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. This disease also affects the bone as it progresses over time.
The earliest stage of periodontitis is 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 (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. Many patient do not experience pain with this disease. 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 and bone destruction. Many times patients have a generic pre-disposition to this type of perio and it can affect localized areas or the entire mouth. Aggressive forms of the disease can be more challenging to treat and control.
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 conditions such as respiratory diseases, diabetes and heart disease are common cofactors.
Treatment for Periodontal Disease
There are surgical and nonsurgical treatments a periodontist may choose to perform, depending upon the exact condition of the teeth, gums and jawbone. A complete periodontal exam of the mouth will be done before any treatment is performed or recommended.
Here are some of the more common treatments for periodontal disease:
Scaling and root planing – In order to preserve the health of the gum tissue, the bacteria and calculus (tartar) which initially caused the infection, must be removed. This procedure is also sometimes called a "deep cleaning." The gum pockets will be cleaned and treated with antibiotics as necessary to help alleviate the infection. A prescription mouthwash may be incorporated into daily cleaning routines.
Tissue regeneration – When the bone and gum tissues have been destroyed, regrowth can be actively encouraged using grafting procedures. A membrane may be inserted into the affected areas to assist in the regeneration process.
Pocket elimination surgery – Pocket elimination surgery (also known as flap surgery or osseous surgery) is a surgical treatment which can be performed to reduce the pocket size between the teeth and gums. Areas of the bone that have been destroyed by infection can be smoothed to serves to eliminate indentations in the bone that may foster the colonization of bacteria.
Dental implants – When teeth have been lost due to periodontal disease, the aesthetics and functionality of the mouth can be restored by implanting prosthetic teeth into the jawbone. Tissue regeneration procedures may be required prior to the placement of a dental implant in order to strengthen the bone.
Ask your dentist if you have questions or concerns about periodontal disease, periodontal treatment, or dental implants.