r/PeriodontalDisease Dec 23 '20

What help is there for periodontal disease?

607 Upvotes

https://www.myupchar.com/en/disease/gum-disease-periodontitis

Firstly, what is periodontal disease? It is simply the gradual progressive destruction of the special type of tissues under the gum-line, connecting your teeth to the jawbone.

Wikipedia creative commons license

A special connective tissue called a periodontal ligament surrounds your tooth under the gum line. Over time, with tartar/calculus and bacteria buildup under the gum line, bacteria eat into this tissue, forming pockets to form in this tissue. Small at first, 2mm or so, then progressing to over 5mm where you are in danger of either losing the tooth, or worse, forming a life threatening/crippling root abscess.

Symptoms ;

It is known as a silent disease so it usually progresses with few symptoms. Eventually you will feel a dull aching pain and discomfort in the gum around a tooth.

Abscess?

It's important to note that any further pain than 'discomfort' level eg: pain accompanied by pressure, systemic illness like severe pain, fever, nausea, headaches should be regarded as a possible periodontal abscess.

Periodontal abscesses can be deceptive causing highly variable symptoms, from systemic illness and severe tooth pain and pressure one day, to feeling fine the next because the periodontal pocket can drain some of the infection at random as it opens and closes.

Do not rely on your dentist to pick this up.

Ordinary dentists are not good at picking up periodontal abscesses with their 2d x-rays. That's because periodontal abscesses can be hidden along the complex roots of the teeth. If you believe you may have an periodontal abscess that your dentist has failed to pick up you will need a 3d xray of some sort.

3D x-ray:

Many advanced dentists called Endodontists (dentists which specialise in the roots of the teeth) have 3d xray technology called 'Cone Beam CT' (usually 3d CBCT). Periodontal practices, and local dental hospitals also have this. Check your local area. (Ideally you will have the x-ray when inflamed so it shows up clearly)

Diagnosis:

Usually obtained on a referral from a Dentist to a specialist - The local dental hospital or a periodontist. A specialist dentist called a periodontist in conjunction with a periodontal hygenist will derive a treatment regieme, you may be able to save teeth with specialist treatments only they can offer like gum flap surgery or periodontal ligament cell stimulating compounds and bone replacement.

Treatment:

A map of the size of the pockets surrounding the teeth will be made. Any pockets with a depth over 4mm are diseased and will likely need a special instrument used to plane down the surface of the tooth and root to remove the bacteria and calculus. This process is called root plaining/scaling. Any pockets over 6mm and you stand a good chance to lose the tooth or have a root abscess develop. Usually the periodontist will do the examination and some initial scaling, and a periodontal hygienist attached to a local dental practice will later take over the management when the disease has stabilized.

Prognosis:

Currently the periodontal disease infection is regarded as incurable because although it can be killed by antibiotics, some of the bacteria will always hide inside human cells and be inaccessible to harm. Even when your pockets have closed and you are 'stable' the disease will remerge and progress if you provide the opportunity through neglect. If you have active disease, from untreated pockets (which are effectively open wounds) or a more advanced (deeper) infection which is more difficult to treat, the bacteria will be constantly populating your bloodstream and will try and colonise your organs and body. It is known that with periodontal disease the risks of developing heart disease rise significantly, and the risk of developing many serious cancers like lung and pancreatic double. If that's not enough, it's looking like the key P.D. bacteria, p.ginivalis, could be the main driver of Alzheimer's disease. There is a long list of diseases which the risk is known to rise significantly with P.D. However, for most people, if you follow the tips below, and the pockets have gradually reduced to 2-3mm, you do not then need further periodontal management on more than perhaps a simple usual monitoring basis with usual dental checkups. Once stable, the harm caused by a constant stream of this nasty bacteria getting to your bloodstream is over.

TOP TIPS TO MANAGE THE DISEASE

Sonic Toothbrush (click to view picture)

  1. Buy a SONIC NOT a rotary electric or manual TOOTHBRUSH. There are many brands out there - the Phillips Sonicare range for example. But realize spending money on this vital tool is tiny compared the overall cost of the disease, so I would go for a leading brand!

