The term “periodontal” means “around the tooth.” Periodontal disease (also known as periodontitis or gum disease) is a common inflammatory condition that affects the supporting and surrounding soft tissues of the tooth, and in its most advanced stages, it can affect the jawbone itself.

Periodontal disease is often preceded by gingivitis, a bacterial infection of the gum tissue. When the toxins in plaque irritate and inflame the gums, the bacterial infection can spread to the gum pockets between the teeth, making it harder to remove and treat. Periodontal disease is progressive and can eventually lead to the destruction of the connective tissue and jawbone. If left untreated, it can cause teeth to shift, become loose, and ultimately lead to tooth loss. It is the leading cause of tooth loss among adults in the developed world and should be treated promptly.

Types of Periodontal Disease

If gingivitis (mild gum inflammation) is left untreated, it can spread below the gum line. The toxins in plaque can cause a chronic inflammatory response, leading the body to destroy its own bone and soft tissue. There may be few or no symptoms as periodontal disease causes teeth to separate from infected gum tissue. Deepening pockets between the gums and teeth often indicate that soft tissue and bone are being destroyed.

Common types of periodontal disease include:

• Chronic Periodontitis: Inflammation within supporting tissues causes deep pockets and gum recession. This is the most common form of periodontal disease and is characterized by a progressive loss of attachment with periods of rapid progression.

• Aggressive Periodontitis: Often occurring in individuals with systemic conditions such as HIV, immunosuppression, and malnutrition, this form involves necrosis (tissue death) in the periodontal ligament, alveolar bone, and gingival tissues.

• Necrotizing Periodontitis: Characterized by pain and tissue death in the periodontal ligament, alveolar bone, and gingival tissues.

• Periodontitis Caused by Systemic Disease: This form of gum disease often begins at an early age and is associated with medical conditions such as respiratory disease, diabetes, and heart disease.

Treatment for Periodontal Disease

There are many surgical and nonsurgical treatments for periodontal disease, depending on the condition of the teeth, gums, and jawbone. A complete periodontal exam of the mouth will be done before any treatment is recommended.

Common treatments for periodontal disease include:

• Scaling and Root Planing: To preserve gum tissue health, bacteria and calculus (tartar) that caused the infection must be removed. Gum pockets are cleaned and treated with antibiotics as necessary, and a prescription mouthwash may be incorporated into daily cleaning routines.

• Tissue Regeneration: When bone and gum tissues have been destroyed, grafting procedures can encourage regrowth. A membrane may be inserted into affected areas to assist in regeneration.

• Pocket Elimination Surgery: Also known as flap surgery, this surgical treatment reduces the pocket size between the teeth and gums. Surgery on the jawbone can also be performed to eliminate indentations that foster bacteria colonization.

• Dental Implants: If teeth are lost due to periodontal disease, the aesthetics and functionality of the mouth can be restored by implanting prosthetic teeth into the jawbone. Tissue regeneration procedures may be needed before placing a dental implant to strengthen the bone.