Periodontal Diseases

What are periodontal diseases?

The word periodontal literally means "around the tooth." Periodontal diseases, also called gum diseases, are serious bacterial infections that destroy the gums and the surrounding tissues of the mouth. If the inflammation is left untreated, the disease will continue and the underlying bone around the teeth will dissolve and will no longer be able to hold the teeth in place. Generally, periodontal disease isn't painful, so it is possible to have it and not be aware of it. A dentist specializing in periodontal disease is called a periodontist.

What causes periodontal disease?

As with many other oral health diseases, bacteria and plaque buildup is often the culprit. In fact, plaque buildup (which contains many species of bacteria) is the leading cause of gum disease. Other factors that contribute to gum disease include:

• Genetics

• Lifestyle choices

• A diet low in nutrients

• Smoking / the use of smokeless tobacco

• Autoimmune or systemic diseases

• Diabetes

• Hormonal changes in the body

• Bruxism (incessant clenching of the teeth)

• Certain medications

What are the signs and symptoms of periodontal disease?

The following are the most common symptoms of gum disease. However, each individual may experience symptoms differently. Symptoms may include:

• Red, swollen, tender gums

• Bleeding while brushing and/or flossing

• Receding gums (gums that pull away from the teeth)

• Loose or separating teeth

• Persistent bad breath

• Dentures that no longer fit

• Pus between the teeth and gums

• A change in bite and jaw alignment

The symptoms of gum disease may resemble other conditions or medical problems. Consult a dentist or other oral health specialist for a diagnosis.

What are the different types of periodontal disease?

The different types of periodontal disease are often classified by the stage the disease has advanced to at the time of evaluation, including:

• Gingivitis. With gingivitis, the mildest form of periodontal disease, the gums are likely to become red, swollen, and tender, causing them to bleed easily during daily cleanings and flossing. Treatment by a dentist and proper, consistent care at home help to resolve the problems associated with gingivitis.

• Mild periodontitis. Untreated gingivitis leads to mild periodontitis. This stage of gum disease shows evidence of periodontal pockets (gums pulling away from the teeth, causing the crevice between the teeth and gums to deepen) and early loss of bone around the teeth. Prompt dental attention is necessary to prevent further erosion of bone and gum damage.

• Moderate to advanced periodontitis. This most advanced stage of gum disease shows significant bone loss, deepening of periodontal pockets, and possibly receding gums surrounding the teeth. Teeth may loosen and need to be extracted.

What are the treatments for periodontal disease?

Specific treatment for periodontal disease will be determined by your dentist based on:

• Your age, overall health, and medical history

• Extent of the disease

• Your tolerance for specific medications, procedures, or therapies

• Expectations for the course of the disease

• Your opinion or preference

Treatment may include any, or a combination of, the following:

• Tartar (calculus) and plaque removal beneath the gums. Deep cleaning (also called scaling and root planing) can help remove tartar beneath the gums and infected tissue in the early stages of the disease, while smoothing the damaged root surfaces of the teeth. The gums can then reattach to the teeth.

• Medication. Antibacterial medications may be placed topically in the periodontal pockets or taken orally.

• Surgery. When the disease is advanced, the infected areas under the gums will be cleaned, and the tissues will then be reshaped or replaced. Types of surgeries include:

  • Pocket reduction

  • A regeneration procedure

  • A soft tissue graft

  • Crown lengthening