Periodontal (gum) disease, including gingivitis and periodontitis are serious infections which, if left untreated, can lead to loss of one or more teeth. The word periodontal literally means “around the tooth.” Periodontal disease is a chronic bacterial infection that affects the gums and bone supporting the teeth. Periodontal disease can affect multiple teeth simultaneously. It begins when the bacteria in plaque causes the gums to become inflamed. Gingivitis is the mildest form of periodontal disease. It causes the gums to become red, swell and bleed easily. There is usually little or no discomfort at this stage. Gingivitis is often caused by inadequate oral hygiene. Gingivitis is reversible with professional treatment and good oral home care.
Untreated gingivitis can advance to periodontitis. Over time plaque spreads and grows below the gum line producing toxins that irritate the gums. The toxins stimulate a chronic inflammation response which the body in essence turns on itself and the tissues and bone that support the teeth are broken down and destroyed. Gums separate from the teeth forming pockets that become infected. As the disease progresses the pockets deepen and more gum tissue and bone are destroyed. Eventually teeth can become loose and may have to be removed.
The following are the most common forms:
Aggressive Periodontitis – occurs in patients who are otherwise clinically healthy. Common features include rapid attachment loss and bone destruction with familial aggregation.
Chronic Periodontitis – results in inflammation within the supporting tissues of the teeth, progressive attachment and bone loss. This is the most frequently occurring form of periodontitis and is characterized by pocket formation and/or recession of the gingiva. It is prevalent ion adults but can occur at any age. Progression of attachment loss usually occurs slowly but periods of rapid progression can occur as well.
Periodontitis – as a manifestation of systemic diseases often begins at a young age. Systemic conditions such as heart disease, respiratory disease and diabetes are associated with this form of periodontitis.
Necrotizing Periodontitis – is an infection characterized by necrosis of gingival tissues, ligament and alveolar bone loss. These lesions are most commonly observed in individuals with systemic conditions such as HIV infection, malnutrition and immunosuppression.
Treatments for periodontitis can be either surgical or non-surgical depending upon the specific variety of periodontitis that you have. Non-surgical treatment involves scaling and root planning followed by therapy. Surgical options are only considered when it has become evident that regaining good periodontal health can not be attained by any other method.