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Periodontal Disease (Gingivitis)

What is Periodontal (Gum) Disease?

Periodontal (around the tooth) disease, also known as periodontitis or gum disease is a common condition where inflammation of the gums is present. This inflammation usually affects the tissue supporting and surrounding the tooth, but in severe cases can affect the jawbone. Periodontal disease is usually preceded by gingivitis, which is a mild bacterial infection of the gum tissue that starts when toxins contained in plaque (enzymes) start irritating and causing inflammation in the gum tissue. The bacteria colonizes inside the gum pockets next to and between the teeth, becoming much more difficult to treat and leading, as the disease progresses, to destruction of connective tissue, bone tissue and, if left untreated, will cause shifting and loose teeth and, eventually, the death and loss of the tooth or teeth.

Periodontal disease is the leading cause of tooth loss among adults in the United States.

There may be little or no symptoms as periodontal disease separates the tooth from the infected gums producing pockets that are continually deepening as bacterial growth progresses. Deepening pockets are a sign that soft tissue and bone are being destroyed by periodontal disease. There are some systemic diseases that increase the risk of development of periodontitis, such as diabetes, heart disease and respiratory diseases.

Treatment

A periodontist has a number of options to treat periodontitis, depending on the individual conditions at the time of treatment.

The main objective of periodontal disease treatment is to preserve the health of gum tissue. In moderate cases of periodontitis, the bacteria and calculus (tartar) that originally caused the disease must be removed. The procedure to do this is called scaling and root planning. The pockets are cleaned and treated with antibiotics to conquer the infection.

When gum and bone tissue has been destroyed it may become necessary to regenerate tissue by means of tissue grafting and sometimes insertion of a membrane in the affected areas to support the grafted tissue.

Pocket elimination surgery (flap surgery) is a surgical option to reduce the pocket size between gum and tooth. Surgery of the jawbone is sometimes used to eliminate indentations or irregularities in the bone which foster the growth of bacteria colonies.

If periodontal disease has progressed to the level of causing the loss of one or more teeth, the aesthetics and functionality of the mouth can be fully restored by implanting prosthetic teeth into the jawbone (see “Implants”). Bone tissue regeneration procedures (grafting) may be required prior to placement of an implant to strengthen the bone support for the implant.