What is Periodontal Disease?


Periodontitis = chronic bacterial inflammation

The periodontal disease, popularly often periodontal disease called, is a chronic bacterial infection of the periodontal apparatus and the gums, which can even lead to tooth loss. The periodontium, also known as the “parodont” (around the tooth), consists of four different parts: the gums, the tooth itself, the tooth socket and the periodontal membrane. If one of the parts of the tooth support system is affected by this inflammation, it is called periodontitis and it can be assumed that it will gradually affect the other components of the tooth support system.


The term periodontal disease is also popularly used in connection with gingivitis. This does not correspond to the medically correct meaning. Periodontal disease, also called dental bed shrinkage, is the age-related and inflammation-free regression of the tooth support system (= connective tissue), often affecting the jawbone (= bony substance). As with untreated periodontitis, teeth can be lost.

Besides dental caries, periodontal diseases are the most common clinical picture in dentistry. After 45 years, the periodontal disease, the leading cause for the loss of teeth. But also, young people are increasingly affected by periodontal disease, according to studies. Around every 7th person under the age of 30 suffers from periodontitis.

This is frustration for anyone who brushes their teeth regularly and believes that they are doing a lot right. But brushing your teeth is not the same as brushing your teeth, but mostly has to be learned or trained in accordance with your own individual teeth as part of a therapy-oriented dental prophylaxis program. In addition, the risk of developing periodontitis varies from person to person.

In any case, it is clear that healthy, firm gums are an important protection against tooth loss and thus against dentures.

What causes periodontitis?

Healthy gums are firm, shimmering light pink and have a harmonious wave profile. In contrast, diseased gums are swollen, dark red, sometimes have an unpleasant smell and tend to bleed when you brush your teeth.

Periodontitis is caused by toxins from some types of bacteria that affect the gums. The toxins are created when the biofilm (Plague, dental plaque) is not regularly at the gingival margin and thoroughly removed. If these toxins exceed the defenses of the body’s own immune system, there is increased foci of inflammation, which causes the teeth supporting apparatus to become ill. The foci of inflammation detach the gums from the jawbone, which in a healthy state lies close to the tooth like a collar. Usually gum pockets then form where more bacteria and viruses can enter. Cleaning these gum pockets is very difficult and requires professional assistance.

The early stage of superficial inflammation of the gums caused by bacteria is known as gingivitis. If the gingivitis progresses, periodontitis develops. Untreated periodontal disease can spread to the entire jaw and even the entire dentition. As a result, the teeth are loosened due to the weakening of the teeth holding apparatus, including the bones, and they ultimately fail.

Is the risk of periodontal disease the same for everyone?

Although periodontitis is a widespread disease, there is still often a lack of knowledge about the general danger of this disease, its course and the individual risk. A major reason for this is likely to be the atypical inflammatory reaction in the body, since gingivitis and, as a result, periodontitis is usually not painful and the often-initial bleeding gums as gingivitis are not recognized or simply ignored. Therefore, periodontitis is always referred to as insidious and for the layman invisible disease of the gums spoken.

In most cases periodontitis progresses slowly (chronic periodontitis) and occurs more frequently after the age of 40. In some cases, there can be a rapidly progressing loss of tissue (aggressive periodontitis), which can also affect adolescents. In any case, therapy is essential.

What influences the individual risk of periodontitis?

The individual risk of developing periodontitis is subject to various influencing factors. The most important risk factors today are:

  • Inadequate oral hygiene
  • Smoke
  • Diabetes mellitus
  • Psychosocial stress
  • Unhealthy eating behavior (overweight or malnutrition and malnutrition
  • Genetically determined ( inherited) dysfunction of the immune system
  • Hormonal changes (menstrual cycle, pregnancy, menopause, etc.)
  • Obesity
  • High blood pressure

Chronically ill people such as diabetes, heart and rheumatism patients or also patients with autoimmune or cancer diseases suffer particularly from the consequences of periodontal disease due to possible interactions.

Knowledge of the individual risk of periodontitis is particularly important with regard to the consequential risks for general health. In the industrialized countries, periodontitis is not only one of the most common chronic infectious diseases, but periodontal diseases can have significantly negative effects on general diseases such as cardiovascular diseases (Heart attack, stroke, heart valve inflammation, endocarditis), lung disease (bronchitis), rheumatism (polyarthritis) or type 2 diabetes. Untreated periodontitis can even greatly increase the risk of premature birth during pregnancy.

