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Periodontitis, also known as pyorrhoea commonly, refers to the class group of inflammatory disorders diseases or ailments that have an effect on the periodontal tissues circumscribing the teeth. Every time we take meals, bacteria or microorganisms get lodged in the mouth and they gradually form a ‘plaque’ or a film around the teeth by combining with mucus.

Brushing your teeth regularly can help prevent plaque formation and flossing helps as well. On the contrary, irregular brushing can leave behind traces of plaque that hardens with time leading to ‘tartar’ also called calculus. Once tartar develops, you cannot get rid of it by simple brushing. You have to seek medical treatment particularly from a periodontist.

When deep seated plaque or tartar is left totally untreated, it leads to a condition called ‘gingivitis’ where the gums get swollen causing them to bleed. Gingivitis is not a serious form of gum disease whose effects can be reversed through regular brushing, flossing and periodic scaling or root planning.

Gingivitis, if not treated in time, can lead to progressive forms of gum diseases such as periodontitis, which is damaging and more often the damages are permanent. The destructive forms or types are:
  • chronic and aggressive periodontitis
  • necrotizing periodontitis
  • systemic periodontitis (an indicator of some systemic disease like diabetes)
  • gangrenous or ulcerative periodontitis
  • periodontium abscesses or gum-boils

The aggressive or destructive forms of periodontitis are characterized by inflammatory gums that are unable to maintain their grip on the dentine (dental structure) and sags down, forming pockets that get infested. Toxins released by the microorganisms and the body’s response mechanism to combat the infection make the alveolar bone surrounding the teeth, brittle and, the connective tissues that clasp the teeth firmly get damaged. Eventually, the supporting structure comprising the alveolar bones, gum, and the connective tissues that keeps the teeth embedded get decayed and the teeth become loose and start falling off.


Periodontitis mostly afflict men and women in their thirties and forties although it may occur in younger age groups as well. Predominance of gum disease is more prevalent in men than women.  Although there are many causes and risk factors that are both directly and indirectly linked to periodontitis, poor oral hygiene has been established as the primary causative factor accounting for more than 60% of all the cases. Poor oral hygienic practices accelerate the process of plaque formation that progresses to form tartars.

Not maintaining proper mealtimes and not taking balanced diet are two other major risk factors. These two causes can cause malnutrition that can affect the health of the gums and teeth. Smoking is also responsible in a big way for accentuating the periodontal process and moreover, it can minimise the chances of an effective treatment. Tobacco abuse in smokeless/ chewing forms is also detrimental for gums and teeth.

Certain systemic diseases like diabetes, cancers, heart diseases, kidney diseases, and AIDS complete with their treatment procedures can have an adverse effect on healthy functioning of the gums or teeth leading to gingivitis and other damaging types of periodontitis.

Many people have a genetic predisposition for developing chronic and aggressive types and even necrotic forms of periodontitis. Hormonal imbalances like at puberty, menstrual periods, pregnancy, menopause and stressful periods can also predispose to various forms of periodontitis. 

Undergoing medical treatment and taking prescription or off the counter medicines can interfere with the smooth functioning of the salivary glands. Consequently, normal saliva secretion does not take place resulting in the dryness of mouth. This discrepancy makes the gums and the teeth susceptible to gum disease and its squeal.

When gum disease starts to set in, there are few tangible symptoms. Only when the periodontal disease becomes full blown, do the symptoms manifest themselves fully. At this stage, preliminary medical dental procedures such as scaling or root planning procedures might not prove successful. One might have to go in for comprehensive surgical procedures like bone or tissue grafting, and flap surgery.

Symptoms indicating gum disease comprise conditions such as:
  • halitosis (bad breath)
  • redness and swelling causing gums to bleed
  • recurrent gum swelling
  • sputtering blood post teeth brushing
  • experiencing pain during chewing
  • tooth sensitivity
  • drifting of teeth
  • teeth loss
  • receding gums


One may need to go in for corrective or invasive treatment procedures for controlling and reversing the infection. The periodontist or the dental specialist might suggest you to go for scaling for getting rid of tartar deposits or root planting for removing abrasive spots on the root of the tooth. Laser technique is being used increasingly in place of conventional treatment methods as it causes less discomfort.
Medications are used alongside such treatments to reduce and minimize the necessity to go for surgery but if periodontitis has progressed to an advanced stage, one will have to go under the scalpel (flap surgery/bone or tissue grafts). Medication categories include oral antibiotics, enzyme suppressants, antibiotic gels, and antimicrobial mouth rinses.
One has recourse to several natural solutions for taking thorough and proper care of gums and teeth. There are many home remedies as well that can help you take good oral care and the best thing about using natural antidotes is that they don’t have any side effects.

