What is periodontal (gum) disease? 

The term “periodontal” means “around the tooth.”  Periodontal disease (also known as gum disease) is a common inflammatory condition and infection that affect the supporting and surrounding soft tissues of the tooth, eventually affecting the jawbone itself in the disease’s advanced stages.

Periodontal disease most often begins with gingivitis which is a bacterial infection and inflammation of the gum tissue.  A bacterial infection affects the gums when the toxins contained in plaque begin to irritate and inflame the gum tissues.  The more severe form of gum disease is periodontitis.  Once this bacterial infection colonizes in the gum pockets between the teeth, it becomes much more difficult to remove and treat.  Periodontal disease is a progressive condition that eventually leads to the destruction of the connective tissue and jawbone.  If left untreated, it can cause shifting teeth, loose teeth, and eventually tooth loss. 

Periodontal disease is the leading cause of tooth loss among adults in the developed world and should always be promptly treated.

Types of Periodontal Disease

When left untreated, gingivitis (mild gum inflammation) can spread to below the gum line.  When the gums become irritated by the toxins contained in plaque, a chronic inflammatory response causes the body to break down and destroy its own bone and soft tissue.  There may be little or no symptoms as periodontal disease causes the teeth to separate from the infected gum tissue.  Deepening pockets between the gums and teeth are generally indicative that soft tissue and bone is being destroyed by periodontal disease.

Here are some of the most common types of periodontal disease:

• Gingivitis- Inflammation of the gums.  This is the early stage of gum disease.  The gums become swollen, red, and may bleed.  No bone destruction occurs with this early stage.  
• Chronic periodontitis – Inflammation within supporting tissues cause deep pockets and gum recession as a result of bone loss.  It may appear that the teeth are lengthening, but in actuality, the gums (gingiva) are receding.  This is the most common form of periodontal disease and is characterized by progressive loss of attachment, interspersed with periods of rapid progression.
• Aggressive periodontitis – This form of gum disease occurs 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 most often occurs in individuals suffering from systemic conditions such as HIV, immunosuppression and malnutrition.  Necrosis (tissue death) occurs in the periodontal ligament, alveolar bone and gingival tissues.
  
  
• Periodontitis caused by systemic disease – This form of gum disease often begins at an early age.  Medical condition such as respiratory disease, diabetes and heart disease are common cofactors.

Treatment for Periodontal Disease

There are many surgical and nonsurgical treatments the periodontist may choose to perform, depending upon the exact condition of the teeth, gums, and jawbone.  A complete periodontal exam of the mouth with dental X-rays 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 restore the health of the gum tissue, the bacteria and calculus (tartar) which initially caused the infection, must be removed.  The teeth and gum pockets will be cleaned, and occasionally treated with antibiotics as necessary to help alleviate the infection. 
  
  
• Tissue regeneration – When the bone and gum tissues have been destroyed, regrowth can be actively encouraged using grafting procedures.  A membrane may be inserted into the affected areas in additioin to the bone graft to assist in the regeneration process.
  
  
• Pocket reduction surgery – Pocket reduction surgery (also known as flap surgery) is a surgical treatment which can be performed to reduce the pocket size between the teeth and gums.  Recontouring of the bone around the teeth is another option which serves to eliminate indentations in the bone which 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 (dental implants) into the jawbone .  Tissue regeneration procedures may be required prior to the placement of a dental implant in order to strengthen the bone, to enhance aesthetics, and to increase implant success outcomes.

Please contact our office if you have questions or concerns about periodontal disease, periodontal treatment, or dental implants.