The answer to the question “how long can you keep your teeth with periodontal disease?” is highly dependent on your commitment to daily oral hygiene, regular professional cleanings and a balanced diet.
Without good brushing and flossing habits, bacterial plaque builds up on your teeth, forming little spaces that are referred to as pockets. These offer a sheltered environment for bacteria to grow, causing periodontitis.
Stage 1: Gingivitis
Gingivitis is the earliest stage of gum disease. It affects the area around your teeth and is often painful. Your gums will become red and swollen and may bleed when you brush or floss. You will have bad breath and your gums will be sensitive to temperature. This is easily treated with better oral hygiene, a more frequent routine cleaning and visits to the dentist.
When gingivitis is caught early, damage is reversible. Our hygienists will remove the bacterial plaque and will trim the edges of any fillings or crowns that protrude from your teeth, as it is harder to clean these areas.
Left untreated, gingivitis will progress to mild periodontitis. At this stage, the gums will pull away from the teeth and form pockets that trap food and bacteria. The gum tissue will start to degrade, causing tooth loss and creating pockets that a toothbrush and floss can’t reach. The bacteria will continue to eat through the bone, destroying it and leaving your teeth loose.
Stage 2: Plaque Buildup
This stage involves plaque forming near the gum line and irritating the gum tissue. It’s a bit more serious than gingivitis, since bacteria can enter the gum tissue and begin attacking teeth and bone.
When left untreated, plaque builds up and hardens into a substance called tartar that’s almost impossible to remove from your teeth. Tartar gives bacteria the staging ground they need to attack and damage your teeth and gums.
It’s important to keep in mind that there’s a strong correlation between periodontitis and cardiovascular disease. The bacteria involved in periodontitis can travel to the arteries and lead to inflammation. An elevated level of C-reactive protein is a key biomarker for inflammation and has been linked to heart disease.
Some modifiable risk factors for periodontitis include smoking tobacco and poor oral hygiene. Other non-modifiable risk factors include age and genetic diseases like diabetes mellitus. Regular dental visits and a healthy diet are essential for maintaining your smile in the long-term.
Stage 3: Pockets
When brushing and flossing do not adequately remove bacteria, infection-causing oral bacteria collect under the gums, forming pockets or crevices that our toothbrushes cannot reach. These pockets attract more food, plaque, and bacteria, causing the bacterial toxins to damage bone and tissue around the teeth. This leads to more inflammation and pain, along with more bacterial colonization.
If the pockets are 5 mm or deeper, more aggressive treatment is needed. This includes gum surgery, scaling and root planing (a deep dental cleaning), antibiotics, and antimicrobial mouth rinses to promote healing and deter bacterial colonization.
During periodontal surgery, the gums are numbed for your comfort and the area is cleaned above and below the gum line to remove infected tissue, reduce pockets and allow the tooth to heal. Afterwards, the teeth and root are repositioned tightly around the tooth and the pocket is reduced to a normal, maintainable size. Occasionally, there is sensitivity and discomfort after surgery; this will subside over the coming months as the area heals.
Stage 4: Bone Loss
When a person gets to the fourth stage of periodontitis, the infection has gone far beyond gingivitis. At this point, the bacteria have accumulated around the roots of teeth and in gum tissue pockets, leading to serious dental damage. The bacteria are also causing the bone to deteriorate. This damages the jawbone and can lead to other health problems. In addition, you may have loose teeth or a different bite than before.
At this point, the condition is not reversible without serious treatment. This might include using a probe to measure pocket depth (it won’t hurt) and taking dental X-rays. Treatment may also include oral antibiotics to fight infection and a surgical treatment to remove infected tissue. A specialist, called a periodontist, can also perform bone and tissue regeneration procedures. For example, they can graft healthy bone tissue to damaged areas of the mouth or gums. They can also do “flap surgery” to reduce the size of the pockets.