How is periodontitis caused?

Written by Li Bao Hua
Dentistry
Updated on April 10, 2025
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Periodontitis is a destructive inflammatory condition of the periodontal supporting tissues. The primary initiating factor of periodontitis is dental plaque, which occurs due to not brushing or rinsing promptly after eating. Over time, soft deposits accumulate around the teeth, which can calcify into tartar. The tartar contains a large amount of biofilm, such as the dental plaque biofilm, which can damage and cause bleeding or congestion in the gingival tissues, manifesting as bleeding when brushing teeth or eating. If gingivitis is not treated in time, it may lead to periodontitis. Periodontitis is also related to other systemic factors, such as genetic factors or smoking, mental stress, etc. Sometimes, discoloration of the tooth surfaces or food impaction can also cause periodontitis.

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What are the symptoms of periodontitis?

The main symptoms of periodontitis include: 1. Inflammation of the gums, which may present as bleeding, swelling, and a soft texture. Patients may experience bleeding while brushing their teeth, biting into hard objects, or even spontaneously. 2. Formation of periodontal pockets, where ongoing inflammation can lead to the development of periodontal pockets, resulting in the loss of periodontal attachment and causing bad breath. 3. Resorption of the alveolar bone, which can lead to weakened chewing capability. 4. Loose teeth, shifting of teeth, or even tooth loss, accompanied by secondary jaw trauma, gum recession, increased space between teeth, weakened chewing capability in the molars, fan-shaped spreading of the anterior teeth, periodontal abscess, food impaction, root caries, tooth sensitivity, etc. Therefore, it is important to maintain oral hygiene by brushing teeth morning and evening, rinsing after meals, and regularly visiting a dental department at an accredited hospital for teeth cleaning and periodontal care.

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Does periodontitis require tooth extraction?

Whether tooth extraction is needed for periodontitis depends on the severity of the inflammation. If the periodontitis is not severe, with no absorption of the alveolar bone, and there is only simple inflammation of the gums, it typically manifests as gum bleeding or bleeding when brushing teeth. There can be dental soft plaque around the gums, or dental plaque irritates and causes the gums to become red, swollen, and pus may ooze. In this case, scaling can be done to remove local irritants, followed by rinsing and medicating around the teeth. This can effectively control the progression of periodontitis and does not require tooth extraction. However, if it causes absorption of the alveolar bone and significant loosening of the teeth, tooth extraction may be necessary.

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Is periodontal disease the same as periodontitis?

Periodontal disease includes periodontitis, but periodontal disease covers a much broader range than periodontitis. Periodontium is the supporting tissue of the teeth, which includes the gums, alveolar bone, and dental cementum, so the scope of periodontal disease is very broad, while periodontitis is just a branch of periodontal disease. Periodontitis is caused by tartar, soft plaque, or dental plaque around the teeth, which if not promptly removed by teeth cleaning, can lead to congested gums or bleeding during brushing. Severe cases can cause absorption of the alveolar bone. Once destructive absorption of the alveolar bone occurs, teeth will become loose and may even fall out. It can also be said that periodontitis is a severe stage in the further development of periodontal disease.

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What to do after tooth extraction due to periodontitis?

After tooth extraction due to periodontitis, it is necessary to promptly fit a dental prosthesis. Periodontitis generally involves significant loss of the alveolar bone, leading to tooth mobility and even loss. After extracting a tooth due to periodontitis, it is essential first to observe for three months. After three months, once the absorption of the alveolar bone stabilizes, dental prosthesis can be performed. Temporary restorative measures, such as using temporary teeth, are also an option during this period. Temporary teeth generally require fitting with a permanent prosthesis after three months, at which point the temporary teeth are discarded. After fitting a permanent prosthesis, it is important to avoid hard foods since the jawbone conditions are not ideal due to periodontitis, and chewing hard objects could accelerate the absorption of the alveolar bone. Therefore, after tooth extraction due to periodontitis, temporary teeth can be worn for three months before permanent prosthetic treatment is carried out.

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Written by Li Bao Hua
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How is periodontitis treated?

Periodontitis is an inflammation of the periodontal supporting tissue, often caused by not brushing or rinsing promptly after eating. Food residue accumulates around the gums, which over time can cause bleeding gums or bleeding during brushing. Severe cases may further develop into periodontal pockets, where dental calculus appears, potentially leading to loose teeth, tooth loss, or even absorption of the alveolar bone. Therefore, the basic treatment for periodontitis involves controlling plaque and eliminating inflammation. This can be achieved through ultrasonic cleaning, which is essentially teeth cleaning to remove dental calculus, followed by rinsing and medicating around the gums to improve their condition. In severe cases, periodontal scaling may be necessary. Thus, treatment of periodontitis is divided into basic treatment and maintenance treatment, with maintenance following the basic treatment phase.