Managing Aggressive Periodontitis

Cases of aggressive periodontitis need to be treated quickly by a dentist. Essentially, it’s when you develop gum disease at a rapid rate, which could quickly lead you to lose a tooth – or teeth. In this article, we’re going to talk about the definition of aggressive periodontitis, its development, common symptoms and how dentists might manage it.

What is Aggressive Periodontitis?

Aggressive periodontitis was defined in the International Workshop for the Classification of Periodontal Diseases in 1999. There are three primary characteristics that classify an aggressive case of periodontitis. They are as follows:

• The absence of systemic conditions – like diabetes or cardiovascular disease – that might contribute to periodontal disease
• Rapid loss of clinical attachment of your tooth to the surrounding gum and alveolar bone
• If gum disease runs in your family

All these factors need to be met for a case of periodontitis to be considered aggressive.

The Development of Periodontitis

Periodontitis, also known simply as gum disease, develops after a build-up of plaque, tartar, and bacteria. Pockets open between the tooth and the gum, where these things continue to build up out of reach of regular brushing and flossing.

If left untreated, your teeth might start to become loose, causing you even more pain. Bleeding around the teeth is common, and the infection can also cause an inflammatory response in other parts of your body.

Advanced stages of the disease are when the connective tissue that holds your tooth in place begins to deteriorate. Your gums, bones, and other supportive tissue are destroyed, leading to severe pain, swelling, and a foul taste in your mouth.

Remember that these stages will occur very rapidly in cases of aggressive periodontitis. If you notice anything strange, the best thing you can do is see a dentist right away.

Common Symptoms

It’s often difficult to diagnose aggressive periodontitis yourself, because at times there might not be any clear symptoms – even at more advanced stages of the disease.

Aggressive periodontitis can be split into two different camps: localised or generalised. If it’s localised periodontitis, this largely affects a child’s first molars and incisors. Generalised periodontitis affects all a patient’s teeth.

Both types if left untreated can lead to attachment loss of the tooth, destruction of the bone, and pain. Ultimately, patients can lose their tooth (or teeth) to this disease.

Keep an eye out for the following symptoms, although remember – they sometimes might not appear.

• Bleeding gums during and after you brush your teeth or floss
• Frequent bad breath
• Your teeth have changed position or come loose
• Gums have started to recede
• Gums are red, tender, or swollen
• Experience pain when chewing

The Management of Aggressive Periodontitis

Recently, managing cases of aggressive periodontitis with both surgical and non-surgical approaches have had some success. If you’ve got a case of aggressive periodontitis, your dentist might take one of the following approaches.

More than likely, you’ll be referred to an endodontist, which is a dentist that specialises in the management and treatment of advanced gum disease.

Scaling and Root Planing

The first goal of managing aggressive periodontitis is to minimize the factors that lead to it developing. That could mean a treatment that involves your dentist removing the build-up of plaque, tartar, and bacteria both above and below the gum line. This is known as scaling.

The next step would be root planing, where the rough spots on your tooth are smoothed out to encourage reconnection with the gum.

Treatment with Antibiotics

Generally, treating aggressive periodontitis with antibiotics has proven to be quite effective. Studies have shown that this treatment greatly improves the pocket depth (where the build-up occurs) and encourages fast clinical attachment (where your tooth re-joins to healthy gums).

Surgical Procedures

There are several surgical procedures involved in the management of aggressive periodontitis:

• Pocket reduction therapy: This is when your dentist clears out the pockets between your tooth and gum tissue. Afterwards, the dentist will then secure your gum tissue back into place in a way that prevents bacteria from building up again.
• Soft tissue graft: This procedure is where the dentist will take healthy gum from elsewhere in your mouth and graft it to areas that have been exposed thanks to your gums receding – a symptom of periodontitis.
• Guided Tissue Regeneration: This procedure involves your dentist folding back your gums to clear out the bacteria. Afterwards, they will place a membrane over the damaged bone. This gives the bone the necessary time and space to heal and regenerate.
• Crown Lengthening: This procedure involves reshaping the gum tissue and bone around your tooth.
• Frenectomy: The frenum is the fold of skin that stretches between the inside of your lip towards the gum line above your two front teeth. A frenectomy removes this, which in turn helps close the space between your teeth to avoid any recession of the gums.