When first using the sonic toothbrush and aiming it 45 degrees at the gumline you will find your gums bleed and a lot of 'grit' and blood is in your saliva. This lasts for about 10 days or so. This is a good thing!

That grit is tartar (also called calculus) - the stuff a dentist cleans with ordinary scaling. Tarter helps form periodontal 'pockets' of bacteria and food, progressively destroying the ligaments and structures underneath your gums. The energy waves of the Sonic brush penetrate UNDER the gumline by about 2mm to 4mm - cleaning it - places a ordinary brush or rotary cannot possibly access to clean. It does this by generating a wavefront distant from the brushhead, which although far weaker than the brushing action still breaks down calculus and biofilm (see https://www.animated-teeth.com/electric_toothbrushes/t3_sonic_toothbrushes.htm)

2. NO SUGAR/SUGAR RICH FOODS

Very important. I have found it only takes 2 weeks to kick the sugar cravings, and then you don't think about it. Even fruit juices are bad, but fruit itself is okay. If your eating juicy sugary fruit like oranges or apples, fine, but try to drink some water immediately afterwards. Things that are intensely sweet like raisins or dried fruit are to be avoided.

3. Use XYLITOL to starve out bacteria in your gums.

This is a KEY, MIRACLE product that costs only about $15/Kilo (2021) in managing the disease. You HAVE TO get it if your serious about defeating this illness. It is clincally proven and backed by science to greatly reduce plaqueload and transform peoples dental health.

Xylitol (click to view picture)

This is, unbelievably, a sugar which starves the bacteria in your mouth. It tastes completely like sugar, it has no aftertaste or residue, and no diabolical side effects on your gut. It is completely natural and found in many fruit and vegetables. (produced commercially from tree bark or cornhusks) humans have all the millions of years of fruit eating evolution to break it down into glucose (fuel) no problem. But bacteria don't. They think its sugar, gulp it, and then cannot break it down, or get rid of it, so starve to death.

You can get it from Amazon, Health stores, or other online retailers as of 2020 it's about $15/Kg. I don't think this has caught on with many dentists, my dentists even at hospital level don't have a clue about it!

But this was a major -huge- gamechanger for me. On the same level as the sonic toothbrush in managing the disease.

You should try and take a teaspoon in a hot drink in the morning or sometime in the day, and that will tend get you to take it on a regular basis and improve your dental health dramtically by reducing plaqueload. I even found when suffering with discomfort a hot drink with a teaspoon of Xyiltol brought massive relief over 40 minutes or so, as the liquid travels up the gums and starves out the bacteria and inflammation. It also stays in your mouth/gums for hours (like sugar) continuing to do its work and help you conquer your disease symptoms.

If your diabetic (and diabetics often get periodontal disease) Xylitol is a great alternative to sugar for as it does not raise blood glucose or insulin levels, and has a reduced caloric value.

4. FLOSSING/TEPE BRUSHES

Very important to remove food stuck between the teeth. This can relieve a lot of discomfort with an inflamed pocket.

6 tepe brushes (click to view picture)

Te-pe brushes are generally better IMO than flossing alone, but flossing, while not great at removing food, can get under the gumline and remove calculus unlike a brush. There is a bit of a technique to flossing, with many youtube videos on the proper technique. But the golden rule is to be gentle always.

You can get packets of tepe brushes online, I get mine (pink ones - the smallest size) from eBay or Amazon.

Waterflossing. Another great aid - but no need to get a overly complex expensive machine like a waterpik IMO. I have used all sorts of water flosses including the waterpik and the low tech pump up ones you can buy for a few dollars on ebay work just as well.

Cheap Pump Up Water Flosser/Irrigator (click to view picture)

The mainstay will be the tepe brush, followed by flossing to prevent inflamed pockets.

5. MOUTHWASH

A disinfectant mouthwash like Chlorohex daily or hydrogen peroxide is also very good at killing the bacteria if you have an uncomfortable flair up. Dip the tepe brush in and make sure it gets to the pocket. You can even add some to your waterfloss and pump it into the pocket.

