The term “periodontal” means “surrounding a tooth”. Periodontal disease, or gum disease, is a common inflammatory condition that affects the supporting and surrounding soft tissues of the tooth. It can also affect the jawbone in its most advanced stages.
Periodontal disease is often preceded by gingivitis, which is a bacterial infection of the gum tissue. A bacterial infection affects the gum tissue when toxins that are located in plaque are released. This causes the gum tissue to become irritated and inflamed. As soon as the bacterial infection colonizes in the gum pockets, between the teeth, it becomes very difficult to remove and treat. Ultimately, periodontal disease is a progressive condition that eventually leads to the destruction of the connective tissue and jawbone. If left untreated, periodontal disease can lead to shifting teeth, loose teeth, and ultimately tooth loss.
As the leading cause of tooth loss among adults, periodontal disease should always be treated promptly.
Types of Periodontal Disease
If left untreated, gingivitis (mild gum inflammation) can spread below the gum line. As the gums become irritated, by the toxins in plaque, a chronic inflammatory response causes the body to break down and destroy its own bone and soft tissue. There may be few, or even no symptoms, as periodontal disease causes the teeth to separate from the infected gum tissue. Deepening pockets, between the gums and teeth, are an indication that the soft tissue and bone is being destroyed by periodontal disease.
Here are some of the most common types of periodontal disease:
- Chronic periodontitis. Inflammation in the supporting tissues results in deep pockets and gum recession. It may seem as though the teeth are lengthening, but the gums (gingiva) are actually receding. This is one of the most common forms of periodontal disease and is characterized by progressive loss of attachment. It’s also interspersed with periods of rapid progression.
- Aggressive periodontitis. This form of gum disease can occur 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 occurs mostly in individuals who are suffering from systemic conditions such as HIV, immunosuppression, and malnutrition. Necrosis, or tissue death, occurs in the periodontal ligament, alveolar bone, and gingival tissues.
- Periodontitis that is caused by systemic disease. This form of gum disease begins at an early age. Medical conditions such as respiratory disease, diabetes, and heart disease are common cofactors.
Treatment for Periodontal Disease
There are various surgical and nonsurgical treatments that the periodontist may choose to perform. Which treatment they the periodontist chooses is dependent upon the 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 reduce the infection. A prescription mouthwash may be incorporated into your daily cleaning routines.
- Tissue regeneration. When the bone and gum tissues have been destroyed, regrowth may be possible using grafting procedures. A membrane will be inserted into the affected areas to further assist in the regeneration process.
- Pocket elimination surgery. Pocket elimination surgery (flap surgery) is a surgical treatment that can be performed to reduce the pocket size between the teeth and gums. Another option is surgery on the jawbone, which serves to eliminate indentations in the bone. Indentations can 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.
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