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Periodontal disease, also known as gum disease, can be classified into gingivitis and periodontitis.
Gingivitis refers to the swelling of the gums (gum inflammation), whereas periodontitis affects the gums as well as the bone supporting the tooth.
Periodontitis can result in eventual bone loss and loss of teeth due to mobility. Gingivitis precedes periodontitis, but not all gingivitis cases progress to periodontitis.
Types of Periodontal Diseases (Gum Diseases)
The two types of periodontal or gum diseases are:
- Gingivitis: Swelling of the gums and the soft tissues surrounding the teeth
- Periodontitis: Advanced form of the disease that originates from the gums and spreads to the underlying tissues such as the bone supporting the tooth
Gingivitis 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 regimen. However, advanced forms of periodontal disease require tooth extraction.
Pathogenesis of Periodontal Diseases (Gum Disease)
The primary cause of periodontal or gum disease is plaque and tartar buildup on the tooth surface.
The cells of the immune system release substances against colonies of microorganisms present in plaque and tartar. These immune substances cause inflammation and the simultaneous destruction of the periodontal tissues.
Initially, it causes the first stage of the disease, which is gingivitis. With the continuous buildup of plaque, destruction of the underlying periodontal ligament occurs, causing periodontitis.
A snowball effect happens, where the plaque buildup below the gum line causes the gums to detach and form a space between the teeth called a periodontal pocket.
The pocket allows for more plaque accumulation, and cleansing becomes even more difficult, resulting in the underlying destruction of the periodontal tissues.
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 plaque, and it cannot be easily removed with toothbrushing. Calculus is rougher than enamel, and it favors further plaque accumulation, culminating in a downward spiral of periodontal disease.
Signs and Symptoms of Periodontal Disease (Gum Disease)
The mouth is the mirror of the entire body, and it is important to know the difference between normal and diseased areas.
Since the periodontal disease can be painless, it is crucial to note its signs and symptoms in the oral cavity.
Signs and symptoms of gingivitis include:
- Swollen gums
- Bleeding from the gums
- Red or bluish-red gums
- An ill-defined contour of the gums
Signs and symptoms of periodontitis include:
- Swollen and tender gums
- Bleeding from the gums
- Red or bluish-red gums
- Persistent bad breath or a bad taste in the mouth
- Gums that recede or move toward the root
- Mobile teeth
- Visible pus in the surrounding teeth and gums
Treatments for Periodontal Disease (Gum Disease)
Several medical treatments are available to manage periodontitis:
- Scaling: This treatment is done to remove the tartar accumulation on the teeth and gums.
- Curettage: It is a form of deep cleaning where the inflamed and diseased gum tissue is removed, consequently facilitating the healing of the tissues supporting the teeth.
- Flap surgery: This involves the separation of the gums from the teeth for the removal of dead tissues and hard deposits around the roots.
- Periodontal plastic surgery: A gingival or gum graft is performed to cover any exposed roots to augment the keratinized tissue.
- Splinting: Periodontal stabilization splints are used to stabilize the teeth that have become loose and to make it more conducive to taking up biting forces.
Home Remedies for Periodontal Disease (Gum Disease)
Various home remedies can be used to manage gum disease.
1. Oil pulling
Oil pulling has been used extensively in traditional medicine to strengthen teeth and gums and prevent oral malodor, bleeding gums, dryness of the throat, and cracking of the lips. It can also strengthen and promote good periodontal health. (1)
Directions:
- Swish a mouthful of organic, unrefined coconut oil or sesame oil in your mouth for 15–20 minutes.
- Spit it out and rinse your mouth with warm water.
- Do this daily in the morning before brushing your teeth.
Oil pulling may prevent plaque buildup and may strengthen the gums to help treat periodontitis.
2. Turmeric
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. (2)
How to use:
- Use turmeric powder to brush your teeth and gums with a soft-bristled toothbrush. Do this twice a day for a few weeks.
- 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 to your gums before going to bed. The next morning, rinse your mouth with warm water. Do this once daily for several weeks.
The curcumin present in turmeric may help promote oral health by inhibiting bacterial activity and the resultant plaque formation.
3. Guava
Being rich in vitamin C, guava is also considered an excellent remedy for periodontitis. It works as an antiplaque agent and helps in removing plaque on the teeth and gums. Plus, it’s anti-inflammatory and analgesic properties help reduce swelling and pain in the gums. (3)
How to use:
- Wash some tender guava leaves. Chew the leaves thoroughly, and then spit them out. Do this regularly to stop the bleeding and reduce the risk of pus formation in the gums.