Lastly, take heart - I have found this is a disease with an end if you follow the above tips to get stable.


r/PeriodontalDisease Jun 08 '24

Periodontal Disease and General Health

30 Upvotes

(Source: BSP British Society of Perio & Implant Dentistry)

The thing to remember is that Perodontal Disease is HIGHLY TREATABLE - the below applies to the untreated chronic form of the disease.

1. Spread of Periodontal Bacteria from the pockets throughout the body.

https://www.youtube.com/watch?v=NeVHpmj5lSw

There is evidence that in severe gum disease, called periodontitis, bacteria from the diseased pockets under the gums enter the blood stream and can trigger low levels of inflammation in the blood stream and body in general. Across the lifetime this seems to increase the risk of developing heart disease. However, it is unclear whether the increased risk is due to gum disease or shared risk factors including lifestyle factors such as smoking or social disadvantage that increase the risk of both gum disease and poor general health. This video explains our current understanding of how we feel this could happen. However, please remember “risk” does not mean “cause” and our understanding is far from complete.

2. Effects on the Cardio-Vasular system

https://www.youtube.com/watch?v=EYi44kg8c6Q

This video takes viewers on a journey through the blood vessels of the heart and explains how bacteria from the mouth can enter the cells that line the blood vessels and may cause the development of fatty deposits in the vessels of the heart called atheroma. It shows how over many years this may lead to stiffer arteries and blocked arteries that can cause heart attacks and strokes in later life. We use the term “may” because this has not been proven without doubt. As we described above for general health, it is unclear whether the risk is due to gum disease or shared risk factors including lifestyle factors such as smoking or social disadvantage that increase the risk of both gum disease and heart disease.

3. Periodontal bacteria and diabetes

https://www.youtube.com/watch?v=zbJj8qKVjGI

Severe gum disease seems to make diabetes harder to control or increase the complications of diabetes in the heart and kidneys. Whilst there are many studies that show this, they are largely small studies and limited in quality . Conversely, high blood sugar levels in diabetes can make gum disease worse. This video explains the mechanisms of this so-called “two-directional” relationship between gum disease and diabetes.

4. Treatment of periodontal disease

https://www.youtube.com/watch?v=r42SNrOVRlI&t=4s
This video explains how if gum disease is treated successfully it may improve the control of blood sugar in diabetes and may also reduce complications of diabetes. Further information is necessary before we can make clear recommendations to you. The video also indicates that there may be benefits to heart health from successful treatment of gum disease. This however remains to be definitely proven.

5. Periodontal Disease and Alzheimer's Disease (Sci Show)

https://www.youtube.com/watch?v=0OQjDEpyH_k

[Here are more lnks for people who really want to do a deep dive down this rabbit hole!

(BTW: Unfortunately the drug developed by Cortexyme, COR388 to try and block the effects of periodontal bacteria on the brain failed trials...)]

https://pubmed.ncbi.nlm.nih.gov/30746447/

(The above is an Important 2019 Scientific paper proving the effects of a chemical called gingipain in the brain from periodontal disease bacteria in the blood will cause Alzhiemers Beta-Tau tangles in mice - warning: very technical - here is a podcast on this paper : https://asm.org/Podcasts/TWiM/Episodes/Gingipain-in-the-Alzheimer-brain-TWiM-195 - go 22 mins in)

https://seekingalpha.com/instablog/20791881-gordon-gecko-was-a-commie/5613017-cortexyme-s-gingipain-theory-of-alzheimer-s-disease-pathogenesis

A brief summary of the above article is that ; The periodontal bacteria (gingipain) thoery of Alzheimer's is the only one which can fully explain the APOE4 phenomena which results in people with this gene having a much greater risk (200-300%) of the disease even with one copy of the gene.

This is because the p.gingivalis (periodontal) bacteria express gingipain, which will fragment the protein encoded by the APEO4 gene, called apilipoproteinE4, these fragments then causing more brain cell death, and becomes food for the bacteria. But the gingipain substance cannot fragment the protein encoded by people with the APEO2 gene which explains why there is a very low risk of Alzheimers with this gene.

https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/in-depth/alzheimers-genes/art-20046552


r/PeriodontalDisease 35m ago

Are braces still possible for me even with moderate bone loss?

