What are Periodontal Diseases?
Periodontal disease, also known as gum disease, can be classified into
gingivitis and periodontitis. Gingivitis refers to the swelling of gums,
whereas periodontitis affects the gums as well as the bone supporting
What are the Types of Periodontal Diseases?
So, the two types of periodontal diseases include:
- Gingivitis: Swelling of the gums and the soft tissues surrounding the teeth.
- Periodontitis: Advanced form of the disease which originates from
the gums and spreads to the underlying tissues such as the bone
supporting the tooth.
The different types of periodontal diseases have to be treated in a
specific manner, and the treatment protocol varies according to the
What are the Causes of Periodontal Diseases?
The primary cause of the periodontal disease is the plaque and tartar
build-up on the tooth surface . The plaque and tartar consist of
colonies of microorganisms that are responsible for the initiation and
progression of periodontal disease.
The plaque deposits form on the teeth a couple of hours after brushing
the teeth, and inadequate cleansing measures will result in the
multiplication of the microorganisms in the oral environment.
Our body also behaves like a double-edged sword wherein while defending
against the microbial infection, the cells of our immune system release
substances that cause inflammation and simultaneous destruction of the
Initially, it causes the first stage of the disease, which is
‘gingivitis’ (swelling of the gums) and with the continuous build-up of
plaque, there is a destruction of the underlying periodontal ligament
and alveolar bone.
This results in the more severe form of the disease that is known as ‘periodontitis.’
There is a snowball effect where the plaque build-up below the gum line
causes the gums to detach and form a space between the tooth and it is
called a ‘periodontal pocket.’
The pocket allows for more plaque accumulation, and the cleansing
becomes even more difficult, resulting in the underlying destruction of
the periodontal tissues.
If left untreated, it can cause eventual tooth loss as the supporting
periodontal structures like the periodontal ligament, cementum, and
alveolar bone get destroyed due to the spread of the inflammatory
Another clinical manifestation is the formation of calculus (tartar) due
to the prolonged accumulation of plaque on the tooth surface.
Calculus is the hardened, calcified form of the plaque, and it cannot be
easily removed with the toothbrush. Calculus is rougher than enamel,
and it favors further plaque accumulation culminating in a downward
spiral of periodontal disease.
What are the Risk Factors for Periodontal Diseases
- Smoking/Tobacco Chewing: Smoking is one of the major risk factors
for periodontal disease . The ‘pack-years,’ which is the number of
cigarettes smoked and the duration of the smoking habit, determine the
extent of the severity of the periodontal disease. The smokers do not
respond favorably to periodontal therapy, and smoking cessation has been
shown to improve periodontal tissue status.
- Diabetes: Periodontal disease is one of the major complications in
diabetes . It has been shown that periodontal disease is worsened in
diabetic individuals due to the high glucose content. Also, periodontal
therapy is not recommended in individuals with uncontrolled diabetes.
- Genetic: Sometimes, it is all about the genes. Genetic
predisposition has been one of the probable risk factors for periodontal
disease . Some people are more prone to periodontal disease, but with
proper preventive and treatment programs, periodontal disease can be
- Stress: Stress has a direct effect on the body’s immune system, and
it can weaken it. This makes periodontal disease worsen and difficult to
- Mal-aligned Teeth: Teeth that are crowded or malposed can be plaque
retentive zones. Proper oral hygiene measures need to be followed, and
if not adhered to, it can result in worsening of periodontal disease .
- Hormonal Fluctuations: Various stages in a woman’s life cause the
hormones to fluctuate and this results in a detrimental effect on the
periodontal tissues. During pregnancy or puberty, women should be more
cautious as the hormonal levels can temporarily aggravate the
periodontal disease process .
- Medications: Certain medications like anti-epileptics (Phenytoin),
anti-hypertensive (Nifedipine) and immunosuppressants (Cyclosporine)
causes enlargement of the gums . This can be corrected when the drug is
substituted, and the enlarged gums are guided back to periodontal
What are the Signs and Symptoms of Periodontal Diseases?
