Periodontal (Gum) Disease

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

Periodontal disease is often preceded by gingivitis, a bacterial infection of the gum tissue. Toxins in plaque irritate and inflame the gums. Once bacteria colonize in the gum pockets between teeth, the infection becomes harder to treat. Periodontal disease is progressive and can lead to destruction of connective tissue and jawbone, causing 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 be promptly treated.

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Types of Periodontal Disease

When untreated, gingivitis can spread below the gum line. Chronic inflammation destroys bone and soft tissue. Deepening pockets between gums and teeth indicate tissue and bone destruction. Common types include:

  • Chronic periodontitis: Inflammation in supporting tissues causes deep pockets and gum recession. This is the most common form and is characterized by progressive loss of attachment, with periods of rapid progression.
  • Aggressive periodontitis: Occurs in otherwise healthy individuals and involves rapid loss of gum attachment, bone destruction, and familial aggregation.
  • Necrotizing periodontitis: Occurs in individuals with systemic conditions such as HIV, immunosuppression, or malnutrition. Necrosis occurs in the periodontal ligament, alveolar bone, and gingival tissues.
  • Periodontitis caused by systemic disease: Often begins early in life and is associated with medical conditions such as respiratory disease, diabetes, or heart disease.

Treatment for Periodontal Disease

Treatment depends on the condition of the teeth, gums, and jawbone. A complete periodontal exam is performed before any treatment is recommended.

  • Scaling and root planing: Removal of bacteria and calculus (tartar) from gum pockets, with antibiotics as needed. Prescription mouthwash may be included in daily cleaning routines.
  • Tissue regeneration: Grafting procedures and membranes may encourage regrowth of destroyed bone and gum tissues.
  • Pocket elimination surgery: Flap surgery or jawbone surgery reduces pocket size and eliminates indentations that harbor bacteria.
  • Dental implants: Prosthetic teeth can restore aesthetics and function after tooth loss. Tissue regeneration may be needed before implant placement.

Ask your dentist if you have questions or concerns about periodontal disease, treatment options, or dental implants.