- Cut unripe guava into four pieces. Sprinkle salt on the guava pieces and chew them slowly. It helps reduce plaque and strengthen your gums and teeth.
The anti-inflammatory, antiplaque, and analgesic properties of guava can help in the treatment of periodontitis.
4. Neem
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. (4) Also, it helps combat bad breath and keeps your gums and teeth healthy.
How to use:
- Extract the juice from a few neem leaves. Apply this juice on your gums and teeth, allow it to sit for 5 minutes, and then rinse it off with warm water. Do this treatment 1–2 times daily.
- Use soft neem twigs to brush your teeth and gums twice daily.
Neem possesses antiseptic and antibacterial properties that can aid relief from gingivitis and periodontitis.
5. Holy basil
The use of holy basil 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, such as toothaches and pus formation or pain in the gums. (5)
How to use:
- 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-bristled toothbrush. Do this twice a day for several weeks.
- Drink a few cups of basil tea daily or use it to rinse your mouth to treat and prevent periodontitis.
Holy basil is used in mouth rinses and other oral hygiene products for its antibacterial activity.
6. Salt
The antiseptic and antibacterial properties of salt can take care of the bacteria that cause periodontitis. Plus, it can reduce inflammation and pain.
How to use:
- Add 2 teaspoons of salt to a glass of lukewarm water. Swish a mouthful of this solution in your mouth for 1 minute. Spit and do it again. Do this treatment 2–3 times a day.
- 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 your mouth thoroughly with warm water. Do this remedy daily in the morning.
7. Cayenne pepper
Cayenne pepper has anti-inflammatory properties that can help reduce gum swelling caused by periodontitis. Rich in capsaicin, cayenne pepper also helps in reducing pain. (6)
Directions:
- Put a few drops of cayenne pepper tincture on a soft-bristled toothbrush.
- Use it to brush your gums for a few minutes.
- Rinse your mouth thoroughly with water.
- Do this treatment once daily to help relieve pain and reverse periodontitis.
8. 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 such as oral thrush and herpes.
How to use:
- Apply tea tree oil in gel form using a toothbrush twice daily for several weeks.
- Add a drop of tea tree oil to your regular toothpaste and brush your teeth with it twice daily.
Lifestyle Changes to Prevent Periodontal Disease
Just like many diseases, periodontal disease is preventable, provided the following habits are included in your daily routine.
- Brush the right way: Take a pea-sized amount of toothpaste and brush your teeth using the brushing technique prescribed by your dentist.
- Brush twice a day: It is mandatory to brush both in the morning and after dinner at night. Also, bacteria can accumulate on the tongue, so do not forget to brush it too.
- Floss on: The areas in between teeth cannot be accessed with a toothbrush. The plaque buildup there has to be removed using dental floss.
- Swish with a mouthwash: A mouthwash can help in removing the plaque and tartar that are left behind after brushing and flossing. Certain medicated mouthwashes can also help in preventing plaque and tartar buildup on the tooth surfaces.
- Be aware of your risk: When you have certain systemic diseases or consuming certain medications mentioned above, please be aware of your risk for periodontal disease.
- 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 good periodontal health.
Risk Factors for Periodontal Disease
Certain factors can increase the risk of periodontal disease development, including:
- Smoking/tobacco chewing: Smokers do not respond favorably to periodontal therapy, and smoking cessation has been shown to improve periodontal tissue status. (7)
- Diabetes: Periodontal disease is worsened in diabetic individuals due to the high glucose content.
- Genetic: Some people are more prone to periodontal disease, but with proper preventive and treatment programs, periodontal disease can be controlled.
- Stress: Stress has a direct effect on and can weaken the body’s immune system, worsening periodontal disease and making it difficult to treat. (8)
- Malaligned teeth: Teeth that are crowded or malposed can be plaque-retentive zones. Proper oral hygiene measures need to be followed; if not adhered to, worsening of periodontal disease can result.
- Hormonal fluctuations: Various stages in a woman’s life cause fluctuation of hormones, which has a detrimental effect on periodontal tissues.
- Medications: Certain medications, such as anti-epileptics (phenytoin), antihypertensives (nifedipine), and immunosuppressants (cyclosporine), cause enlargement of the gums. This can be corrected when the drug is substituted and the enlarged gums are guided back to periodontal health.
Final Word
Gum disease often doesn’t cause any symptoms, but it can result in permanent tooth damage. Therefore, it is important to be aware of the subtle changes in your teeth and maintain good oral hygiene.
The most common factors that can predispose you to gum disease include smoking and stress. Always consult a dentist if you experience gum problems, as it can lead to tooth loss as it worsens.
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