The first signs are swollen gums, bleeding gums or sensitive teeth.

Dentists have long described periodontitis as a widespread disease, it is considered one of the most common chronic diseases worldwide. The consumer advice center speaks of 35 million sick people in Germany. More than half of all adults are affected, writes the German Medical Association. In general, the disease affects all age groups, but the risk and frequency increase with age. Incidentally, periodontitis is a much more common cause of tooth loss in adulthood than tooth decay. The most common form is chronic periodontitis. It accounts for around 95 percent of cases. Aggressive periodontitis is much less common (5 percent).

Periodontitis or periodontal disease – is there a difference at all?

Yes. Periodontitis is not periodontal disease – sometimes both terms are mistakenly equated. Although both diseases lead to receding gums, there is no inflammation in the case of periodontal disease. It therefore initially poses a low health risk, but can disturb the aesthetics of the teeth. In addition, the increasingly exposed tooth necks can also form a collecting tank for bacteria over time, even in the case of periodontal disease.

Periodontal disease often goes unnoticed for a long time because it initially causes no pain. Only after a while do the first symptoms appear, such as bleeding gums when brushing your teeth or biting into an apple. Swollen gums and teeth that are sensitive to irritation are typical indicators of more advanced periodontitis. As the gums progress, the inflamed gums recede more and more, the necks of the teeth become visible and so-called periodontal pockets form, which in turn form the ideal breeding ground for further bacterial colonization. The body’s immune system reacts to the bacterial attack by activating bone-degrading cells (osteoclasts). Over time, the periodontium and your own bones are destroyed. The tooth continues to protrude from the receding gums, becoming loose and eventually falling out.

In the worst case, periodontitis can also spread beyond the oral cavity. If bacteria enter the bloodstream, they can cause inflammation and damage to organs and tissues. The consequences can be unclear fever or a bacterial infection of heart valves or endoprostheses.

Dentists divide periodontitis into different degrees of severity. This periodontal screening index (PSI) is primarily based on the depth of the gum pockets that have formed.

Causes and risk factors

Periodontitis is favored by various causes. Poor oral hygiene is at the top of the list. But a weakened immune system, smoking or certain metabolic diseases such as diabetes mellitus can also promote periodontitis. Unhealthy diet also plays a role, too much sugar, for example, can promote inflammation.

The best prevention is to avoid the risk factors. Proper oral and dental care is the top priority here. This includes brushing your teeth at least twice a day and also cleaning your tongue and the spaces between your teeth. You should also go to the dentist for check-ups once or twice a year. He recognizes periodontitis at an early stage and can prevent it, for example by regularly removing tartar. In addition, it is important to avoid other risk factors, such as smoking and sugary foods.

Can periodontitis be treated?

Yes, but the procedure is quite complex depending on the stage, and complete healing is often not possible. The focus is always on eliminating the bacteria and stopping the inflammatory processes. Depending on how far the bacterial infestation has progressed, the more time-consuming the treatment. Cleaning can be done with ultrasound or laser. In exceptional cases, when particularly aggressive or stubborn germs colonize the oral cavity, an antibiotic must be taken. The German Society for Periodontology (DG Paro) has published guidelines for the treatment of the individual degrees of severity of periodontitis.