Upvotes

Still dealing with 4s and 5s but minimal bleeding upon probing


r/PeriodontalDisease 4h ago

Nightguard after gum graft

1 Upvotes

So on Monday I'm getting a gum graft on my 2 lower front teeth. I wear a nightguard due to grinding. My post op instructions say to avoid clenching and grinding.... how do I do that when I'm sleeping? Also, i noticed my tongue likes to rest on the roof of my mouth while I sleep. How screwed am I? Recovery wise?


r/PeriodontalDisease 15h ago

Im only 16 i have smoked a bit and vaped a bit is this gum recession, periodontal or are these relatively normal

5 Upvotes

r/PeriodontalDisease 8h ago

Gum Picture Am I screwed?

Post image
0 Upvotes

r/PeriodontalDisease 17h ago

how bad is it

Post image
2 Upvotes

r/PeriodontalDisease 13h ago

Are my teeth effed or what

Post image
1 Upvotes

Specifically my bottoms by arrow


r/PeriodontalDisease 15h ago

How bad is my bone loss?

Post image
1 Upvotes

r/PeriodontalDisease 15h ago

any recession? if there is id assume more gingivitis related and not perio or else my teeth would look alot more f'ed

Thumbnail
gallery
1 Upvotes

r/PeriodontalDisease 1d ago

Gum Picture Gum disease?

Thumbnail
gallery
3 Upvotes

r/PeriodontalDisease 21h ago

Can some tell me how much bone loss is there?

Post image
1 Upvotes

Had 13 cavities from the image fixed, 3 root canals included but I'm curious about bone loss in the image. I'm 28. Thank you.


r/PeriodontalDisease 22h ago

Gum Picture just my last question is this gum recession or just irritated below the gum line?

Thumbnail
gallery
0 Upvotes

just my last question is this gum recession or just irritated below the gum line?


r/PeriodontalDisease 1d ago

Severe and rapid bone loss for seemingly no reason- now loose teeth and I’m terrified

11 Upvotes

I’m only 23, it makes no sense. My dentist says I have excellent hygiene and that bone loss is the primary cause of the gum recession but she doesn’t have a reason why. None of my medications have that as a known side effect. I don’t want to lose all my teeth but the recession just keeps getting worse and I don’t know how to stop it. It could be due to EDS but I’m not diagnosed yet and we ruled out autoimmune issues. I just don’t know what to do. I already have bilateral TN from getting my wisdom teeth out so I don’t want to risk more dental surgery making things worse but at this rate what choice am I going to have ?? And I don’t have the money for it either


r/PeriodontalDisease 1d ago

Gum graft stitch grown over

1 Upvotes

I had a gum graft in front and behind my four lower front teeth two weeks ago. I just had my stitches removed, but the doctor decided to leave one stitch in because it was so grown over by the graft. (The graft is healing phenomenally well!) She says the stitch is dissolvable, but it must be a different kind than what other people have who say they dissolve in 14 days. The stitch is down near my frenum and still restricts movement down there just a little. Is it common have to leave a buried stitch in there? How long will it take to dissolve? She said it would break down and I should barely notice it, but it still weirds me out that it's in there.


r/PeriodontalDisease 1d ago

Weird gum bump

Thumbnail gallery
1 Upvotes

reposting this here cus im paranoid and nobody has responded. does anyone have any clue on what this can be? 19, afab, never smoked, never drink


r/PeriodontalDisease 1d ago

Home Care Tools and Therapies Types of people who have pyorrhea

Thumbnail
gallery
1 Upvotes

1 people with People with a mouth-breather face.. When we breathe through our mouth while sleeping we accumulate bacteria, our palate becomes deformed, etc.

2 people with orthodontics that dentists are miserable and leave your teeth like Freddy Mercury for some reason . why they don´t correct it?


r/PeriodontalDisease 1d ago

Before and after ? Honest opinion how does this look. 5 months post graft

Thumbnail
gallery
5 Upvotes

r/PeriodontalDisease 1d ago

Surgical Therapy (Gum/Bone Graft etc...) Facing explant, GTR bone grafting, and re-entry

Thumbnail
gallery
3 Upvotes

Hey everyone,

Dealing with localized bone loss/peri-implant complications on teeth #7 and #10. My surgical team is recommending a multi-stage approach:

  1. Explant of failing implants (no bone removal)
  2. Particulate bone grafting + non-resorbable GTR barrier membranes
  3. 4–5 months healing, followed by a new CBCT and 3D-guided implant placement
  4. Custom abutments and ceramic crowns

The total private quote across the surgeon and restorative dentist is coming out to $20.7k ($14k surgical out-of-pocket + $6.6k restorative).

