Generalized aggressive periodontitis
Generalized aggressive periodontitis has a clinical appearance that is similar to chronic periodontitis; the two diseases differ, however, in that generalized aggressive periodontitis appears most commonly in people under the age of 30, and the disease progresses far more rapidly than chronic periodontitis. Like localized aggressive periodontitis, generalized aggressive periodontitis presents with a level of damage and destruction that is not commensurate with the amount of plaque and tartar that is present in the oral cavity. These two types of aggressive periodontitis are similar in most ways; the primary difference between the two is that generalized aggressive periodontitis affects a greater number of teeth than the localized form of the disease.
Generalized aggressive periodontitis also presents in an episodic manner. At times, the tissues of the periodontium appear red, inflamed, and ulcerated, and they may bleed or manifest abscess with no stimulation or apparent cause. These symptoms appear during the actively destructive phase of the disease and correlate with the loss of bone and attachment. At other times, during periods of quiescence, the periodontal tissues have a healthy pink appearance with no visible inflammation. However, despite this healthy appearance, there may be deep periodontal pockets present.
Generalized aggressive periodontitis leads to varying levels of bone destruction, depending on the severity of the disease. In its more mild forms, there may be minimal resorption of the crestal bone, while in its more severe forms, the alveolar bone may be completely destroyed. Bone loss also may occur with both vertical and horizontal defects.
Early diagnosis of generalized aggressive periodontitis is a vital step in slowing the destruction caused by the disease, which is otherwise both rapid and permanent. Routine periodontal examinations, which are normally included in dental checkups, are an essential part of the early diagnosis of this detrimental disease. During these routine examinations, dentists visually assess the color and texture of the gum tissue, check the depth of the gingival pockets with a probing instrument, and note any inflammation or bleeding on probing. When periodontitis is evident, x-rays can be used to further determine the type of periodontitis by measuring alveolar bone levels and assessing the location and direction of bone loss. Dentists will also review the patient’s medical history and family medical history, as both types of aggressive periodontitis are hereditary.
Treatment for generalized aggressive periodontitis is similar to treatment for chronic periodontitis and often includes a combination of mechanical and medical approaches, combined with cause-related therapies. Cause-related therapies include the implementation of smoking-cessation plans, if applicable, and instruction in proper oral hygiene methods. They may also include the adjustment of restorations or appliances whose location or placement may exacerbate plaque and tartar buildup and retention. Because of the rapid rate at which generalized aggressive periodontitis destroys the bone, however, and the generally young age of the patients, treatments for generalized aggressive periodontitis are as aggressive as the disease. When cause-related therapies and mechanical solutions, including root scaling and planing and debridement, do not stabilize the disease, surgical or medical therapies may be necessary. Once the disease is stabilized, frequent medical checkups are recommended to prevent relapse.