Periodontal Disease – Silent Poison

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Have you seen a bit of blood in your sink when you brush your teeth lately? Have you noticed your gums being sore, reddened and wondered why are they this way? Well, they are the most common problems that u will be noticing often with your mouth which are usually ignored maybe because that doesn’t hurt.

The thoughts of something fishy going with your mouth might crawl around for a moment but soon you manage to ignore it because that isn’t causing much trouble in your daily life.

We have built upon our own school of thought that we must visit the dentist only when there is pain. So unless the thing doesn’t hurt, who cares! We don’t bother landing upon the dental chair unless we have a severe toothache.

One might notice their teeth getting loosened prematurely when they always assumed their oral cavity to be healthy. They might end up visiting a dental office but it might be too late then. Then arises the query that you  never had any pain neither you ever noticed a cavity in your teeth; how did the teeth loosened on its own?

Well, it is the ignorance that you had regarding the symptoms that you once considered harmless. They could have been the early signs of having a gum disease. Gum disease is the second most common pathology associated with oral health: dental caries being the first.

It is very common to have a gum disease and there is nothing much to worry about it if you take good care of your oral health as soon as you notice anything wrong. They do not cause destruction in a single day, rather it is patient enough to wait for months or maybe years to build a empire of its own and take a giant leap, the destruction of which is almost impossible to revert back to normal.  Gum disease is a threat to your oral health. 

Whether it is stops, slows, or gets worse depends a great deal on how well you care for your teeth and gums every day, from this point forward.

The bleeding of gums that you frequently had can be one of the first warning signs that you’ve got gum disease. The mild variety is called gingivitis. When you have that, only your gums are infected. If you don’t treat it, the infection can travel below your gum line and into your bone.

Then it becomes a more serious form of gum disease called Periodontitis. Periodontal diseases range from simple gum inflammation to serious disease that results in major damage to the soft tissue and bone that support the teeth. In the worst cases, teeth are lost. In many cases, they are associated with many systemic diseases.

They could even be the oral manifestation of the systemic disease that u might be suffering from. It  could lead you to a early diagnosis or simply present itself as the side effect of the medications that you are taking.

So what causes periodontal disease?

Our mouths are full of bacteria. These bacteria, along with mucus and other particles, constantly form a sticky, colorless substance commonly known as plaque. Brushing and flossing helps get rid of plaque. 

Plaque that is not removed can harden and form calculus that brushing doesn’t clean. Calculus is the most site of attachment for plaque. So the accumulated plaque and calculus acts as an irritant and starts causing trouble in oral cavity.


The longer plaque and calculus remain on your teeth, the more harmful they become. Meanwhile our gums try to defend the bacteria from causing further trouble and starts fighting against it by producing different mediators.

So, if we manage to clean up the irritant and help our cells in combating them, the bacteria cannot cause much destruction.The bacteria cause inflammation of the gums that is called “gingivitis.”  In gingivitis, the gums become red, swollen and can bleed easily. 

So , gingivitis is a mild form of gum disease that can usually be reversed with daily brushing and flossing, and regular cleaning by a dentist or dental hygienist. This form of gum disease does not include any loss of bone and tissue that hold teeth in place.


However when we fail to take good care of our oral health , the bacteria wins the battle. It starts causing more and more destruction eventually leading to a more severe form of gingivitis.  When gingivitis is not treated, it can advance to “periodontitis” which is  inflammation around the tooth.

In periodontitis, gums pull away from the teeth and form “pockets” that are infected. The body’s immune system fights the bacteria as the plaque spreads and grows below the gum line. Bacterial toxins and the body’s enzymes fighting the infection actually start to break down the bone and connective tissue that hold teeth in place.

If not treated, the bones, gums, and connective tissue that support the teeth are destroyed.  The teeth may eventually become loose and have to be removed.  

Apart from the plaque and calculus which is the most common cause for the gum disease, there are other associated risk factors such as smoking, stress, hormonal changes during puberty, pregnancy, diabetes, genetic susceptibility, and many other illness such as AIDS, leukemia and the list goes on. Intake of certain drugs such as immunosuppressants and some heart medicines  might be another associated risk factor.

Who suffers from periodontal disease?

So, anyone can suffer from gum disease as it is multi factorial and there could be various causes that might land you up with a gum disease. However, people usually don’t show signs of gum disease until they are in their 30s or 40s.  Men are more likely to have periodontal disease than women. 

Although teenagers rarely develop periodontitis, they can develop gingivitis, the milder form of gum disease. Similarly, the diabetic patient are at a higher risk of developing periodontal disease if they don’t take good care of their oral hygiene. Moreover smokers are at a greater risk of developing gingivitis and they even respond poorly to the treatment.

 How can we prevent gum diseases?

Preventing gum disease is possible if done at a early stage. Maintaining a good oral hygiene is the ultimate key.

Here are some things you can do to prevent periodontal diseases:

  1. Brush your teeth twice a day (with  fluoridated toothpaste) and don’t forget to floss
  2. Visit the dentist routinely for a check-up and professional cleaning
  3. Eat a well balanced diet and avoid tobacco products

What are the symptoms of having gum disease?

Symptoms are often not noticeable until the disease is advanced. You can find and treat the problem before it gets serious if you know what to look for.

Take note if you notice:

  • Red or swollen gums: It is usually the first sign that your gum needs care
  • Tender or bleeding gums
  • Loose teeth:Gum disease can attack the bones that hold your teeth in place, making them loosen or move.
  • Painful chewing: Periodontal tissue is the major support system for the tooth. When there is damage to the supporting tissues there is pain while chewing and it can evemchange the way your teeth fits while biting.
  • Receding gums: If your teeth look longer than they used to, chances are they’re not growing chances are that your gums are shrinking. When bone starts to break down, gums start separating from teeth causing pocket.
  • Sensitive teeth: With receding gums, the sensitive area of tooth called dentin is exposed leading to sensitivity.
  • Foul breath : In advanced conditions, bacteria causes foul smell

How can gum diseases be treated?

The ultimate goal of treatment is to control the infection so, the number and types of treatment will vary, depending on the extent of the gum disease.  Any type of treatment requires that the patient keep up good daily care at home. 

Additionally, modifying certain behaviors, such as quitting tobacco use, might also be suggested as a way to improve treatment outcome. Patient compliance is a must while treating gum disease. There is no magic drug that cures the condition. It requires a long term effort from the part of both dentist and patient.

The dentist, periodontist, or dental hygienist removes the plaque through a deep-cleaning method called scaling and root planing.  Scaling means scraping off the calculus from above and below the gum line. 

Root planing gets rid of rough spots on the tooth root where the germs gather, and helps remove bacteria that contribute to the disease.Your dentist may also recommend antimicrobial mouthwash. You swish this in your mouth as part of your daily brushing routine to help control bacteria.

It’s available both by prescription and over-the-counter.Similarly, your dentist might prescribe certain medications. In the most advanced cases, you might even need surgery to be done.


Having a gum disease is a chronic process. It doesn’t occur in a day or two but turning a blind eye to it cause it to progess. Slowly and slowly, it weakens the support system of tooth eventually leading to a more dreadful condition. So early intervention and taking a good care of your oral health is a must.

Don’t wait to have a visit when the tooth hurts because you might land up having to suffer a great pain of loosing your teeth. You never know that your own ignorance might be promoting a poison that is causing destruction silently but steadily. Take good care of your teeth and gums as well.

Prativa Pandey
Dental Student BPKIHS

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