Periodontal Diseases

What are periodontal diseases?

The word periodontal means "around the tooth." Periodontal diseases, also called gum diseases, are serious bacterial infections that attack the gums and the surrounding tissues. If it's left untreated, the disease will continue and the underlying bone around the teeth will dissolve and will no longer be able to hold the teeth in place. Generally, periodontal disease isn't painful, so it is possible to have it and not be aware of it.

A dentist specializing in periodontal disease is called a periodontist.

What causes periodontal disease?

As with many other oral health diseases, bacteria and plaque buildup is often the cause. In fact, plaque buildup (which contains many kinds of bacteria) is the leading cause of gum disease. Other factors that contribute to gum disease include:

• Genetics

• Lifestyle choices

• A diet low in nutrients

• Smoking or the use of smokeless tobacco

• Autoimmune or systemic diseases

• Diabetes

• Hormonal changes in the body

• Bruxism (habitual, involuntary clenching or grinding of the teeth)

• Certain medicines

• Excessive alcohol consumption

What are the signs and symptoms of periodontal disease?

These are the most common signs and symptoms of gum disease:

• Red, swollen, tender gums

• Bleeding while brushing and/or flossing

• Receding gums (gums that pull away from the teeth)

• Loose or separating teeth

• Persistent bad breath (halitosis)

• Partial dentures that no longer fit

• Pus between the teeth and gums

• A change in bite and jaw alignment

The signs and symptoms of gum disease may look like other conditions or medical problems. See a dentist or other oral health specialist for a diagnosis.

What are the different types of periodontal disease?

The different types of periodontal disease are often classified by the stage the disease including:

• Gingivitis. This is the mildest form of periodontal disease. The gums are likely to become red, swollen, and tender. They may bleed easily during daily cleanings and flossing. Treatment by a dentist and proper, consistent care at home helps resolve these problems.

• Mild periodontitis. Untreated gingivitis leads to mild periodontitis. This stage of gum disease shows evidence of periodontal pockets. This is when gums pull away from the teeth, causing the crevice between the teeth and gums to deepen.  It also causes early loss of bone around the teeth. Prompt dental care is needed to prevent further erosion of bone and gum damage.

• Moderate to advanced periodontitis. This most advanced stage of gum disease shows significant bone loss, deepening of periodontal pockets, and possibly receding gums surrounding the teeth. Teeth may loosen and need to be extracted.

What are the treatments for periodontal disease?

Treatment may include any, or a combination of, the following:

• Tartar (calculus) and plaque removal beneath the gums. Deep cleaning (also called scaling and root planing) can help remove tartar beneath the gums and infected tissue in the early stages of the disease. It also smoothes the damaged root surfaces of the teeth. The gums can then reattach to the teeth.

• Medicine. Antibacterial medicines may be placed topically in the periodontal pockets or taken orally.

• Surgery. When the disease is advanced, the infected areas under the gums will be cleaned, and the tissues will then be reshaped or replaced. Types of surgeries include:

  • Pocket reduction

  • A regeneration procedure

  • A soft tissue graft

  • Crown lengthening