Periodontal disease (also known as periodontitis and gum disease)
is a progressive disease which affects the supporting and surrounding tissue of the gums, and also the underlying
jawbone. If left untreated, periodontal disease can result in loose, unstable teeth, and even tooth loss. Periodontal
disease is in fact the leading cause of tooth loss in adults in the developed world and should not be taken lightly.
Periodontal disease begins when the toxins found in plaque start to attack the soft or gingival
tissue surrounding the teeth. This bacterium embeds itself in the gum and rapidly breeds, causing a bacterial
infection. As the infection progresses, it starts to burrow deeper into the tissue causing inflammation or irritation
between the teeth and gums. The response of the body is to destroy the infected tissue, which is why the gums appear
to recede. The resulting pockets between the teeth deepen and, if no treatment is sought, the tissue which makes up
the jawbone also recedes causing unstable teeth and tooth loss.
Types of Periodontal Disease
There are many different varieties of periodontal disease, and many ways in which these variations
manifest themselves. All require immediate treatment by a periodontist to halt the progression and save the gum tissue
and bone. Here are some of the most common types of periodontal disease along with the treatments typically performed
to correct them:
Gingivitis
Gingivitis is the mildest and most common form of periodontitis. It is caused by the toxins in plaque
and leads to periodontal disease. People at increased risk of developing gingivitis include pregnant women, women
taking birth control pills, people with uncontrolled diabetes, steroid users and people who control seizures and blood
pressure using medication.
Treatment: Gingivitis is easily reversible using a solid combination of home care and professional
cleaning. The dentist may perform root planing and deep scaling procedures to cleanse the pockets of debris. A
combination of antibiotics and medicated mouthwashes may be used to kill any remaining bacteria and promote the good
healing of the pockets.
Chronic Periodontal Disease
Chronic periodontal disease is the most common form of the disease, and occurs much more frequently
in people over 45. Chronic periodontal disease is characterized by inflammation below the gum line and the progressive
destruction of the gingival and bone tissue. It may appear that the teeth are gradually growing in length, but in
actuality the gums are gradually recessing.
Treatment: Unfortunately unlike gingivitis, chronic periodontal disease cannot be completely cured
because the supportive tissue cannot be rebuilt. However, the dentist can halt the progression of the disease using
scaling and root planing procedures in combination with antimicrobial treatments. If necessary, the periodontist can
perform surgical treatments such as pocket reduction surgery and also tissue grafts to strengthen the bone and improve
the aesthetic appearance of the oral cavity.
Aggressive Periodontal Disease
Aggressive periodontal disease is characterized by the rapid loss of gum attachment, the rapid loss
of bone tissue and familial aggregation. The disease itself is essentially the same as chronic periodontitis but the
progression is much faster. Smokers and those with a family history of this disease are at an increased risk of
developing aggressive periodontitis.
Treatment: The treatments for aggressive periodontal disease are the same as those for chronic
periodontal disease, but aggressive periodontal disease sufferers are far more likely to require a surgical
intervention. This form of the disease is harder to halt and treat, but the dentist will perform scaling, root
planing, antimicrobial, and in some cases laser procedures in an attempt to save valuable tissue and bone.
Periodontal Disease Relating to Systemic Conditions
Periodontal disease can be a symptom of a disease or condition affecting the rest of the body.
Depending on the underlying condition, the disease can behave like aggressive periodontal disease, working quickly to
destroy tissue. Heart disease, diabetes and respiratory disease are the most common cofactors, though there are many
others. Even in cases where little plaque coats the teeth, many medical conditions intensify and accelerate the
progression of periodontal disease.
Treatment: Initially, the medical condition which caused the onset of periodontal disease must be
controlled. The dentist will halt the progression of the disease using the same treatments used for controlling
aggressive and chronic periodontal disease.
Necrotizing Periodontal Disease
This form of the disease rapidly worsens and is more prevalent among people who suffer from HIV,
immunosuppression, malnutrition, chronic stress or choose to smoke. Tissue death (necrosis) frequently affects the
periodontal ligament, gingival tissues and alveolar bone.
Treatment: Necrotizing periodontal disease is extremely rare. Because it may be associated with HIV
or another serious medical condition, it is likely the dentist will consult with a physician before commencing
treatment. Scaling, root planing, antibiotic pills, medicated mouth wash and fungicidal medicines are generally used
to treat this form of the disease.
If you have any question or concerns about the different types of periodontal disease and
treatments, please ask your dentist.