Periodontal disease is the major cause of tooth loss in adults. Mainly caused by
plaque, it is usually painless. Regular dental visits are essential to timely diagnosis
Early and moderate periodontal disease may exhibit few, if any, symptoms. Warning
signs of advanced periodontal disease may include red, swollen or bleeding gums,
persistent bad breath, loose or spreading permanent teeth, or changes in the way
your teeth fit together when you bite.
There are many forms and stages of periodontal disease, the most common are gingivitis,
periodontitis, and advanced periodontitis.
A mild inflammation of the gums caused by plaque build-up. Gums may be red and/or
sore, and bleed upon probing. An anti-microbial mouth rinse may be prescribed.
If left untreated, the gum infection damages the bone and supporting tissues. Your
gum separates from the tooth and the bone level deteriorates.
Your gums recede farther and separate. Pus may develop, bone loss continues, and
your teeth may loosen or fall out.
Your dentist will examine you for periodontal disease during each routine checkup.
A periodontal probe will be used to determine if there is any breakdown in the gum
tissue attachment or if pockets have developed between your gums and teeth. Silverman
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Treatment will depend upon the type of periodontal disease and how far the condition
has progressed. Treatment options include scaling, root planing, and oral irrigation
as explained below:
- Scaling cleans the teeth to remove deposits above and below the gumline.
- Root planing smooths rough root surfaces so the gum can heal. Local anesthesia may
- Oral Irrigation directs anti-microbial (anti-plaque) liquid below the gumline to
flush out and kill germs to allow the regeneration of healthy tissue.
If deep pockets are found and bone has been destroyed, your dentist may recommend
periodontal surgery. A proper program of brushing, flossing, and regular professional
cleanings will help fight plaque accumulation and gum disease, and help you keep
your teeth for a lifetime.
Be sure to follow the special home care instructions provided by your dental professional.
Periodontal (gum) diseases, including gingivitis and periodontitis, are serious
infections that, left untreated, can lead to tooth loss. 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 one tooth or many teeth. It begins when the bacteria
in plaque (the sticky, colorless film that constantly forms on your teeth) causes
the gums to become inflamed.
In the mildest form of the disease, gingivitis, the gums redden, swell and bleed
easily. There is usually little or no discomfort. 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. With time, plaque can spread
and grow below the gum line. Toxins produced by the bacteria in plaque irritate
the gums. The toxins stimulate a chronic inflammatory response in 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 (spaces
between the teeth and gums) that become infected. As the disease progresses, the
pockets deepen and more gum tissue and bone are destroyed. Often, this destructive
process has very mild symptoms. Eventually, teeth can become loose and may have
to be removed.
Causes of Periodontal Disease
The main cause of periodontal disease is bacterial plaque, a sticky, colorless film
that constantly forms on your teeth. However, factors like the following also affect
the health of your gums.
As you probably already know, tobacco use is linked with many serious illnesses
such as cancer, lung disease and heart disease, as well as numerous other health
problems. What you may not know is that tobacco users also are at increased risk
for periodontal disease. In fact, recent studies have shown that tobacco use may
be one of the most significant risk factors in the development and progression of
Research proves that up to 30% of the population may be genetically susceptible
to gum disease. Despite aggressive oral care habits, these people may be six times
more likely to develop periodontal disease. Identifying these people with a genetic
test before they even show signs of the disease and getting them into early interventive
treatment may help them keep their teeth for a lifetime.
Pregnancy and Puberty
As a woman, you know that your health needs are unique. You know that brushing and
flossing daily, a healthy diet, and regular exercise are all important to help you
stay in shape. You also know that at specific times in your life, you need to take
extra care of yourself. Times when you mature and change, for example, puberty or
menopause, and times when you have special health needs, such as menstruation or
pregnancy. During these particular times, your body experiences hormonal changes.
These changes can affect many of the tissues in your body, including your gums.
Your gums can become sensitive, and at times react strongly to the hormonal fluctuations.
This may make you more susceptible to gum disease. Additionally, recent studies
suggest that pregnant women with gum disease are seven times more likely to deliver
preterm, low birth weight babies.
As you probably already know, stress is linked to many serious conditions such as
hypertension, cancer, and numerous other health problems. What you may not know
is that stress also is a risk factor for periodontal disease. Research demonstrates
that stress can make it more difficult for the body to fight off infection, including
Some drugs, such as oral contraceptives, anti-depressants, and certain heart medicines,
can affect your oral health. Just as you notify your pharmacist and other health
care providers of all medicines you are taking and any changes in your overall health,
you should also inform your dental care provider.
Clenching or Grinding Your Teeth
Has anyone ever told you that you grind your teeth at night? Is your jaw sore from
clenching your teeth when you're taking a test or solving a problem at work? Clenching
or grinding your teeth can put excess force on the supporting tissues of the teeth
and could speed up the rate at which these periodontal tissues are destroyed.
Diabetes is a disease that causes altered levels of sugar in the blood. Diabetes
develops from either a deficiency in insulin production (a hormone that is the key
component in the body's ability to use blood sugars) or the body's inability to
use insulin correctly. According to the American Diabetes Association, approximately
16 million Americans have diabetes; however, more than half have not been diagnosed
with this disease. If you are diabetic, you are at higher risk for developing infections,
including periodontal diseases. These infections can impair the ability to process
and/or utilize insulin, which may cause your diabetes to be more difficult to control
and your infection to be more severe than a non-diabetic.
As you may already know, a diet low in important nutrients can compromise the body's
immune system and make it harder for the body to fight off infection. Because periodontal
disease is a serious infection, poor nutrition can worsen the condition of your
Other Systemic Diseases
Diseases that interfere with the body's immune system may worsen the condition of
Types of Periodontal Disease
There are many forms of periodontal disease. The most common ones include the following.
Gingivitis is the mildest form of periodontal disease. It causes the gums to become
red, swollen, and bleed easily. There is usually little or no discomfort at this
stage. Gingivitis is reversible with professional treatment and good at home oral
A form of periodontitis that occurs in patients who are otherwise clinically healthy.
Common features include rapid attachment loss and bone destruction and familial
A form of periodontal disease resulting in inflammation within the supporting tissues
of the teeth, progressive attachment and bone loss and is characterized by pocket
formation and/or recession of the gingiva. It is recognized as the most frequently
occurring form of periodontitis. It is prevalent in adults, but can occur at any
age. Progression of attachment loss usually occurs slowly, but periods of rapid
progression can occur.
Periodontitis as a Manifestation of Systemic Diseases
Periodontititis, often with onset at a young age, associated with one of several
systemic diseases, such as diabetes.
Necrotizing Periodontal Diseases
An infection characterized by necrosis of gingival tissues, periodontal ligament
and alveolar bone. These lesions are most commonly observed in individuals with
systemic conditions including, but not limited to, HIV infection, malnutrition and
Treatment of Periodontal Disease
If you're diagnosed with periodontal disease, your periodontist may recommend periodontal
surgery. Periodontal surgery is necessary when your periodontist determines that
the tissue around your teeth is unhealthy and cannot be repaired with non-surgical
treatment. Following are the four types of surgical treatments most commonly prescribed:
- Pocket Reduction Procedures
- Regenerative Procedures
- Crown Lengthening
- Soft Tissue Grafts