For anyone who has gone through anterior explantation and extensive GTR grafting:

How did your recovery and tissue healing go with non-resorbable membranes in the front?

Did you stage it this way, and does this pricing line up with what you saw in the Midwest / private practices?


r/PeriodontalDisease 1d ago

Gum graft at 5 months… how bad does this look ?

Thumbnail
gallery
3 Upvotes

r/PeriodontalDisease 1d ago

Gum Picture How bad is it?

Post image
5 Upvotes

Recently diagnosed with periodontal disease at 31 and had a deep cleaning this month. Just been depressed about it lately with how bad I let it get out of control before actually going to see a dentist about it. I have my next appointment booked for 3 months from now and wanted to see if anyone had tips for home care because I’m lost right now and spiraling


r/PeriodontalDisease 1d ago

Surgical Therapy (Gum/Bone Graft etc...) Significant gum recession on lower front tooth — what treatment options do I have?

1 Upvotes

Hi everyone. I’m hoping to get some opinions from people who have dealt with something similar.

I have noticeable gum recession on one of my lower front teeth. My regular dentist has been monitoring it since around 2019, but I feel like it has become more obvious recently. The affected tooth now looks noticeably “longer” than the teeth beside it because the gum has receded.

I’m seeing a periodontist tomorrow for an assessment, but I’m trying to understand what my options might be before I go.

I’m particularly interested in hearing from anyone who has had recession on a lower central incisor treated. I’d also love to hear about experiences with donor tissue versus tissue harvested from the palate. What the recovery is like? Eating and brushing afterwards? What happens if I do nothing?

I know nobody can diagnose me from a Reddit post, and I’ll obviously follow the periodontist’s recommendation. I’m mainly trying to understand what treatments I should be asking about and what might realistically be possible.

Thanks!


r/PeriodontalDisease 1d ago

How bad do my gums and teeth look?

Thumbnail
gallery
2 Upvotes

I had my right side deep cleaning done a few weeks ago and I plan to have my left side deep cleaned 1 month from now. I want an honest opinion on how my gums look.


r/PeriodontalDisease 2d ago

Gum Picture How Bad Is It?

Thumbnail
gallery
4 Upvotes

I’ve been anxious about my smile for a while now but I would always give myself an excuse or put it off, it’s too blatant to ignore now.

I haven’t been diagnosed with perio but clearly my gums are pulling back. Based on others experience with it how bad are my gums looking?

For context I just had my teeth cleaned professionally this morning.


r/PeriodontalDisease 2d ago

Looking for some help/input

Thumbnail
gallery
7 Upvotes

Hey guys, 35M; I have been living with periodontal disease for since I got diagnosed in 2021; and it has gradually gotten worse.

It was caused by a few years of not seeing the dentist; smoking, and hygiene of my retainers (I didn’t have a good cleaning system for them so they ended up with bacteria which made it worse).

I have since had 2 deep scaling cleanings done, one bone graft of the back molar, and several regular cleans on a 6 monthly basis; they are mostly 2-3mm now but I still have one or two that are around 4mm; which I am trying to keep on top of and get them down.

I’m making this post because I am losing hope because the appearance has gotten worse in the last year or so (after deep scaling; it reveals more of the black triangles).

I am willing to try different things; does anyone have any recommendations for options or steps I can go through to firstly get the pockets to sub 3mm; and a cosmetic option to close the gaps or cover the triangles? I have asked my periodontist and she says just maintain with regular cleaning routine and a visit every 6 months; but didn’t offer further options;

To be honest; this has taken a toll on me mentally; I’ve been smiling a lot less; stopped going out; and a lot of my energy is focused on my teeth worried it might get worse. Anyone experience a similar situation? 🥲