Periodontal Disease

What is Periodontal (Gum) Disease?

The term “periodontal” means “around the tooth.”  Periodontal disease (also known as periodontitis and gum disease) is a common inflammatory condition which affects the supporting and surrounding soft tissues of the tooth; also the jawbone itself when in its most advanced stages.

Periodontal disease is most often preceded by gingivitis which is a bacterial infection of the gum tissue.  A bacterial infection affects the gums when the toxins contained in plaque begin to irritate and inflame the gum tissues.  Once this bacterial infection colonizes in the gum pockets between the teeth, it becomes much more difficult to remove and treat.  Periodontal disease is a progressive condition that eventually leads to the destruction of the connective tissue and jawbone.  If left untreated, it can lead to shifting teeth, loose teeth and eventually tooth loss.

Periodontal disease is the leading cause of tooth loss among adults in the developed world and should always be promptly treated.

Types of Periodontal Disease

When left untreated, gingivitis (mild gum inflammation) can spread to below the gum line.  When the gums become irritated by the toxins contained in plaque, a chronic inflammatory response causes the body to break down and destroy its own bone and soft tissue.  There may be little or no symptoms as periodontal disease causes the teeth to separate from the infected gum tissue.  Deepening pockets between the gums and teeth are generally indicative that soft tissue and bone is being destroyed by periodontal disease.

Here are some of the most common types of periodontal disease:

  • Chronic periodontitis – Inflammation within supporting tissues cause deep pockets and gum recession.  It may appear the teeth are lengthening, but in actuality, the gums (gingiva) are receding.  This is the most common form of periodontal disease and is characterized by progressive loss of attachment, interspersed with periods of rapid progression.
  • Aggressive periodontitis – This form of gum disease occurs in an otherwise clinically healthy individual.  It is characterized by rapid loss of gum attachment, chronic bone destruction and familial aggregation.
  • Necrotizing periodontitis – This form of periodontal disease most often occurs in individuals suffering from systemic conditions such as HIV, immunosuppression and malnutrition.  Necrosis (tissue death) occurs in the periodontal ligament, alveolar bone and gingival tissues.
  • Periodontitis caused by systemic disease – This form of gum disease often begins at an early age.  Medical condition such as respiratory disease, diabetes and heart disease are common cofactors.

Treatment

Periodontal treatment methods depend upon the type and severity of the disease.  Your dentist and dental hygienist will evaluate for periodontal disease and recommend the appropriate treatment.

Periodontal disease progresses as the sulcus (pocket or space) between the tooth and gums gets filled with bacteria, plaque, and tartar, causing irritation to the surrounding tissues.  When these irritants remain in the pocket space, they can cause damage to the gums and eventually, the bone that supports the teeth!

If the disease is caught in the early stages of gingivitis, and no damage has been done, one to two regular cleanings will be recommended.  You will also be given instructions on improving your daily oral hygiene habits and having regular dental cleanings.

If the disease has progressed to more advanced stages, a special periodontal cleaning called scaling and root planing (deep cleaning) will be recommended.  It is usually done one quadrant of the mouth at a time while the area is numb.  In this procedure, tartar, plaque, and toxins are removed from above and below the gum line (scaling) and rough spots on root surfaces are made smooth (planing).  This procedure helps gum tissue to heal and pockets to shrink.  Medications, special medicated mouth rinses, and an electric tooth brush may be recommended to help control infection and healing.

If the pockets do not heal after scaling and root planing, periodontal surgery may be needed to reduce pocket depths, making teeth easier to clean.  Your dentist may also recommend that you see a Periodontist (specialist of the gums and supporting bone).

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