DEFINITION

Periodontitis is a fairly common condition in which inflammation of the gums progresses to dissolve away the bone supporting the teeth.

DESCRIPTION

Periodontitis (or Pyorrhoea) is a condition which occurs due to plaque. People with Periodontitis often have particularly active forms of bacteria in their mouth, and/or have difficulty fighting off this form of infection. The inflammation from the bacteria causes the bone surrounding the teeth to be dissolved away which can cause loosening and drifting of teeth, and may even lead to loss of teeth because of lack of support. The gums usually show signs of problems e.g., gingivitis, including; swelling, redness and in addition to bleeding, there may also be pus present as well. This condition can be made worse by smoking and, by other medical conditions such as diabetes, leukaemia and other ailments resulting in poor immune function.

Most gum and tooth problems are due to poor oral hygiene. It is essential to regularly remove the bacteria (plaque) that naturally forms on teeth, to prevent gingivitis and Periodontitis. Bleeding gums are NOT normal. The bleeding is a sign of irritation caused by the bacteria. Bleeding gums need more (or better) brushing and flossing, never less. A toothbrush with a small head and soft bristles will more than adequately clean your teeth without causing damage to the teeth or gums. Always make sure you brush all your teeth both inside and out to ensure thorough cleaning.

Hold the brush with the bristles about 45 degrees to the tooth and gum and move the brush in a small circular action (concentrating on one tooth at a time). When a circular action is too difficult to manage try using a small horizontal scrubbing action. Use firm pressure, but never press too hard to not wear away the enamel. It is important to clean both the teeth AND the gum next to the teeth.

Brushes can only clean some surfaces of the teeth. To clean between teeth, it is important to use floss. Flossing can be a little difficult to start with but after a few weeks practise it becomes very easy. Most floss comes with instructions on the pack. It is important the floss passes slightly below the gum line to clean out the small crevice between the tooth and the gum. Brushing and flossing will not remove good fillings. Only fillings that are in poor condition may be removed by flossing and are best replaced before any further decay has the chance to form.

TREATMENT OPTIONS

As with all dental conditions your Dentist should be consulted. Patients with Periodontitis need special attention and will sometimes be referred for specialist treatment from a Periodontist. Your Dentist will diagnose and treat your particular problem. Periodontitis can usually be controlled but once the bone loss has occurred it is very difficult to ever restore it. Ask your Dentist about how to brush and floss your teeth. Your Dentist may recommend other oral hygiene aids such as; special toothbrushes and interdental cleaning sticks (toothpicks) which are available from your Pharmacist. Ask your Dentist to show you how to use these.

PHARMACIST'S ADVICE

Ask your Pharmacist for advice. 1) Your Pharmacy stocks a wide range of suitable toothbrushes. 2) Brushes can only clean some surfaces of the teeth. To clean between teeth, it is important to use floss. There are many brands and types of dental floss. Ask your Pharmacist for the floss recommended by your Dentist. 3) Consider using a toothpaste specially formulated for gum problems. 4) Ask your Pharmacist about mouthwashes which provide temporary help in controlling Gingivitis. 5) Follow the Diet Hints. 6) Sugarless chewing gum, available from your Pharmacy, can help to increase the flow of protective saliva to the teeth and gums. Saliva helps to neutralise acid which can damage teeth and also helps to prevent the growth of plaque. 7) Other oral hygiene aids such as special toothbrushes and interdental cleaning sticks (toothpicks) may be recommended by your Dentist and are available from your Pharmacy. 8) The symptoms of Periodontitis can be made worse by smoking. Your Pharmacist can provide guidance and support to help you quit. 9) Follow the Diet Hints.

DIET HINTS

- Having a wholesome, balanced diet helps to promote healthy teeth and gums. It is a good idea to eat plenty of fruit and vegetables which are good sources of vitamins, minerals and soluble fibre. - Food should be as fresh as possible and it is best to eat vegtables raw or lightly steamed if possible to help retain the nutrient content. - Try not to snack between meals. Eating between meals without brushing afterwards, allows plaque to build up which can result in Peridontitis and gingivitis. Eating between meals becomes a habit. - After eating it is important to clean your teeth to reduce the formation of bacteria which can cause Periodontitis and gingivitis. - Make sure that you clean your teeth before going to sleep. Going to bed without brushing allows plaque to grow on teeth and gums during the night.

SUPPLEMENTARY NOTES

The importance of good oral hygiene cannot be over emphasised. Having an adequate diet alone will not prevent gingivitis and Periodontitis. There is no substitute for good regular mechanical cleaning with a toothbrush, toothpaste and floss.

Calculus (tartar) is a hard and calcified plaque deposit on the surface of teeth which cannot be brushed or flossed away and needs to be removed by your Dentist. Calculus is always coated with a microscopic layer of plaque which may cause Periodontitis. It can form underneath the gum line and needs to be carefully removed by your Dentist. Due to the serious nature of this condition, your mouth should be thorougly checked by your Dentist on a regular basis.

REFERENCE SOURCES

All information has been compiled in collaboration with leading Dental Practitioners and Researchers.

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