What is Periodontal (Gum) Disease?

The term “periodontal” refers to “around the tooth.” Periodontal disease, also known as periodontitis and gum disease, is a prevalent inflammatory condition that affects the soft tissues surrounding and supporting the tooth. In its most advanced stages, it can also impact the jawbone itself.

Periodontal disease usually begins with gingivitis, a bacterial infection of the gum tissue. This infection occurs when the toxins in plaque irritate and inflame the gums. Once the bacterial infection establishes itself in the gum pockets between the teeth, it becomes much harder to remove and treat. Periodontal disease is progressive, ultimately leading to the destruction of connective tissue and jawbone. If untreated, it can result in shifting teeth, loosening, and eventually loss of teeth.

Periodontal disease is the primary cause of tooth loss among adults in the developed world and requires prompt treatment.

Types of Periodontal Disease

If not treated, gingivitis can extend below the gum line. The toxins in plaque can irritate the gums, triggering a chronic inflammatory response that leads the body to destroy its own bone and soft tissue. Often, there are few or no symptoms, as periodontal disease causes the teeth to detach from the infected gum tissue. Deepening pockets between the gums and teeth generally indicate that soft tissue and bone are being destroyed by periodontal disease.

The most common types of periodontal disease include:

• Chronic periodontitis – This condition involves inflammation within the supporting tissues, causing deep pockets and gum recession. It may seem like the teeth are lengthening, but in reality, it’s the gums that are receding. This is the most prevalent form of periodontal disease, marked by progressive loss of attachment interspersed with periods of rapid progression.
• Aggressive periodontitis – This occurs in clinically healthy individuals and is characterized by rapid gum attachment loss, chronic bone destruction, and familial aggregation.
• Necrotizing periodontitis – Often seen in individuals with systemic conditions such as HIV, immunosuppression, or malnutrition, this form involves tissue death in the periodontal ligament, alveolar bone, and gingival tissues.
• Periodontitis caused by systemic diseases – Often starting at an early age, this form of gum disease is frequently associated with other medical conditions such as respiratory diseases, diabetes, and heart disease.

Treatment for Periodontal Disease

Various surgical and nonsurgical treatments may be implemented by a periodontist depending on the specific condition of the teeth, gums, and jawbone. A comprehensive periodontal exam will be conducted before any treatment is recommended.

Common treatments for periodontal disease include:

• Scaling and root planing – To preserve gum health, the bacteria and calculus (tartar) that caused the infection must be removed. The gum pockets are cleaned and treated with antibiotics as needed to help alleviate the infection. A prescription mouthwash might also be recommended as part of daily cleaning routines.
• Tissue regeneration – When the bone and gum tissues have been destroyed, regrowth can be actively encouraged using grafting procedures. A membrane might be inserted into the affected areas to aid in the regeneration process.
• Pocket elimination surgery – Also known as flap surgery, is a surgical treatment that aims to reduce the pocket size between the teeth and gums. Surgery on the jawbone may also be performed to eliminate indentations that foster bacterial colonization.
• Dental implants – After tooth loss due to periodontal disease, the aesthetics and functionality of the mouth can be restored with prosthetic teeth implanted into the jawbone. Tissue regeneration procedures might be necessary before placing a dental implant to strengthen the bone.

If you have questions or concerns about periodontal disease, periodontal treatments, or dental implants, consult your dentist.