Periodontitis Treatment: Causes, Therapy and Tooth Preservation in Gum Diseases
Periodontitis: The insidious danger for your teeth
Periodontitis — medically correct Periodontitis — is a chronic inflammation of the tooth-supporting apparatus and the most common cause of tooth loss in adulthood. In Germany, according to the Fifth German Oral Health Study, over 50 percent of adults are affected. The insidious part: The disease initially progresses painlessly and is often only recognized late.
In this guide, you will learn how to recognize periodontitis early, what treatment options are available, and when Dental implants are the best solution for lost teeth.
What exactly is periodontitis?
Periodontitis is a bacterial inflammation that attacks the gums, the jawbone, and the fibers that anchor the tooth in the bone. If left untreated, it leads to:
- Gum recession: The teeth appear longer (“long teeth”)
- Bone loss: The jawbone is resorbed
- Tooth mobility: Teeth become loose and may fall out
- Systemic health risks: Connections to cardiovascular diseases, diabetes, and premature births are scientifically proven.
Periodontosis vs. Periodontitis — The Difference
In common parlance, 'periodontosis' is often used. Medically correct is Periodontitis (ending '-itis' = inflammation). 'Periodontosis' strictly refers to a non-inflammatory recession, which is very rare. In practice, both terms refer to the same clinical picture.
Causes and Risk Factors
Main cause: Bacterial plaque
The main cause of periodontitis is bacterial dental plaque (plaque). If this is not regularly removed, tartar forms — an ideal breeding ground for aggressive bacteria that attack the gums.
Risk factors that promote periodontosis
- Smoking: The largest avoidable risk factor. Smokers are three times more likely to suffer from periodontitis and more severely
- Diabetes mellitus: Poorly controlled blood sugar significantly increases the risk
- Genetic predisposition: About 30 percent of the population has a hereditary susceptibility
- Stress: Weakens the immune system and promotes inflammation
- Poor oral hygiene: Irregular tooth brushing and lack of inter-dental care
- Hormonal changes: Pregnancy, puberty, menopause can increase the risk
- Certain medications: Some blood pressure medications and immunosuppressants affect the gums
Symptoms: How to recognize periodontosis
Watch for the following warning signs:
Early signs (gingivitis — precursor)
- Bleeding gums when brushing or eating
- Red, swollen gums
- Bad breath despite good hygiene
Advanced symptoms
- Gums recede — exposed tooth necks
- Sensitive teeth to cold and hot
- Pus formation between tooth and gum
- Change in tooth position
- Teeth feel loose
- Pain when chewing
Important: In smokers, the gums often do not bleed, as nicotine restricts blood flow. Periodontitis thus progresses even less conspicuously and is only recognized very late.
Diagnosis: How is periodontosis diagnosed?
The diagnosis is made by the dentist through:
- Periodontal Screening Index (PSI): Measurement of the depth of gum pockets with a special probe. A depth of 3.5 mm or more indicates suspicion of periodontitis
- X-rays: Show bone loss around the tooth roots
- Bacterial test: Identifies specific periodontitis pathogens
- Bleeding index: Documents where the gums bleed
Treatment of periodontitis: Modern therapeutic approaches
Stage 1: Professional dental cleaning and hygiene phase
The foundation of any periodontitis therapy:
- Thorough removal of tartar and plaque
- Guidance for optimal home oral hygiene
- Use of interdental brushes and dental floss
- If necessary, antibacterial mouth rinse (chlorhexidine)
Stage 2: Closed periodontitis therapy (Scaling and Root Planing)
Under local anesthesia, the gum pockets are cleaned:
- Scaling: Removal of tartar and bacterial deposits from the pockets
- Root planing: The tooth root surface is smoothed to reduce bacterial accumulation
- Duration: 2-4 sessions of 45-60 minutes each
- Success rate: In cases of mild to moderate periodontitis, sufficient in 70-80 percent of cases
Stage 3: Surgical therapy
In advanced periodontitis with deep pockets (over 6 mm):
- Flap surgery: The gums are opened, and the root surface is cleaned under direct vision
- Regenerative procedures: Bone replacement materials and special membranes promote the regeneration of lost bone
- Emdogain: Enamel matrix proteins stimulate the regeneration of bone and periodontal attachment
Stage 4: Supportive periodontitis therapy (UPT)
After active treatment, lifelong follow-up care is crucial:
- Professional dental cleaning every 3-6 months
- Regular measurement of pocket depths
- Adjustment of oral hygiene measures
Tooth loss due to periodontitis: What now?
Despite the best treatment, teeth can be lost due to severe periodontitis. In this case, there are various replacement options:
Dental Implants — The Best Long-Term Solution
Dental implants are the highest quality form of dental prosthetics after tooth loss due to periodontitis. It is important:
- Periodontitis must be completely treated before implantation be
- Often a bone augmentation is necessary, as periodontitis has caused bone loss in the jaw
- Special implant aftercare is essential to avoid peri-implantitis (inflammation around the implant)
- With successfully treated periodontitis, implants have a success rate of over 90 percent
All-on-4 / All-on-6 for advanced tooth loss
When many or all teeth have been lost due to periodontitis, All-on-4 or All-on-6 concepts offer an efficient solution: Fixed teeth on 4 or 6 implants — often even without extensive bone augmentation.
Removable dental prosthetics
Partial or full dentures are the most cost-effective, but also the least comfortable option. They cannot stop bone loss and require regular adjustments.
Preventing periodontitis: How to protect your teeth
- Brush your teeth thoroughly twice a day — at least 2 minutes with an electric toothbrush
- Clean between your teeth daily — interdental brushes are more effective than dental floss
- Professional dental cleaning at least twice a year
- Do not smoke — the most important avoidable risk factor
- Balanced diet with sufficient vitamin C and D
- Regular dental visits for early detection (PSI measurement)
- Manage diabetes well — the relationship between blood sugar and periodontitis is bidirectional
Frequently asked questions about periodontitis
Is periodontitis curable?
Periodontitis can be effectively treated and halted. However, complete healing in the sense of restoring lost bone is only limitedly possible. The earlier treatment begins, the better the prognosis.
Can teeth be saved in periodontitis?
In many cases, yes. Through consistent therapy and aftercare, even severely loosened teeth can be stabilized for years. In cases of very advanced bone loss, sometimes removal and a durable implant replacement is the better choice.
What does a periodontal treatment cost?
The basic therapy is covered by the statutory health insurance. Additional measures such as bacterial tests, laser therapy, or regenerative procedures are self-pay. Implants after tooth loss are only subsidized with a fixed grant.
Can implants be placed despite periodontitis?
Yes, but only after successful periodontal treatment. An active inflammation must be healed before implantation. Experienced implantologists, like those working at Dent360, specialize in the care of periodontal patients.
How are periodontal disease and general health related?
Periodontitis bacteria can enter the bloodstream and spread throughout the body, and they have been proven to be associated with cardiovascular diseases, diabetes, rheumatoid arthritis, and even Alzheimer’s. Therefore, a healthy oral cavity is essential for overall health.
Conclusion: Act early and save teeth
Periodontitis is a serious but treatable condition. The earlier it is detected, the more successful the therapy. Regular dental visits, thorough oral hygiene, and avoiding risk factors are the best strategies for prevention.
If teeth have already been lost due to periodontitis, modern dental implants offer an excellent way to restore function and aesthetics. At Dent360, we provide comprehensive advice on all options — from post-periodontitis care to implantation.
Schedule your free consultation and let us find the best solution for your dental health together.