Periodontal Disease

Periodontal disease is also known as gum disease and is characterized by inflammatory conditions that affect the periodontium, which is the set of tissues that surround and support the teeth. Periodontal disease is classified as gingivitis in its earlier stages and is characterized by swelling, redness, and bleeding. In its more destructive stages, it is classified as periodontitis; when periodontitis is present, the gingival tissue can separate from the teeth, the bone supporting the teeth can degrade, and the teeth may loosen or fall out. Periodontal diseases usually develop because of a buildup of bacteria in the mouth, which results from dental plaque. Poor oral hygiene and inadequate access to professional care are the primary causes for this bacterial buildup, though risk factors that can exacerbate periodontal diseases include smoking, family history, certain medications, and some systemic diseases and conditions. Periodontal disease is diagnosed with a periodontal exam, which includes a visual assessment as well as manual probing of pockets in the gums, and x-rays.

It is estimated that nearly half of people over 30 in the United States have some type of periodontal disease, and these numbers increase in people over 65. Males are more likely to have periodontal disease than females. Because periodontal disease has few symptoms in its early stages, it may progress significantly before treatment can begin. Treatment consists of professional deep cleaning and may also include antibiotics or dental surgery, and maintenance includes proper oral hygiene and routine professional cleanings, which is also recommended to prevent periodontal diseases from occurring in the first place. When symptoms do occur, they include redness, swelling, and bleeding of the gums; persistent bad breath or a bad taste in the mouth; recession of the gums; deep pockets in the area between the gums and the teeth; and, in its later stages, loosening of the teeth. Because the destruction caused by advanced periodontitis can be largely painless, any of these symptoms should be taken seriously and should be cause for a dental appointment. Additionally, periodontal diseases that do not manifest clear symptoms can be diagnosed at routine dental examinations, which are recommended as part of a thorough health-care plan.

Periodontal diseases are classified based on the level of damage that has occurred; all but one classification, which is gingivitis, are considered destructive forms of the disease. Gingivitis is reversible and is characterized by inflammation, while more severe forms of periodontitis have different symptoms and characteristics. The severity of periodontal disease is determined by the amount of the periodontal ligament that has been lost; this clinical attachment loss is the primary characteristic of periodontitis, which is subclassified based on other considerations. X-rays can also be used to assess the amount of bone that has been adversely affected by periodontal disease. Other conditions that can affect the periodontium, besides those that are bacterially induced, include systemic diseases that cause conditions that affect the supporting tissues of the periodontium, abscesses and lesions that may arise inside a damaged tooth, deformities of the mucous membrane, occlusal trauma, and factors related to dental prostheses. Treatment depends on the cause and characteristics of each type of periodontal disease.