WHAT IS PERIODONTAL DISEASE?

Periodontal disease affect all the tissues surrounding the teeth including the gums and the bone underneath. When your gums become inflamed they bleed and get swollen in this case we call it gingivitis .  If your inflamed gums are left untreated the inflammation spread to the underlying structure which is the bone supporting the teeth and  become chronic which might result in 90% of the cases that the bone supporting the teeth is lost and develop a gap (pocket) under the gums and in this case we call it Periodontitis. The most common symptom of periodontitis is loose teeth in its moderate phase and the patient might not feel it till the most severe phase where the patient might realize that his or her teeth are exhibiting severe mobility which could be most of the time too late to save them.

The periondontal disease affect more than 80%of the population of the world which eventually might result to a total loss of the teeth if left untreated sometimes in young ages.

Periodontal treatment is necessary when various conditions affect the health of your gums and the regions of your jaw bone that hold your teeth in place. Retaining your teeth is directly dependent on proper periodontal care and maintenance.

Healthy gums enhance the appearance of your teeth, like a frame around a beautiful painting. When your gums become unhealthy, they can either recede or become swollen and red. In later stages, the supporting bone underneath is destroyed and your teeth will shift, loosen, or fall out. These changes not only affect your ability to chew and speak, they also spoil your smile.

Periodontal diseases are ongoing infections of the gums that gradually destroy the support of your natural teeth. Periodontal disease affects one or more of the periodontal tissues: alveolar bone, periodontal ligament, cementum, or gingiva. While there are many diseases which affect the tooth-supporting structures, plaque-induced inflammatory lesions make up the majority of periodontal issues, and are divided into two categories: gingivitis and periodontitis. While gingivitis, the less serious of the diseases, may never progress into periodontitis, it always precedes periodontitis.

GINGIVITIS

Dental plaque is the primary cause of gingivitis in genetically-susceptible individuals. Plaque is a sticky colorless film, composed primarily of food particles and various types of bacteria, which adhere to your teeth at and below the gum line.

Plaque constantly forms on your teeth, even minutes after cleaning. Bacteria found in plaque produce toxins or poisons that irritate the gums. Gums may become inflamed, red, swollen, and bleed easily. If this irritation is prolonged, the gums separate from the teeth causing pockets (spaces) to form.

If daily brushing and flossing is neglected, plaque can also harden into a rough, porous substance known as calculus (or tartar). This can occur both above and below the gum line.

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.

PERIODONTITIS

If gingivitis progresses into periodontitis, the supporting gum tissue and bone that holds teeth in place deteriorates. The progressive loss of this supporting bone, the alveolar bone, can lead to loosening and subsequent loss of teeth. Periodontitis is affected by bacteria that adhere to the tooth surface, along with an overly aggressive immune response to these bacteria.

Periodontal disease is dangerous in that it is often painless and symptomless. Eighty percent of Americans will be afflicted with periodontal disease by age 45, and 4 out of 5 patients with the disease are unaware they have it. It is important to maintain proper home oral care and regular dentist visits to reduce the risk of obtaining this disease.

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(degeneration) of gingival(gums) tissues, periodontal ligament and alveolar bone(supporting bone). These lesions are most commonly observed in individuals with systemic conditions such as HIV infection, malnutrition and immunosuppression.