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 for Periodontal Disease
There are many surgical and nonsurgical treatments the 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. 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) is a surgical treatment which can be performed
to reduce the pocket size between the teeth and gums. Surgery on the jawbone
is another option which serves to eliminate indentations in the bone which
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.