Understanding Periodontal Disease

The term “periodontal” means “around the tooth.” Periodontal disease—also called gum disease or periodontitis—is a common inflammatory condition that affects the soft tissues supporting the teeth and, in advanced stages, the underlying jawbone.

Periodontal disease often begins as gingivitis, a bacterial infection of the gums caused by toxins in plaque. If plaque is not properly removed, bacteria can colonize the gum pockets between teeth, making the infection harder to treat. Over time, the disease progressively destroys connective tissue and bone, potentially leading to shifting teeth, loose teeth, and eventually tooth loss. In fact, periodontal disease is the leading cause of adult tooth loss in the developed world and should always be treated promptly.

Types of Periodontal Disease

If gingivitis is left untreated, the infection can spread below the gum line. The body’s chronic inflammatory response may break down soft tissue and bone. Often, there are few noticeable symptoms, but deepening pockets between teeth and gums are a clear sign of tissue destruction.

Common types of periodontal disease include:

  • Chronic periodontitis: The most common form. Gum inflammation leads to deep pockets and gum recession. Teeth may appear longer as gums recede. This type progresses gradually but may have periods of rapid advancement.
  • Aggressive periodontitis: Occurs in otherwise healthy individuals and is marked by rapid loss of gum attachment, chronic bone destruction, and familial links.
  • Necrotizing periodontitis: Usually affects individuals with systemic conditions such as HIV, immunosuppression, or malnutrition. Tissue death (necrosis) occurs in the gums, periodontal ligament, and jawbone.
  • Periodontitis associated with systemic disease: Often begins at a young age and may be linked to conditions like diabetes, heart disease, and respiratory disorders.

Treatment of Periodontal Disease

Treatment depends on the severity and type of periodontal disease, as well as the condition of the teeth, gums, and jawbone. A complete periodontal exam is always performed before recommending any procedures.

Common treatments include:

  • Scaling and root planing: Deep cleaning removes bacteria and tartar from below the gum line. Antibiotics may be applied, and prescription mouthwashes can help control infection and support healing.
  • Tissue regeneration: When bone or gum tissue has been lost, grafting procedures can encourage regrowth. Membranes may be placed to aid tissue regeneration.
  • Pocket elimination (flap) surgery: Reduces the size of gum pockets to remove bacteria-friendly indentations. Jawbone surgery may also be performed to reshape areas that encourage bacterial buildup.
  • Dental implants: When teeth are lost, implants restore both function and appearance. Tissue regeneration may be necessary beforehand to ensure the jawbone can support the implants.

For any questions about periodontal disease, treatment options, or dental implants, please contact our office.