Periodontal disease

Understanding the risks of periodontal disease can motivate patients to adhere to a good oral homecare routine.

Periodontal disease begins with gingivitis – a mild form that causes the gums to become red, swollen and prone to bleeding. The good news is that, with professional treatment and good oral homecare, the disease is reversible.

Left untreated, however, gingivitis can advance to periodontitis. Plaque can spread and grow below the gum line over time, and toxins produced by the bacteria in plaque irritate the gums. The toxins stimulate a chronic inflammatory response, causing the tissues and bone that support the teeth to break down. In turn, the gums separate from the teeth, forming pockets, which can become infected. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. Eventually, teeth can become loose and may need to be removed.

The most common forms of periodontitis include:

  • Aggressive periodontitis.Aggressive periodontitis occurs in patients who are otherwise clinically healthy. Common features include rapid attachment loss and bone destruction, and familial aggregation.
  • Chronic periodontitis. 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. This 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. 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.

Source: The American Academy of Periodontology. For more information visit https://www.perio.org/consumer/types-gum-disease.html.