The mouth is the mirror of the entire body and it is pivotal not to know the difference between normal and diseased areas.
The gums normally appear pink in color with a well-defined contour and
are firm in their consistency. The inflammatory disease process because
of the microorganisms results in a change in the color, contour, and
consistency. Since the periodontal disease can be painless, it is
crucial to note these signs in the oral cavity.
- Swollen gums
- Bleeding from gums
- Red/Bluish red gums
- An ill-defined contour of the gums
- Swollen and tender gums
- Bleeding from gums
- Red/Bluish red gums
- Persistent bad breath or a bad taste in the mouth
- Gums that recede or move towards the root
- Mobile teeth
- Visible pus in the surrounding teeth and gums
What are the Different Stages of Periodontal Disease?
In the gingivitis stage of the disease, it is usually reversible, and
with the removal of plaque and tartar, it can revert to normalcy.
In mild-moderate periodontitis, periodontal therapy can be advised in
various phases along with a strict oral hygiene maintenance regiment. In
advanced forms of periodontal disease, the extraction of hopeless teeth
may be the only treatment modality that can be advisable in those
What are the Different Treatments Available for Periodontal Disease?
- Scaling: This treatment is done to remove the tartar accumulation on
your teeth and gums. These hard and soft deposits harbor bacteria and
can contribute to decay and/or periodontal disease. The frequency varies
from person to person, and it is individualized, but the general
recommendation time is every 6 months.
- Curettage: It is a form of deep cleaning where the inflamed and
diseased gum tissue is removed, and this facilitates the healing of the
tissues supporting the teeth.
- Flap Surgery: Gingival flap surgery is a type of surgical procedure.
The gums are separated from the teeth, and this allows the periodontist
to reach the roots of the teeth and bone. The diseased tissues, along
with the hard deposits, are removed from the bone and root surfaces of
the teeth. The gums are folded back and sutured.
- Periodontal Plastic Surgery: Gingival recession or receding gums is
the exposure of the roots of the teeth caused by a loss of gum tissue
and/or retraction of the gingival margin from the crowns of the teeth
due to a high frenum. A gingival graft, also called gum graft or
periodontal plastic surgery, is a generic term for any periodontal
procedure in which the gum tissue is grafted to cover the exposed roots
or to augment the keratinized tissue.
- Splinting: The teeth can become loose and mobile due to periodontal
disease as a result of the loss of supporting bone or heavy bite stress.
Periodontal stabilization splints are used to stabilize the teeth that
have become loose and make it more conducive to taking up biting forces.
What Can Be Done to Prevent Periodontal Disease?
Just like most of the diseases, periodontal disease is also preventable,
provided these habits are inculcated in your daily routine.
- Brushing the Right Way: Take a pea-sized amount of toothpaste and
brush your teeth using the recommended brushing technique prescribed by
your dentist. The brush techniques can be customized according to the
individual and his/her periodontal status.
- Brushing Twice a Day: It is mandatory to brush both in the morning
and after your dinner in the night. The bacteria can hide on the tongue
too. Do not forget to remove it.
- Floss on: The areas in between your teeth cannot be accessed with
the toothbrush, and the plaque build-up there has to be removed with
- Swish with a Mouthwash: A mouthwash can help in removing the plaque
and tartar that has been left behind after brushing and flossing.
Certain medicated mouthwashes can also help in preventing plaque and
tartar build-up on the tooth surfaces.
- Be Aware of Your Risk: When you have certain systemic diseases or
consuming certain medications as mentioned above, please be aware of
your risk for periodontal disease. If you are a high-risk individual,
make sure to consult with your dentist.
- Refer to a Periodontist: If you have been diagnosed with periodontal
disease, your dentist will refer you to a periodontist who is a
specialist in treating your gums and alveolar bone. Make sure to follow
the instructions to achieve your periodontal health.
What are the Home Remedies for Periodontal Disease?
