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Periodontitis - recognising, treating, preventing
Gums and jawbone: how periodontitis develops, how to recognise it and what a treatment really achieves.
A portal for patients
The Periodontology Adviser explains what happens when the tooth-supporting apparatus becomes diseased and what a treatment can achieve. It answers the questions that arise before the first appointment – independently and without advertising.
Alongside the explanations you will find advice on dental care, a glossary of technical terms, detailed articles under Dental knowledge and current reports under News. Anyone looking for a practice can enter their postcode in the dentist search.
Keeping your own teeth
That wish lies at the heart of a dentistry built on prevention. Careful oral hygiene at home and professional support at the practice are not opposites but two halves of the same path – and they spare you elaborate treatment later on.
Home periodontitis
Roughly three in four adults develop periodontitis in the course of their lives – many without noticing. That makes it one of the most common diseases there is.
It begins quietly: no pain, just a little blood when brushing. Those who pay it no attention often notice only when teeth start to loosen – and by then bone has been lost that does not come back.
Signs of periodontal disease
Periodontal disease usually runs its course without pain and is therefore often noticed only at a late stage. Possible signs of gingivitis or periodontitis:
- Red, swollen gums
- Gums bleed when touched
- Receding gums and elongated tooth necks
- Pain in the teeth and gums
- Teeth loosen or shift
- Bad taste and persistent bad breath
- Progressive loss of jawbone
At an advanced stage tissue is lost irretrievably, so an early diagnosis is decisive. If you notice one or more of these signs, consult your dental practice.
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The essentials at a glance
- Periodontitis is an inflammation of the tooth-supporting tissues – the gums, the periodontal ligament and the jawbone.
- It usually runs its course without pain and is therefore often noticed late.
- The first signs are reddened, swollen gums, bleeding when brushing and persistent bad breath.
- Left untreated, jawbone is lost, teeth loosen and may fall out. This loss cannot be reversed.
- The earlier treatment begins, the more tooth substance can be preserved.
Answered briefly
Frequently asked questions
The cost depends on the steps involved and on which teeth are affected, so it differs from patient to patient. Before treatment begins, the practice draws up a treatment and cost plan setting out the charges. It also shows which costs the statutory health insurer covers and which additional services you have to pay for yourself.
An implant can last many years – what matters is how healthy the surrounding tissue stays. Anyone who has had periodontitis carries a higher risk: the same bacteria can attack the tissue around an implant. This is known as peri-implantitis.
Periodontitis should therefore be fully treated before an implant is placed. After that, aftercare decides the outcome: regular check-ups, professional cleaning and careful oral hygiene at home. On those terms, implants remain a reliable solution even after periodontitis.
Follow your dentist's instructions closely. They will tell you exactly what to watch out for.
A single application of enamel matrix proteins is normally sufficient. The regenerative process they set in motion continues over a longer period – often for more than a year.
Consistent oral hygiene is the key. Your practitioner will tell you whether further rules apply in your case – cutting down on smoking or giving it up, for instance.
Periodontal disease is usually caused by bacteria that settle between tooth and gum and trigger an inflammation. Existing systemic conditions such as diabetes, stress or inadequate oral hygiene can also influence how the disease progresses.
The first signs of periodontal disease are red, swollen gums, bleeding gums, receding gums, pain in the teeth and gums, loosened teeth, a bad taste in the mouth and bad breath.
Under 'Find a dentist' you can enter your postcode and narrow the search area to find a practitioner near you.
Bleeding gums can be a sign of periodontal disease. If it happens regularly, for example when brushing, you should consult your dentist.
During the active phase of treatment your dentist sets the intervals between appointments; depending on the stage of the disease these can be close together. Even without periodontal disease you should attend a check-up once or twice a year.
Detected in time, the progress of periodontal disease and the loss of one or more teeth can be prevented in most cases. If a tooth is already damaged beyond saving, removal is often the only option.
Connections exist with diabetes mellitus in particular, where poorly controlled blood sugar is a risk factor. Caries, stress or a generally weakened immune system can also encourage periodontitis. Periodontitis is in turn considered a risk factor for heart disease, for the premature birth of underweight babies and for arthritis. Hormonal changes during pregnancy can likewise trigger periodontal disease.
Gingivitis can be treated by improved and consistent oral hygiene. If gum problems persist, a dentist should always be consulted.
Depending on how far the periodontal disease has advanced and on the wish to keep the affected tooth, a surgical procedure may be unavoidable. Your dentist will tell you whether it is necessary in your case.
Yes, periodontitis can be transmitted – for example by sharing a toothbrush or cutlery, or by moistening a dummy in your own mouth.
Recent studies have shown that tissue rebuilt with the help of enamel matrix proteins was still stable after five years.
In the worst case, untreated periodontal disease leads to the loss of the affected tooth or teeth.