Gum disease (also known as periodontitis) is one of the leading factors in tooth loss. Periodontitis is a serious gum infection that damages the soft tissue around teeth. Without treatment, gum disease can destroy the bone that supports your teeth. When the bone is compromised, it causes teeth to loosen or fall out. 

Many times, people don’t realize that they have periodontitis because they aren’t aware of the signs. It is common for people who have gum disease symptoms in the early stages to experience bleeding and soreness when brushing and flossing. They may think the symptoms are from a temporary irritation or an infection that will get better on its own. However, gum disease does not clear up without treatment.

At Sninski & Schmitt Family Dentistry, we are both knowledgeable and experienced in treating patients who have periodontitis in every stage. In this article, we cover the 5 stages of gum disease, when bone loss can occur, and whether there are treatments that can rebuild bone when it is lost.

Gum Disease Explained

Gum disease begins with bacteria that stay on the teeth for a prolonged time. The bacteria infects the tissue surrounding the tooth, which causes inflammation that then leads to periodontal disease. When the buildup of bacteria, called tartar, spreads below the gum line and is not removed, the environment is just right for gum disease to start. Only a dental health professional can remove the tartar and stop the periodontal disease process.

Warning Signs and Risk Factors for Gum Disease

Some of the signs that can warn you that you may have gum disease:

  • Bad breath
  • Bad taste that lingers
  • Red or swollen gums
  • Tender or bleeding gums
  • Painful chewing
  • Loose teeth
  • Sensitive teeth
  • Gums that have pulled away from your teeth
  • Any change in the way your teeth fit together when you bite
  • Any change in the fit of partial dentures

Factors that increase the risk for periodontal disease:

  • Smoking
  • Diabetes
  • Poor oral hygiene
  • Stress
  • Heredity
  • Crooked teeth
  • Fillings that have become defective
  • Taking medications that cause dry mouth
  • Bridges that don’t fit properly
  • Female hormonal changes
  • Immune system deficiencies

The 5 Stages of Periodontal Disease

Bleeding Gums: The First Stage

The earliest sign of gum disease is bleeding when you brush or floss your teeth. This may not mean that you have gum disease, but it is a sign that your gums aren’t healthy. You may see evidence of blood on your toothbrush or after flossing or you may see blood when you are eating hard foods like an apple or pear. When you see blood, make an appointment to see your dental professional because you could be in the early stage of gum disease.

Gingivitis: The Second Stage

In this stage, you will see inflammation in the gums, swollen gums, and experience some pain. Your gums will bleed more than in stage 1. Gingivitis can be treated and does not have to progress to periodontal disease. By engaging in a more diligent focus on oral hygiene, brushing, and regular flossing, you may be able to prevent moving into the third stage.

Early Periodontitis: The Third Stage

In the early stage of periodontitis, inflammation of your gums extends deeper and begins to enter the supporting bone, damaging the jaw. It may not be apparent, but your gums are beginning to detach from your teeth and are forming pockets. More plaque and bacteria begin to reside in the pockets and become even more difficult to remove. You must seek the help of a dentist at this stage. A dental professional will treat you with scaling and root planing to provide a deep cleaning procedure. A deep cleaning addresses the plaque and tartar buildup beneath the gum line in halting the progress of the disease.

Moderate Periodontitis: The Fourth Stage

The fourth stage of gum disease is a significant progression that exhibits noticeable damage to the bone supporting your teeth. Bacteria begin to affect the ligaments and soft tissues as well as bone. In moderate periodontitis, bone loss is more pronounced with increased pocket depth between your gums and teeth where more bacteria reside. In this stage, besides scaling and root planing, the dentist may consider localized antibiotic treatment or more advanced periodontal procedures.

Advanced Periodontitis: The Fifth Stage

Lasting damage occurs in the fifth stage of gum disease, advanced periodontitis. Your teeth will feel increasingly loose, causing a change in your bite and discomfort. The pockets are now deeper and the bacteria in them cause chronic inflammation and abscesses. This stage of gum disease is serious and requires several different approaches. If you don’t see a dental professional, you will more than likely lose teeth. Your dentist may recommend gum grafts for receding gums or surgical procedures to access and clean deeper pockets, which will preserve your jawbone and prevent irreparable damage.  

Periodontal Bone Loss

Bone loss begins to occur in the third stage of periodontitis and becomes more significant and advanced in the fourth and fifth stages. As bacteria make a home in the pockets between the tooth and gum, infection increases. As the infection progresses so does inflammation and it becomes more difficult to get rid of the bacteria that are causing the bone loss.  

Treatment for Bone Loss

It is important to note that bone cannot regenerate on its own after periodontal disease. It isn’t possible to stimulate the bone to regrow and rebuild the lost bone around the teeth. Procedures such as bone grafts, membranes, and tissue-stimulating proteins can be used to promote regrowth in areas where bone has been lost. 

Bone Grafting

Bone grafting (regeneration) can use small bits of your bone or the bone can be made of artificial material. It can also use bone purchased from a human tissue bank or an animal tissue bank. The bone graft helps prevent tooth loss by holding your tooth in place and serves as a platform for the regrowth of natural bone. An incision is made in the gum to expose the underlying bone. Any active infection is removed and cleaned out. At that time, a graft material is placed in the bone. Afterward, a membrane may be used to prevent down growth of the gum into the bone.

Using Plasma Rich in Growth Factors (PRGF)

Plasma Rich in Growth Factors (PRGF) during the surgery may be injected to maximize bone regeneration and expedite the healing process. The science behind using PRGF is similar to Platelet-Rich Plasma (PRP) injections that are common in expediting healing following an orthopedic injury. PRGF is a relatively new technique in dentistry that promotes bone healing and regeneration and is used in conjunction with bone grafting. This procedure uses your blood processed in a centrifuge to concentrate the platelets and growth factors that promote new bone tissue growth. 

Contact Sninski & Schmitt Family Dentistry to Schedule an Appointment Today

If you are seeing any signs of gum disease, contact our professional team at Sninski & Schmitt Family Dentistry right away. Our dentists are experienced in determining which stage of periodontitis you are in and how best to treat it. Gum disease isn’t something you should ignore. Without treatment, it will not get better. Call our Holly Springs dentist office at 919-600-6262 and our Cary, NC dentist office at 919-467-2203. Or, use our online form below to schedule an appointment.

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