Periodontitis, also known as gum disease, is a common infection of the tissues surrounding and supporting the teeth. It is caused by a buildup of plaque, a sticky film of bacteria, on the teeth. If not treated properly, periodontitis can lead to pain, bleeding gums, receding gums, tooth loss, and bone loss in the jaw. Unfortunately, once periodontitis develops, it cannot be completely cured. However, with proper treatment, it can be controlled and progression can be slowed or stopped.
What causes periodontitis?
Periodontitis is caused by certain bacteria in the plaque that forms on and between the teeth. When plaque builds up, it causes inflammation in the gums surrounding the teeth. As inflammation continues over time, the gums start to pull away from the teeth, forming pockets that become infected. Bacterial toxins and the body’s enzymes break down gum tissue and bone. Without treatment, the pockets deepen and more gum tissue and bone are destroyed. Eventually, teeth can become loose and may have to be removed.
Why can’t periodontitis be cured?
There are several reasons why periodontitis cannot be completely cured:
Bacteria are impossible to fully eliminate
The main cause of periodontitis is bacteria accumulating in dental plaque. Even with thorough dental cleanings, it is impossible to fully eliminate all the bacteria that cause periodontitis. Some bacteria remain behind and slowly multiply, starting the infection process all over again.
Tissue and bone loss cannot be reversed
Periodontitis causes progressive damage to the gums, periodontal ligaments, and jawbone. This damage cannot be reversed. No technology exists that can regenerate lost gum tissue or bone. Though procedures like gum grafting can replace lost gum tissue, the original tissue is gone forever.
The immune system is permanently altered
Periodontitis changes the immune system’s response to bacterial plaque in the mouth. It causes a hyperinflammatory immune response that leads to further tissue damage. This altered immune response does not return to normal, even after a thorough professional cleaning. Patients remain at high risk for recurrent periodontitis.
Genetic factors affect susceptibility
Research shows that genetics influences the immune system’s inflammatory response to periodontal bacteria. Certain genes can make individuals more prone to severe, progressive periodontitis. Genetic susceptibility remains for life. Managing periodontitis requires particularly vigilant plaque control in genetically predisposed patients.
Healthy habits must be maintained
Controlling periodontitis relies heavily on the patient’s daily oral hygiene and dental care. However, it can be challenging for patients to maintain the required level of diligence forever. Poor oral hygiene habits like inadequate brushing and flossing make periodontitis almost inevitable. For periodontitis to stay in remission, oral health self-care must be exceptional.
Is there a cure on the horizon?
Complete cures for periodontitis remain elusive. However, encouraging research is being done on new treatments that could eventually eliminate periodontitis altogether:
Gene therapy
Gene therapy aims to change the genes responsible for a hyperinflammatory immune response to periodontal bacteria. This could potentially make patients immune to developing periodontitis. However, gene therapy research remains in the early experimental stages.
Stem cell regenerative therapy
Stem cells have the ability to regenerate bone and soft tissues like the gums. Stem cell therapies are being researched to regenerate periodontal tissues damaged by disease. However, major obstacles remain before stem cell therapy becomes a widespread option.
Antimicrobial photodynamic therapy
This treatment uses laser light and a topical photosensitizing agent to selectively kill periodontal bacteria. Research indicates it can effectively eliminate even deep-seated bacteria within periodontal pockets. If proven effective through further study, antimicrobial photodynamic therapy may significantly impact periodontitis treatment in the future.
Vaccines
Vaccines are being investigated that could prevent bacterial infections that lead to periodontitis. By stimulating immunity against specific periodontal bacteria, vaccines could potentially offer long-term protection against the disease. Vaccines remain years away from clinical use but offer promising opportunities.
Tips for managing periodontitis
While a complete cure for periodontitis may not be developed for years, patients can take action now to manage the disease and prevent extensive damage:
- Brush teeth twice daily with antibacterial toothpaste
- Floss once daily
- Use antiseptic mouthwash daily
- See a dentist regularly for cleanings and checkups
- Undergo professional deep cleanings if recommended
- Avoid smoking and tobacco products
- Follow any other recommendations from your dentist
Proper oral hygiene and professional care can keep periodontitis controlled. With diligence, most patients retain their natural teeth for life and avoid tooth loss from periodontal disease.
Conclusion
Periodontitis remains stubbornly incurable due to the impossibility of completely eliminating bacteria, reversing gum and bone loss, and normalizing the immune system and genetic factors. Promising new treatments like gene therapy, stem cell regeneration, and antimicrobial photodynamic therapy may one day revolutionize treatment, but currently periodontitis can only be well-controlled, not cured. However, with determination and excellent oral hygiene habits, patients can successfully manage periodontitis and avoid tooth loss. Seeing the dentist regularly and following their recommended care is key to keeping the infection in check. With vigilance, most people can retain their natural teeth lifelong despite this incurable disease.