Periodontal (gum) diseases, including the two most common forms of gum disease called Gingivitis and Periodontitis (Pyorrhea), are serious infections that can lead to tooth loss if left untreated. Periodontal disease results from a chronic bacterial infection that affects the gums and bone supporting the teeth.
There are many forms of periodontal disease. The most common ones include:
- Gingivitis. This is the mildest form of periodontal disease, causing the gums to become red, swollen, and to bleed easily. There is usually little or no discomfort at this stage. Gingivitis is reversible with professional treatment and good home care.
- Aggressive Periodontitis. This is a form of periodontitis that occurs in patients who are otherwise clinically healthy. Common features include rapid attachment loss, bone destruction and familial aggregation.
- Chronic Periodontitis. This form of periodontal disease results in inflammation within the supporting tissues of the teeth, progressive attachment and bone loss and is characterized by pocket formation and/or recession of the gum. It is recognized as the most frequently occurring form of periodontitis. While prevalent in adults, it 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. Periodontitis, often with onset at a young age, is associated with one of several systemic diseases, such as diabetes.
- Necrotizing Periodontal Diseases. This is characterized by necrosis of gingival tissues, periodontal ligament and alveolar bone. These lesions are most commonly observed in individuals with systemic conditions including, but not limited to, HIV infection, malnutrition and immunosuppression.
Causes and Development
Causes of Periodontal Disease:
- Plaque. The main cause of periodontal disease is bacterial plaque.
- Genetics. Research shows that up to 30% of the population may be genetically susceptible to gum disease. Despite aggressive oral care habits, these people may be six times more likely to develop periodontal disease.
- Other systemic diseases. Diseases that interfere with the body's immune system may worsen the condition of the gums.
Signs and Symptoms
Periodontal disease can affect one tooth or many and begins when the bacteria
in plaque (the sticky, colorless film that constantly forms on your teeth) causes the gums to become inflamed
. In the mildest form of the disease - gingivitis
- the gums redden, swell and bleed easily.
Pain is usually not a symptom, which partly explains why the disease may become advanced before treatment is sought and why some patients avoid treatment even after periodontitis
With time, plaque can spread and grow below the gum line and untreated gingivitis can advance to periodontitis. 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: 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 but eventually teeth can become loose and may have to be removed.Gum Bleeding.
Bleeding of the gums, even during brushing, is a sign of inflammation
and the major marker of periodontal disease. One exception is juvenile periodontitis, in which symptoms are mild or even absent. It should be noted that the gums of smokers with periodontal disease tend to bleed less than nonsmokers.Bad Breath.
Debris and bacteria can cause a bad taste in the mouth and persistent bad breath.Gum Recession and Loose Teeth.
As the disease advances the gums recede, and supporting structure of bone is lost. Teeth loosen, sometimes causing a change in the way the upper and lower teeth fit together when biting down or a change in the fit of partial dentures.Abscesses.
Deepening periodontal pockets between the gums and bone can become blocked by tartar or food particles. The infection fighting white blood cells
become trapped and die. Pus
forms and an abscess
develops. Abscesses can destroy both gum and tooth tissue, cause nearby teeth to become loose and painful, and may cause fever and swollen lymph nodes