Signs and Symptoms of Periodontal Disease

Periodontal disease includes conditions such as gingivitis, periodontitis, and peri-implant diseases. These are often “silent” conditions, with most individuals experiencing no symptoms, much like chronic conditions such as hypertension or cardiovascular disease. Regular dental check-ups are crucial for screening and diagnosis. However, certain signs and symptoms may indicate the presence of periodontal disease.

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Bleeding Gums

The gums are akin to the skin in the mouth. Bleeding from the gums is comparable to skin bleeding—it signals a problem.

• Spontaneous or brushing-induced bleeding: Bleeding may occur spontaneously in cases of severe inflammation but is more commonly noted after brushing. Even minimal bleeding is a potential sign of gum disease and should not be ignored.
• Hidden inflammation: A lack of visible bleeding doesn’t necessarily mean the gums are healthy. Inflammation may exist in deeper gum pockets, detectable only through professional examination or only in the interdental areas which can only be accessed by interdental brushes.

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Visible Inflammation of the Gums

Healthy gums are pink and firm. In the presence of inflammation, the gums may appear:

• Reddened and swollen: These are signs of insufficient plaque removal and early gum disease.

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Bad Smell or Taste (Halitosis)

Periodontal disease may cause:

• Persistent bad breath or an unpleasant taste: This can affect eating habits and confidence. Successful treatment of periodontal disease often resolves these issues.
• Other contributing factors: Dehydration, digestive problems, or acid reflux can also play a role.

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Swelling of the Gums

In some cases, individuals may experience:

• Recurrent gum swelling: Often around the same teeth or different areas of the mouth. This can indicate severe periodontitis.
• Associated symptoms: Discomfort, profuse bleeding, pus discharge, and bad odour or taste. Diabetics with poor glycaemic control may be more susceptible.

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Gum Recession

Periodontitis often leads to:

• Receding gums: Exposing tooth roots and forming dark “black triangles” between teeth.
• Aesthetic concerns: The teeth may appear longer and more triangular, exposing darkened roots, metal crown margins, or dental implants. This can significantly impact confidence and aesthetics.

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Food Packing Between Teeth

Gum recession and periodontal pockets can result in:

• Food trapping: Certain foods, like salad, meat fibres, or seeds, may lodge between teeth, causing irritation or discomfort.
• Recommended cleaning tools: Use interdental brushes, such as those from The Teeth Keeper, to remove lodged food effectively.

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Sensitivity to Food and Drinks

Exposed tooth roots from gum recession may lead to:

• Temperature sensitivity: Usually to cold and occasionally to hot or sweet foods and drinks.
• Management options: Desensitising toothpastes, gels, or mouth rinses can help. Persistent or severe sensitivity should be evaluated by a dentist, as it may indicate other issues like cavities.

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Pain or Discomfort

Periodontal disease rarely causes pain unless very severe. Some individuals report:

• Itchiness or mild discomfort: Any persistent pain should be evaluated by a dentist to identify the cause.

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Movement of Teeth

As periodontitis progresses:

• Bone loss occurs, reducing tooth support. Teeth may shift, crowd, tilt, or protrude forward.
• Impact on oral function: This can affect biting, chewing, speech, and aesthetics.

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Loose Teeth

Teeth with substantial bone loss become:

• Loose and poorly supported: Although some loose teeth can be retained for years after stabilising periodontitis, their prognosis remains poor.

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Loss of Teeth

Severe periodontitis is a leading cause of tooth loss globally:

• Impact on quality of life: Tooth loss affects eating, digestion, and social confidence.
• Aesthetic and structural changes: Multiple missing teeth lead to facial sinking and an aged appearance.
• Rehabilitation challenges: Bone loss complicates treatments such as dentures or implants, requiring extensive procedures.

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Importance of Early Diagnosis

Recognising the signs and symptoms of periodontal disease early can prevent progression and tooth loss. Regular dental visits are essential for maintaining oral health and addressing these issues promptly.