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Bad breath and bleeding gums are often signs of periodontitis. A large proportion of adults in Germany suffer from this. But many of those affected wait too long for treatment - and risk serious damage.

About 95 percent of the population in Germany suffer from local gum disease. In more than half of those afflicted, not only the gums are affected but also the tooth-bearing bones. "Many people are aware of their problem but are afraid of treatment. Yet that is unnecessary, and long-term will take its toll," says Professor Dr. Petra Ratka-Krüger, section head and senior physician in the Department of Operative Dentistry and Periodontology at the Medical Center – University of Freiburg. Those who react in a timely manner can often counteract this using simple means.

The causes for it can have various origins: bacterial deposits, genetic predisposition, hormonal changes, an unhealthy lifestyle with high tobacco consumption, a high-sugar and high-fat diet or special drugs. Patients with diabetes mellitus are particularly at risk because of the poorer circulation in the gums.

It starts with bad breath and redness

Bad breath, redness, bleeding and swelling of the gums indicate early periodontitis. If the gums are only locally affected it is called gingivitis. "Gingivitis often heals with improved oral hygiene and regular professional cleaning," says Professor Ratka-Krüger. Because with special instruments, the dentist can remove the bacterial coating gently and very thoroughly, a prerequisite for the healing of gingivitis. In addition, patients should reduce risk factors such as smoking, and regularly go to the dentist for check-ups.

In professional tooth cleaning, deposits are removed from the teeth, an important step in the treatment of periodontitis.

If pockets form between the teeth and gum, or if teeth have already become loose, this is advanced periodontitis. In the worst case, tooth loss can even occur. "For a lay person it is almost impossible to assess how far advanced periodontitis is. This is why regular dental examinations are important," says Professor Ratka-Krüger.

In addition, untreated periodontitis can also have an effect on general health. The relationships between periodontitis and diabetes are now well documented scientifically, and there are also numerous indications for the interrelations between periodontitis and arteriosclerotic cardiovascular diseases.

The last recourse: minimally invasive treatment

When bacteria have penetrated widely between tooth and gum, minimally invasive treatment is sometimes necessary. In this case, the hard dental plaque that sits on the tooth roots is removed via a gentle procedure. If the bone has already receded, it can if necessary be refilled or regenerated in a surgical procedure. "Patients can go to the dentist relaxed," says the dentist Professor Ratka-Krüger. "Because the treatment can be performed well using a local anesthetic, if even that is necessary."