Periodontitis

Periodontitis - What is it?

Periodontitis is a chronic inflammatory disease that affects the supporting tissues of the teeth, including the gums, alveolar bone and periodontal ligament. It usually develops from untreated gingivitis, when plaque and tartar build up in the areas between the teeth and gums. This process triggers inflammation which, if left unchecked, can lead to the progressive destruction of the supporting tissues.

Vermelhidão devido a infecção bacteriana localizada na gengiva ao redor do dente

The disease comes in different forms:

Chronic periodontitis

Associated with factors such as poor oral hygiene, smoking and ageing.

Aggressive periodontitis

Less common, it develops rapidly and often affects younger people.

Periodontitis associated with systemic diseases

Linked to conditions such as diabetes or autoimmune diseases.

Without treatment, periodontitis can cause tooth mobility, tooth loss and even systemic problems, such as an increased risk of cardiovascular disease.

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Possible Symptoms 

Periodontitis can show subtle signs in the early stages, making it difficult to see the problem until it has progressed. However, some symptoms can serve as a warning, and their early identification is essential to prevent serious complications. The main signs include:

Red, swollen or bleeding gums

One of the first signs of periodontitis is inflammation of the gums, which manifests itself through redness, swelling and bleeding when brushing or flossing. These symptoms indicate that the gum tissue contains the presence of bacteria and toxins.

Gum recession

As the disease progresses, it is common for gums to recede, leaving the roots of the teeth progressively exposed. As well as compromising the aesthetics of the smile, the condition increases the vulnerability of the teeth to tooth sensitivity and other problems.

Increased tooth sensitivity

The exposure of tooth roots due to gum recession can cause discomfort when eating hot, cold or sweet food or drinks, impacting on the patient's quality of life.

Persistent bad breath (halitosis)

Chronic halitosis is another common symptom of periodontitis. It occurs due to the accumulation of bacteria in the oral cavity and the degradation of inflamed tissues. 

Presence of periodontal pockets

Periodontal pockets are spaces formed between the teeth and gums due to the destruction of the supporting tissue. These pockets accumulate food debris and bacteria, aggravating inflammation.

Pain or discomfort when chewing

Inflammation and loss of support can cause discomfort or pain when chewing, making it difficult to eat.

Tooth mobility or changes in tooth position

In the advanced stages of periodontitis, the weakening of bone and gum support can lead to tooth mobility, misalignment or even tooth loss.

Importance of Early Identification

Identifying the symptoms of periodontitis in its early stages is crucial to avoiding complications such as tooth loss and negative impacts on general health, since periodontitis is associated with conditions such as cardiovascular and pulmonary diseases and diabetes. Early detection allows for effective interventions, which can include anything from changes in oral hygiene habits to specific treatments carried out by a dental professional. 

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Available Treatments 

The treatment of periodontitis varies according to the severity of the disease, but the main aim is to control the infection, preserve the health of the supporting structures of the teeth and prevent future complications. The main approaches include:

Scraping and Root Straightening

This is one of the initial stages in the treatment of periodontitis and aims to remove accumulated bacteria and tartar. 


  • Removal of tartar and plaque:  Deep cleaning is carried out below the gum line, eliminating the build-up of plaque and tartar that causes infection.


  • Smoothing the surface of the tooth root: Root surfaces are smoothed to reduce the areas where bacteria can adhere, facilitating the regeneration of healthy gum tissue.

Periodontal Surgery

In more advanced cases, where the infection has already caused significant damage, surgical intervention may be necessary: 


  • Elimination of infections: Surgical procedures help to remove the inflamed and infected tissue in depth.


  • Repairs damaged tissue: Techniques such as tissue grafts or bone regeneration can be used to restore the supporting structures of teeth.


Regular Maintenance

After the initial treatment, maintenance is essential to prevent recurrences and ensure periodontal health:


  • Regular consultations: Regular visits to the dentist to monitor the periodontal condition and identify any signs of recurrence early on.


  • Proper oral hygiene: Reinforcing the importance of consistent brushing and flossing practices, adapted to the patient's needs.

Continuous Prevention

In addition to treatment, prevention is a crucial element in maintaining oral health and avoiding recurrence of periodontitis:


1. Proper Oral Hygiene


  • Regular brushing: This should be done at least twice a day, using proper technique and a soft-bristled brush.
  • Flossing: Essential for removing plaque that builds up between the teeth and at the gum line.
  • Mouthwash: Antibacterial products can be recommended to help reduce oral bacteria.


2. Regular visits to the dentist


  • Monitoring periodontal disease: Regular appointments ensure that any signs of inflammation are treated early.
  • Oral hygiene appointments: Regular oral hygiene appointments are essential to prevent the build-up of plaque and tartar.


3. Healthy lifestyle


  • Balanced diet: Eating nutrient-rich foods strengthens the immune system and promotes oral health. 
  • Avoid tobacco: Tobacco is one of the main risk factors for periodontitis, aggravating its progression and making treatment more difficult.

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FAQ's

  • 1. Can periodontitis be cured?

    Although there is no definitive cure, periodontitis can be controlled with proper treatment and strict maintenance.

  • 2. How can periodontitis be prevented?

    Prevention involves good oral hygiene: regular brushing, flossing and regular visits to the dentist.

  • 3. Is periodontitis hereditary?

    Genetic factors can increase predisposition, but the main cause is the accumulation of plaque due to inadequate oral hygiene.

  • 4. Are the treatments painful?

    The procedures are carried out under local anesthesia, minimizing discomfort.

  • 5. Is it possible to lose teeth because of periodontitis?

    Yes, especially in advanced cases. However, early diagnosis and treatment can prevent tooth loss.


  • 6. What to expect from a periodontology appointment?

    1. Assessment appointment; 
    2. Panoramic radiography
    3. Access to the most innovative treatment methods on the market; 
    4. Treatment plan with the right treatment solutions for your case; 
    5. Follow-up by a highly specialized clinical team; 
    6. Maintenance/follow-up appointments; 
    7. Advice on possible aesthetic dental procedures to improve the aesthetic consequences of periodontitis

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