The antiseptic and antibacterial properties of salt can take care of the
bacteria that cause periodontitis. Plus, it can reduce inflammation and
- Add 2 teaspoons of salt to a glass of lukewarm water. Swish a
mouthful of this solution around in your mouth for 1 minute. Spit and do
it again. Follow this treatment 2 or 3 times a day.
- Another option is to mix a pinch of salt and a little mustard oil to
make a paste. After brushing your teeth, rub this mixture on the gums
and leave it on for 5 minutes. Then, rinse thoroughly with warm water.
Follow this remedy daily in the morning.
In traditional medicine, oil pulling has been used extensively to
strengthen the teeth, gums, prevent oral malodor, bleeding gums, dryness
of the throat, and cracking of lips. It can even strengthen and promote
good periodontal health .
- Swish a mouthful of organic, unrefined coconut oil or sesame oil around in your mouth for 15 to 20 minutes.
- Spit it out and rinse your mouth with warm water.
- Do this daily in the morning before brushing your teeth.
Turmeric can easily kill the bacteria present in the gums as well as
relieve pain and inflammation. Curcumin is the active ingredient in
turmeric, and it has potent anti-inflammatory and antioxidant
properties. It also promotes oral health .
- Use turmeric powder to brush your teeth and gums using a soft-bristle toothbrush. Do this 2 times a day for a few weeks.
- Alternatively, prepare a gum pack with turmeric to treat
periodontitis. Mix a pinch of turmeric powder with a little water or
vitamin E oil to make a paste. Apply it on your gums before going to
bed. The next morning, rinse your mouth with warm water. Do this once
daily for several weeks.
Being rich in vitamin C, guava is also considered an excellent remedy
for periodontitis. It works as an anti-plaque agent and helps in
removing plaque present on the teeth and gums. Plus, it’s
anti-inflammatory, and analgesic properties help reduce swelling and
pain on the gums .
- Wash some tender guava leaves. Chew the leaves thoroughly, then spit
them out. Do this on a regular basis to stop bleeding and reduce the
risk of pus forming in the gums.
- Another option is to cut unripe guava into four pieces. Sprinkle
salt on the guava pieces and chew them slowly. It will help reduce
plaque and make your gums and teeth strong.
Indian lilac, also known as neem, is also very beneficial in getting rid
of periodontitis. Its antibacterial properties help keep your gums free
from harmful bacteria. Also, it helps combat bad breath and keeps your
gums and teeth healthy .
- Extract the juice from a few neem leaves. Apply this juice on the
gums and teeth, allow it to sit for 5 minutes and then rinse it off with
warm water. Follow this treatment 1 or 2 times daily.
- You can also use soft neem twigs to brush your teeth and gums twice daily.
It is a good remedy for treating bleeding gums, one of the most common
symptoms of periodontitis. Its antibacterial property can reduce the
effect of harmful bacteria in the mouth. It also helps safeguard against
other dental problems like toothaches and pus or pain in the gums .
- Mix 1 teaspoon of dried and powdered holy basil leaves with enough
mustard oil to make a paste. Rub this paste on your teeth and gums and
brush gently using a soft-bristle toothbrush. Do this 2 times a day for
- You can also drink a few cups of basil tea daily or use it to rinse your mouth to treat and prevent periodontitis.
It has anti-inflammatory properties that can help reduce swelling of the
gums caused by periodontitis. Being rich in capsaicin, cayenne pepper
also helps in reducing pain .
- Put a few drops of cayenne pepper tincture on a soft-bristle toothbrush.
- Use it to brush your gums for a few minutes.
- Rinse your mouth thoroughly with water.
- Follow this treatment once daily to help relieve pain and reverse periodontitis.
Tea Tree Oil
Tea tree oil has natural antibacterial and antiseptic properties that
help fight microorganisms. Also, it helps reduce bleeding and gingival
inflammation . Tea tree oil is also beneficial for other dental issues
like oral thrush and herpes.
- Apply tea tree oil in the form of the gel using a toothbrush twice daily for several weeks.
- Another option is to add a drop of tea tree in your regular toothpaste and brush your teeth with it twice daily.