Periodontal Disease is a broad term that actually encompasses multiple different diseases with different classifications under the broader umbrella of the term Periodontal Disease. The classifications can encompass anything from mild bleeding gums leading all the way to teeth that are so diseased, they can fall out of your mouth.
The American Academy of Periodontolgy classifies periodontal disease in the following way—
Gingivitis is the mildest form of periodontal disease. It causes the gums to become red, swollen, and bleed easily. There is usually little or no discomfort at this stage. Gingivitis is often caused by inadequate oral hygiene. Gingivitis is reversible with professional treatment and good oral home care.
Factors that may contribute to gingivitis include, diabetes, smoking, aging, genetic predisposition, systemic diseases and conditions, stress, inadequate nutrition, puberty, hormonal fluctuations, pregnancy, substance abuse, HIV infection, and certain medication use.
Untreated gingivitis can advance to periodontitis. With time, plaque can spread and grow below the gum line. Toxins produced by the bacteria in plaque irritate the gums. The toxins stimulate a chronic inflammatory response in which the body in essence turns on itself, and the tissues and bone that support the teeth are broken down and destroyed. Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. Often, this destructive process has very mild symptoms. Eventually, teeth can become loose and may have to be removed.
There are many forms of periodontitis. The most common ones include the following.
- Aggressive periodontitis occurs in patients who are otherwise clinically healthy. Common features include rapid attachment loss and bone destruction and familial aggregation.
- Chronic periodontitis results in inflammation within the supporting tissues of the teeth, progressive attachment and bone loss. This is the most frequently occurring form of periodontitis and is characterized by pocket formation and/or recession of the gingiva. It is prevalent in adults, but can occur at any age. Progression of attachment loss usually occurs slowly, but periods of rapid progression can occur.
- Periodontitis as a manifestation of systemic diseases often begins at a young age. Systemic conditions such as heart disease, respiratory disease, and diabetes are associated with this form of periodontitis.
- Necrotizing periodontal disease is an infection characterized by necrosis of gingival tissues, periodontal ligament and alveolar bone. These lesions are most commonly observed in individuals with systemic conditions such as HIV infection, malnutrition and immunosuppression.
Causes — In most cases, periodontitis begins with plaque — a sticky film composed mainly of bacteria. If left untreated, here’s how plaque can eventually advance to periodontitis:
- Plaque forms on your teeth when starches and sugars in food interact with bacteria normally found in your mouth. Brushing your teeth twice a day and flossing once a day removes plaque, but plaque re-forms quickly.
- Plaque can harden under your gumline into tartar (calculus) if it stays on your teeth. Tartar is more difficult to remove and it’s filled with bacteria. The longer plaque and tartar remain on your teeth, the more damage they can do. You can’t get rid of tartar by brushing and flossing — you need a professional dental cleaning to remove it.
- Plaque can cause gingivitis, the mildest form of periodontal disease. Gingivitis is irritation and inflammation of the part of your gum around the base of your teeth (gingiva). Gingivitis can be reversed with professional treatment and good home oral care.
- Ongoing gum inflammation can cause periodontitis, eventually causing pockets to develop between your gums and teeth that fill with plaque, tartar and bacteria. In time, these pockets become deeper, filling with more bacteria. If not treated, these deep infections cause a loss of tissue and bone, and ultimately you may lose one or more teeth. Also, ongoing chronic inflammation can put a strain on your immune system.
Risk factors — Factors that can increase your risk of periodontitis include:
- Poor oral health habits
- Smoking or chewing tobacco
- Older age
- Hormonal changes, such as those related to pregnancy or menopause
- Substance abuse
- Inadequate nutrition, including vitamin C deficiency
- Certain medications that cause dry mouth or gum changes
- Conditions that cause decreased immunity, such as leukemia, HIV/AIDS and cancer treatment
- Certain diseases, such as diabetes, rheumatoid arthritis and Crohn’s disease
Periodontitis is a bacterially induced infection that destroys the bone and other tissues that support the teeth. If left untreated, periodontal disease will ultimately lead to tooth loss. The disease has been called “pyorrhea” in the past as well as “gum disease.” According to the National Institute of Health, the number one cause of tooth loss in U.S. adults is periodontitis. It is estimated that 90% of the U.S. population is affected by some form of periodontal disease.
Periodontal disease is often referred to as the “silent disease” because more often than not, signs and symptoms of the disease may not become evident until its too late. Some of the symptoms may include:
- Gums that bleed even occasionally
- Spaces developing between your teeth
- Gums that feel swollen or tender
- Gums that pull away or recede from your teeth
- Persistent bad breath
- Puss between your teeth and gums
- Pain in your mouth or loose teeth
- A change in your bite or the way your teeth close together
- Sores or swellings in your mouth
To provide you with a better understanding of periodontics, we have provided the following multimedia presentation. Many common questions pertaining to periodontics are discussed.
The lack of symptoms is one of the reasons so many people have undiagnosed periodontitis. We have seen numerous cases of severe bone loss that exhibited no signs of inflammation and where no pain was present for the patient. Don’t let periodontal disease take away your smile and function. If you have any of the symptoms, please seek the treatment you need and help save your natural teeth. Call us for an evaluation today!