Periodontal disease is the most common reason for adult tooth loss in industrialized nations, and is a problem to be taken seriously. It comprises a number of illnesses (collectively called gum disease or periodontitis), and it is a progressively degenerative disease afflicting the underlying jawbone as well as the gums and tissues surrounding the infected teeth. Untreated periodontitis will ultimately lead to loosened teeth, and even complete tooth loss. The initial stage of periodontal disease begins when toxic by-products of plaque damage the gingival (soft) tissues at the base of the teeth. Later, bacterium becomes embedded in the affected gums, rapidly leading to infection. As this infection spreads and increases in intensity, it penetrates even deeper into these soft tissues, resulting in irritation between the teeth and gums. The body’s natural response is to quarantine & eliminate this infected tissue, giving the appearance of receded gums. Larger and larger “pockets” form between the gum tissues and teeth as the gum tissue withers, and without timely treatment, the infection eventually makes its way to the underlying bone tissue, causing it to decay, resulting in tooth instability, and finally, tooth loss.

Types of Periodontal Disease

Here, we’ve described a few of the most frequently encountered forms of periodontal disease, along with their typical treatment solutions:

Gingivitis

Description: Gingivitis is the mildest, most prevalent, and initial stage of periodontitis. Those most at risk of contracting gingivitis include: unmanaged diabetics, patients using blood pressure or seizure medication, women who are pregnant or on birth control pills, and steroid users (of all kinds).
Treatment: In this early stage, gingivitis is quite easily reversible through a two-fold approach of professional cleaning and follow-up care at home. Your dentist may opt for deep scaling and root planing in order to thoroughly remove bacteria and debris from the pockets which have already formed. Prescription antibiotics and medicated dental mouthrinses can stem the tide of infection, thus speeding up healing of the affected gums.

Chronic Periodontal Disease

Description: Chronic periodontal disease is the second most common form, especially for patients over 45 years of age. This form is characterized by the progressive damage & death of the gingival and bone tissue, with an associated significant inflammation beneath the gum line. The untrained eye may perceive that the teeth are gradually increasing in length, but the unfortunate reality is that the gums are receding at a slow rate.
Treatment: Due to the irreparable damage to tissue, chronic periodontal disease cannot be completely cured because the supportive tissues (especially bone) cannot be regrown. However, the dentist can halt further damage and disease progression using similar treatment methods as gingivitis – antibiotics along with scaling and root planing procedures. Sometimes, the periodontist may find it necessary to perform surgical treatments to reinforce the surviving bone structure and make a small aesthetic improvement to the oral cavity.

Aggressive Periodontal Disease

Description: Aggressive periodontal disease is characterized by rapid loss in many aspects of the teeth and bone structure. Loss of bone tissue, attachment of gums, and rapid familial aggregation. It is nearly identical to chronic periodontitis, except for an accelerated rate of damage and progression. Frequent tobacco users and those linked to a hereditary history of this disease are especially at higher risk of contracting aggressive periodontal disease.
Treatment: Treatments are similar to those for gingivitis and chronic gum disease, although a host of surgical treatments are much more likely to be applied. This highly advanced, late stage of disease is more difficult to stem against the tide of ever-increasing damage, but the dentist will perform the usual treatments as well as resorting to laser dentistry in an attempt to salvage valuable bone & soft tissue.

Periodontal Disease Relating to Systemic Conditions

Description: Periodontal disease is sometimes symptomatic of a wider condition or disease which may be negatively affecting the body as whole. Considering other factors, some diseases can behave in much the same way as aggressive periodontal disease, quickly destroying fragile tissues. Types of diabetes, cardiopulmonary disease, and certain respiratory diseases are a few common cofactors, among many others. Even in cases where the teeth are in a healthy condition, with minimal plaque present, other medical conditions may increase and accelerate the progression and intensity of periodontal disease.
Treatment: Initially, the medical condition which initiated the periodontal disease must be managed with professional care. The dentist will then stop or slow further progression of the disease employing similar treatments used for controlling aggressive and chronic periodontal disease.

Necrotizing Periodontal Disease

Description: This form of the disease speedily progresses to more advanced stages and is more widespread in people afflicted with malnutrition, predilection for smoking and other tobacco use, HIV, chronic stress, and immunosuppression. It is characterized by tissue death (necrosis), which commonly affects the periodontal ligament, alveolar bone, and gingival tissues. The tissues simply die, rather than the more gradual progression of other forms of periodontitis.
Treatment: Although necrotizing periodontal disease is extremely rare, it is probable that the dentist will first discuss treatment options with a physician, because of the associations of this type of periodontitis with HIV and other severe medical conditions. In addition to the normal treatments, fungicidal medicines may be used as part of the treatment strategy.
Should you have any additional questions or specific concerns regarding the different types of periodontal disease and their treatments, please contact us.