Periodontal Disease (also known as gum disease, periodontitis or pyorrhea) is an infection of the underlying supporting structures of the teeth. Periodontal disease is quite common. According to the American Dental Association 75% of all adults over age 35 have some form of periodontal disease. One major problem is that periodontal disease is usually painless, with few obvious symptoms in its early stages. If left untreated, periodontal disease can eventually result in tooth loss. In fact, periodontal diseases are now the leading cause of tooth loss in adults.

What is Periodontal Disease?

Teeth are surrounded by several anatomically distinct structures. In figure 1 which is a cross section of a healthy tooth the gingiva (gums) is the pink tissue surrounding the teeth visible to the eye. Out of sight, underneath the gingiva, the periodontal ligament attaches each tooth to the alveolar bone. The gingiva is also attached directly to the teeth, and the small space above this attachment is called a sulcus.

The term "periodontal disease" may refer to problems only of the gingiva or to disorders of the deeper structures, such as the underlying bone. Periodontal diseases are broadly classified into gingivitis and periodontitis.

Gingivitis: Defined as inflammation of the gingiva, gingivitis is characterized by red, swollen, bleeding gums. This is the mildest stage of periodontal disease and is common in adults as well as children. There is usually little or no discomfort at this stage and with treatment, gingivitis is usually reversible.

Periodontitis: A more advanced stage of the disease, periodontitis involves the inflammation and eventual destruction of the underlying periodontal ligament and the alveolar bone.

Figure 2 depicts a periodontally diseased tooth. The normally shallow sulcus is deepened, becoming a pocket and the supporting alveolar bone is destroyed. This illustration shows an instrument called a periodontal probe being gently inserted into the pocket to detect periodontal disease.

What causes periodontal disease?

Periodontal diseases are bacterial gum infections that destroy the attachment fibers and supporting bone that hold your teeth in your mouth. The main cause of these diseases is bacterial plaque, a sticky, colorless film that constantly forms on your teeth.

If plaque is not removed on a daily basis it can become organized on the tooth surface and turn into a hard substance called calculus. Calculus, also known as tartar, is calcified dental plaque and is considered a secondary or contributing etiologic factor in causing periodontal diseases. When plaque and calculus are not removed the bacteria in plaque produce toxins (or poisons) that can destroy the supporting tissues and bone around the teeth. Your own immune system attacks not only these invading bacteria but also the body's own tissues, carving deep pockets between the teeth and gums. As the diseases progress, these pockets deepen, more gum tissue and bone are destroyed and the teeth eventually become loose. If periodontal diseases are not treated, the teeth may eventually need to be removed.

What is the treatment for periodontal diseases?

The first line of defense against periodontal disease is actually prevention. This includes a good oral hygiene routine at home. Brushing at least twice a day and cleaning between teeth once a day with floss helps prevent plaque from accumulating. Depending on the severity of the disease, more in-depth oral hygiene instructions may be recommended. Our dental office staff may provide instructions on additional cleaning methods or oral hygiene products to use at home depending on your specific needs.

Depending on how far the diseases have progressed, treatment can vary widely. In the early stages of gum disease, treatment may involve scaling and root planing. This means removing plaque and calculus in the pockets around the tooth and smoothing the root surfaces. Scaling and root planing helps rid the mouth of infection-causing bacteria and irritants beneath the gumline.

More advanced cases may require periodontal surgical treatment. The goals of this treatment are to remove calculus from deep pockets around teeth, reduce the pockets, smooth root surfaces and arrange gum tissue into a shape that will be easier to keep clean.

The many benefits of periodontal treatment include fresh breath, the ability to chew your food more easily, healthy gums that are free from infection and most importantly, helping you achieve your goal of keeping your natural teeth for a lifetime!

Whatever the treatment may entail, our goal is to return you to good oral health and then to help you to maintain it.

How can you prevent periodontal diseases from returning?

Periodontal diseases can and will recur if you do not follow a strict program of supportive periodontal therapy. You play the primary role in preventing further outbreaks of disease. Nothing will help you maintain the results of professional treatment better than daily removal of plaque by proper brushing, flossing and other cleaning methods recommended for you.

We believe in a team approach to help prevent your periodontal disease from returning. Once the diseases have been arrested, a regular maintenance (cleaning) recall schedule will be set up for you typically alternating between your general dentist and our office. This ongoing supportive phase of treatment will allow your dental health team to continuously assess your periodontal health and make sure the infection stays under control. During these recall appointments, your mouth is closely examined, new calculus and plaque are removed, your dental restorations (fillings and crowns) are inspected, and your teeth are polished.

Remember, good oral hygiene and regular professional care are the keys to preventing dental diseases. By following this simple, straightforward program of good dental health, you can help prevent gum disease and keep your teeth a lifetime!