Periodontal Disease

What is Periodontal (Gum) Disease?

The word “periodontal” simply refers to the structures that are located around the teeth. Periodontitis or periodontal disease is often simply called gum disease because gums are located around the teeth, but this inflammatory condition also involves other soft tissue and supporting tissue. The jawbone itself is affected by advanced stages of periodontal disease.

Periodontal disease usually starts with gingivitis, a bacterial infection of the gums. This infection takes hold as the toxins in plaque start to inflame and irritate gum tissue. Once the bacteria have colonized the gum pockets between the teeth, it is difficult to treat and remove. Periodontal disease gets gradually worse and eventually causes the destruction of connective tissue and even the jawbone. When untreated, teeth can shift and eventually be lost. Gum disease is a major factor and common cause of tooth loss in adults in modern nations and should be treated quickly.

Periodontal Disease Types

When not properly treated, the mild gum inflammation called gingivitis can go below the gum line. As gums are irritated by the toxins in plaque, there is a chronic inflammatory response that causes the body to destroy its own soft tissue and even bone. There may be few symptoms if any, but this gum disease can cause the teeth to separate from the damaged gum tissue. Pockets get deeper as the bone and soft tissue in the area is destroyed by periodontal disease. Some of the most common periodontal disease types are:

Chronic periodontitis: This is inflammation of the tissue that supports teeth and involves gum recession and deep pockets. Teeth may look like they are lengthening when, in fact, gums are instead receding. The most common of all gum disease types, this condition is characterized by progressive attachment loss that can at times move along rapidly.
Aggressive periodontitis: This is a type of gum disease that happens in someone who is otherwise clinically healthy. It involves rapid loss of attachment of the gums and chronic destruction of bone.
Necrotizing periodontitis: This type of periodontal disease often happens in people who suffer from HIV, immunosuppression, malnutrition and other systemic conditions. Tissue death happens in the ligaments, gum tissue and jawbone.
Periodontitis caused by systemic disease: A form of gum disease that can happen at any age, this happens because of existing medical conditions that may include diabetes, respiratory disease, and heart disease.

Periodontal Disease Treatment

When periodontal disease is present, there are a variety of surgical and non-surgical alternatives that can be performed to improve the situation, depending on the condition of the jawbone, teeth and gums. A complete examination of the mouth is necessary before any treatment can be recommended or any actions taken, however.

Here are the most likely treatments that will be recommended if you are determined to have periodontal disease:

Scaling and root planing: To preserve healthy gum tissue, bacteria and calculus or tartar must be removed to prevent or limit infection. Pockets between teeth and gums are cleaned and treated as necessary with antibiotics to help clear away the infection. In addition, a mouthwash may be prescribed for daily use.
Tissue regeneration. When gum tissue and bone have already been destroyed, grafting of tissue from another location or source can encourage regrowth. In many cases, a membrane is also inserted into the graft area to further aid regeneration.
Pocket elimination surgery. Flap surgery or pocket reduction surgery can reduce or eliminate pockets that can harbor infection between teeth and gums. In addition, jawbone surgery is possible to eliminate indentations in the bone that help bacteria colonize.
Dental implants. If teeth have been lost because of periodontal disease, functionality and a pleasing look can be restored through the implantation into the jawbone of prosthetic teeth. In some cases, tissue regeneration is required before placement of dental implants when the remaining bone is not sufficient or strong enough.