If you belong to the group of high-risk patients, encounter several risk factors or have an attacked immune system, then a good cooperation between your dentist and your family doctor is recommended.

In principle, everyone over 40 years of age, even if they do not belong to a risk group, should take advantage of regular prophylaxis and six-monthly check-ups at the dentist. With this you not only take care of your teeth but also your general health and fitness.

Periodontal disease diagnosis

With the help of the Periodontal Screening Index (PSI), an expert can check the state of health of the periodontium. At the same time, although progressive periodontitis usually remains painless for a long time, everyone can pay attention to any symptoms or warning signals. The following signs can indicate periodontal disease:

  • Bleeding gums (e.g. during home oral hygiene or spontaneously)
  • Red, swollen and sensitive gums
  • Receding gums (enlargement of the gum spaces or dark triangles between teeth
  • Gums sensitive to touch
  • Sensitive tooth necks
  • Persistent bad breath or a persistent unpleasant taste in the mouth
  • Pus emerges from the gingival pockets
  • Loose or wandering teeth (larger distances between the teeth)
  • Changes in biting behaviour (bite)
  • Changed prosthesis fit , poor hold of the prosthesis
  • Gingivitis

If you discover one or more of these warning signs or symptoms, be sure to visit a dentist and let them know of your observations. He can carry out further clarification or refer you to a specialist in periodontics.

What to do with periodontal disease?

As with diagnosis, the dentist, ideally an expert with special training in periodontics, takes the leading role in treatment. The primary goals of periodontal treatment are to preserve as many teeth as possible and to recover the diseased tooth support system. To do this, it is first necessary to stop or at least slow down the progression of the disease in accordance with the latest findings in periodontology. After the basic periodontal examination, treatment usually takes place in three phases:

Initial or hygiene phase (phase 1) – in several prophylaxis sessions, plaque is removed and the patient is trained in oral hygiene at home and the relationships between care, eating habits and active prevention

Periodontal therapy (phase 2) – removal of bacterial plaque and calculus in the gingival pockets using curettes (hand instrument) and ultrasonic cleaning device, possibly under local anesthesia, is a prerequisite for successful therapy. This leads to the elimination of inflammation in the periodontium and to a reduction in the inflamed gum pockets.

Follow-up and maintenance therapy (phase 3) – control of the efficiency of home dental care , and above all a thorough professional cleaning of all bacterial tooth surfaces above and below the gums at regular intervals (2-6 times a year – called recall or follow-up session) as part of a therapy-oriented dental prophylaxis program .

It is also important to know that damage to the tooth support system due to periodontitis or periodontal disease cannot be completely repaired. Therefore, prevention, early diagnosis and therapy are of great importance.


1. 2X2 MINUTES: Dental and oral hygiene 2×2 minutes a day with fluoridated toothpaste.

2. CLEANING BETWEEN THE TEETH: Daily cleaning of the interdental spaces with dental floss and / or interdental brushes.

3. CLEANING BETWEEN THE TEETH: Daily cleaning of the interdental spaces with dental floss and / or interdental brushes.

4. CHANGE THE TOOTHBRUSHES: Change your toothbrushes regularly – at least 4 times a year and definitely after a cold.

5. TOOTH-FRIENDLY & BALANCED DIET: Sugary foods are not “taboo”, but they should be consumed in the right amount after a main meal, not as a snack between meals.

6. REGULAR FLUSHING: Regular rinsing is best with pure water to rinse out food particles and bacteria and to avoid dry mouth.

7. INDIVIDUAL PROBLEM AREAS: Pay attention to places where bleeding gums have already occurred or where you have been advised and brush there with particular care.

8. PROFESSIONAL TEETH CLEANING: You should have your teeth cleaned professionally at least 2 to 4 times a year.

9. DENTAL CHECK-UP: Go to your dentist for regular checks, at least twice a year.

10. QUIT SMOKING: Studies show that nicotine addicts have a nine-fold increase in the risk of periodontitis.

11. VITAMIN A / CAROTENOIDS & FOLIC ACID: Vitamin A / carotenoids & folic acid are said to have a supporting effect in periodontal disease. Both can be obtained from leafy vegetables. Since folic acid is sensitive to heat, it is therefore only contained to a small extent in cooked dishes.

12. OMEGA-3 FATTY ACIDS: Omega-3 fatty acids are also said to have positive effects in the fight against periodontal disease. Omega-3 fatty acids can be absorbed through various oils such as linseed oil, hemp oil or krill oil.


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