While using commercial toothpastes and mouthwashes read the ‘conditions of use’ and be aware of the possible risk factors associated with ingredients and additives that might be toxic or chemically polluting.
The following simple home-made remedies can be quite effective in maintaining oral health over the years.
  • Salt water rinse with tincture of myrrh or sage plant
  • Granules or powder of Propolis cera
  • Neem toothpaste and mouthwash
  • Myrrh tincture or powder
  • Mouthwashes containing calendula
  • Powdered cayenne pepper
  • Aloe vera
  • Tormentil
  • Mouthwash containing sage
  • Mint preparations
  • Certain toothpastes

Apart from the above remedies, there are number of other corrective measures one can take up including but not limited to Echinacea tincture, ginger tea with cinnamon, lemon and honey, and licorice root preparations. Gum packs containing vitamin E, turmeric powder, alum tincture, and turmeric powder works fine. Ayurvedic and herbal tooth powders work wonders.

One can also abide by the following hygienic practices that include:-

  • Brushing teeth regularly and at least two times in a day. Brushing at bedtime is most important.
  • Regular flossing for preventing plaque depositions and tartar formations
  • Regular visits to dentist for routine check-ups
  • Avoiding smoking or tobacco use in any form.

1) What is periodontal disease?

‘Peri’ means around and ‘dontal’ refers to teeth. So, periodontal disease is an infection of the gums, periodontal ligament and alveolar bones surrounding the teeth area. The early stage of the disease is known as gingivitis wherein the gums of the teeth gets affected with the infection. As the infection spreads to the other parts of the mouth, jaw and teeth it develops into something more serious resulting in symptoms like bleeding, swollen, sore and painful gums. It occurs due to leftover food particles trapped in the spaces between teeth and gums. When left uncleaned for long, they result in multiplication of germ causing bacteria in the mouth.   

2) How is periodontal disease diagnosed?

A visit to the dentist will enable you to diagnose if you have periodontal disease or not and its severity levels.  A dentist may help you check your dental history and check if symptoms like smoking, medication or some unhealthy eating habits are the underlying causes to be held responsible for the problem. He would check-up for plaque, tartar and bacteria built up in the mouth and also look for any deeper pockets made between gums and teeth with the help of tools and x-ray to determine the real cause and intensity of the disease.

3) Signs of periodontal disease

Look out for these signs if you suspect yourself to be suffering from periodontal infection or diseases. Bleeding or swollen gums, redness of gums or change in the appearance of gums from pink to dark purple, gums that bleed easily, gums that have turned soft and are painful to touch, spaces being developed between teeth, pus in the area between teeth and gums, bad breath, tooth abrasion or loose teeth, pain in the tooth and gum area while chewing, receding gums that are making your teeth look long and a change in the way the bite fits into your mouth.

4) Can periodontal disease be prevented?

With proper care and following healthy oral care habits can help prevent the disease. Brushing your teeth properly followed by flossing goes a long way in keeping your mouth, teeth and gums germs and bacteria free. Flossing helps get tiny food particles trapped in the spaces between teeth and gums out where the brush can’t reach. Removal of plaque and tartar is the key to keeping your teeth and gums infection free. Therefore, using an antibacterial toothpaste is always recommended as it helps control the spread and further accumulation of bacteria in the mouth.

5) What are some of the treatments that my dentist might recommend for periodontal disease?

A regular dental care check-up and visit to your dentist will help diagnose the problem at the early stages. Alternatively, doing so will help clean all the accumulated tartar and plaque from the surface of the teeth. A professional dentist would also suggest you to keep the health of your teeth and gums intact by regularly following the brushing and flossing routine. It will help clean food debris from deep within and keep your mouth clean and germ causing bacteria free. If the situation is of severe kind, the dentist will use tools and equipment to help clean the deep pockets within the space between your gum and teeth to make them smooth and diseases and infection free.

6) What happens after I receive treatment for periodontal disease?

While treatment for the disease may help you get rid of the immediate problem at hand, not taking care of your teeth and gum properly may again make the infection make a revisit. To keep your teeth and gums healthy all the time, a proper oral hygiene regime must always be followed, irrespective of the disease or infection you might have had. Using a quality toothpaste to brush your teeth twice daily will help control and prevent accumulation of germ and plaque causing bacteria in the mouth. A routine of flossing, post brushing, will help clear any food debris left inside the mouth or in the pockets between teeth and gums and keep the mouth healthy and clean to keep all dental problems away.

7) Can periodontal disease contribute to health problems beyond the mouth?

Not taking proper care of your gums, teeth and overall mouth can result in some serious complications, going forward. The bacteria and germs collected in the mouth, gums and teeth spreads across the body causing some serious health issues. From cavities, teeth decay to severe infection in the mouth & gum area and teeth abrasion; any kind of problem in the mouth gives birth to pain that can be unbearable and even fatal in near future. Research even says, people with serious tooth diseases like periodontitis are more likely to get heart problems, dementia and respiratory diseases compared to those who don’t have it.

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