What is Periodontal (Gum) Disease?

The term “periodontal” literally means “around the tooth.”  Periodontal disease (sometimes called periodontitis or just “gum disease”) is an inflammatory condition which attacks the supporting and surrounding soft tissues of the gums teeth, and (in advanced cases) even of the jawbones.

Periodontal disease is usually preceded by gingivitis. This is a bacterial infection of the gum tissues.  Bacterial infections are able to penetrate the gums when the toxins produced in plaque irritate and cause inflammation of the gum tissues.  If this bacterial infection succeeds in colonizing in the gum pockets between the teeth, it can be very difficult to remove and treat.

Periodontal disease is a progressive condition, and if left uncontrolled, it will eventually lead to the destruction of the connective tissue holding the teeth in place. In severe cases, it can even result in destruction the jawbone.  When allowed to progress, it may result in teeth shifting their location, becoming loose, and eventually to loss the affected teeth.

Periodontal disease is the most common cause of tooth loss among adults in much of the world, and has been linked with other “non-dental” health issues, as well. It should ALWAYS be treated promptly.

Types of Periodontal Disease

If not properly treated, gingivitis (mild inflammation of the gums) can spread below the gum line.  When this occurs, the gums become irritated by the toxins that are contained / produced in plaque, resulting in a chronic inflammatory response. This inflammation can actually cause the body to attack and destroy its own soft tissue and bone.  In the early stages, the patient may detect little or no symptoms, even while periodontal disease is causing the teeth to separate from infected gum tissue. An early sign of gingivitis is deepening pockets between the gums and teeth. Such separation and deepening of the sulcus (pocket) is generally evidence that soft tissue and bone is being destroyed by periodontal disease – but unless it is detected during a regular dental check-up, it may go undetected until serious damage has occurred.

The following list constitutes several of the most common forms of periodontal disease:

  • Chronic periodontitis – This diagnosis describes a condition of inflammation within supporting tissues around teeth that results in deep pockets (sulcus) and gum recession.  It may appear that teeth affected by this condition are lengthening, but in reality, that impression is caused by the gums (gingiva) receding.  Chronic periodontitis is the most common type of periodontal disease. Characteristic symptoms are progressive loss of attachment, followed by periods of rapid progression.
  • Aggressive periodontitis – This type of gum disease often occurs in an individual who seems to be otherwise clinically healthy.  Symptoms include rapid loss of gum attachment, chronic bone destruction. The problem is more common in families that have a history of this ailment.
  • Necrotizing periodontitis – This periodontal disease occurs most frequently in individuals who are suffering from systemic conditions such as malnutrition, immunosuppression, and HIV.  It is characterized by necrosis (tissue death) in the gingival tissues, periodontal ligament, and alveolar bone.
  • Periodontitis caused by systemic disease – Medical conditions such as diabetes, heart disease and respiratory disease are common cofactors of this gum disease, which often begins at an early age.

Treatment for Periodontal Disease

There are various surgical and nonsurgical treatments from which the periodontist may choose, depending upon evaluation of the condition of teeth, gums and jawbone.  Before any treatment can be recommended or performed, it is essential that a complete periodontal exam of the mouth be conducted.

The following list describes some of the more common treatments for periodontal disease:

  • Scaling and root planing – Removal of the bacteria and calculus (tartar) which caused the infection is absolutely essential in order to restore and preserve the health of the gum tissue.  This process will entail cleaning and treating the gum pockets with antibiotics (when necessary) in order to combat the infection.  In some cases, prescription mouthwash may be recommended.
  • Tissue regeneration – In the event that bone and gum tissues have been destroyed, it may be helpful to actively encourage regrowth by utilizing grafting procedures.  In some cases, a membrane may be inserted to aid and promote the regeneration process.
  • Pocket elimination surgery – Pocket elimination surgery (sometimes called “Flap Surgery”) is a type of surgical treatment which can reduce the size of the pockets between the teeth and gums.  Another option is to perform surgery on the jawbone to eliminate indentations in the bone which may have been fostering bacterial.
  • Dental implants – When teeth are lost due to periodontal disease, it is possible to restore the aesthetics and functionality of the mouth by implanting prosthetic teeth directly into the jawbone.  In some cases, tissue regeneration procedures may be prerequisite to the placement of a dental implant, if the bone lacks strength.

If you have doubts, questions or concerns about periodontal disease, periodontal treatment, or dental implants, Ask Dr. Raanan.