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What is Periodontal (Gum) Disease?

The term “periodontal” means “around the tooth.” Periodontal disease (also known as periodontitis or gum disease) is a common inflammatory condition that affects the supporting and surrounding soft tissues of the tooth. In its most advanced stages, it can also effect the jawbone itself.

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 teeth, it becomes much more difficult to remove and treat. Periodontal disease is a progressive condition that eventually leads to the destruction of connective tissue and the 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 below the gumline. When 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 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 a few of the most common types of periodontal disease:

  • Chronic periodontitis – Inflammation within supporting tissues cause deep pockets and gum recession. It may appear as though the teeth are lengthening; however, in actuality, the gums (gingiva) are receding. This is the most common form of periodontal disease and is characterized by a 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 the 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 conditions, such as respiratory disease, diabetes, and heart disease, are common cofactors.

Treatment for Periodontal Disease

There are many surgical and nonsurgical treatments a periodontist may choose to perform, and their choice will depend upon the exact condition of the teeth, gums, and jawbone. A complete periodontal exam of the mouth must 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) that initially caused the infection must be removed. To help alleviate the infection, the gum pockets will be cleaned and treated using antibiotics as necessary. 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 that can be performed to reduce the pocket size between the teeth and gums. Surgery on the jawbone is another option that serves to eliminate indentations in the bone that 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.

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