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Periodontal Diseases

  • Overview

    The word periodontal means "around the tooth." Periodontal diseases, also called gum diseases, are serious bacterial infections that destroy the gums and the surrounding tissues of the mouth. Cavities in the tooth affect only the tooth. Periodontal disease affects the bones around the tooth, gums, coverings of the roots of the teeth and membrane of the tooth.

    A dentist specializing in periodontal disease is called a periodontist.

    The importance of early diagnosis

    If the inflammation is left untreated, the disease will continue and the underlying bones around the teeth will dissolve and will no longer be able to hold the teeth in place.

    • Chronic inflammation, resulting from a periodontal disease, is responsible for 70 percent of all adult tooth losses.
    • It affects 75 percent of people at some point in their lives.

    How periodontal disease affects children and adults

    • About 66 percent of young adults have periodontal disease.
    • About 50 percent of children have periodontal disease.
    • Periodontal disease is the most common cause of tooth loss in adults.


  • In-Depth

    As with many other oral health diseases, bacteria and plaque build-up is often the culprit. In fact, plaque build-up is the leading cause of gum disease. Other potential causes of gum disease include:

    • genetics
    • poor oral hygiene
    • food stuck in the gums frequently (may be due to a malocclusion, or "bad bite")
    • mouth breathing (may lead to severe drying of the gums and teeth in front of the mouth)
    • a diet low in nutrients and/or a vitamin C deficiency
    • smoking or the use of smokeless tobacco
    • autoimmune or systemic diseases
    • diabetes
    • hormonal changes in the body
    • bruxism (incessant clenching and grinding of the teeth)
    • certain medications (some medications cause an overgrowth of the gums that can lead to periodontal disease)

    What are the symptoms of periodontal disease?

    The following are the most common symptoms of gum disease. However, each adolescent may experience symptoms differently. Symptoms may include:

    • red, swollen, tender gums
    • bleeding while brushing and/or flossing
    • receding gums
    • loose or separating teeth
    • persistent odorous breath
    • dentures no longer fit
    • puss between the teeth and gums
    • change in bite and jaw alignment
  • Tests

    Periodontal disease is usually diagnosed based on a complete history and physical examination of your child's mouth. Your child's physician will probably refer him to a dentist for complete evaluation and treatment, where he'll probably have x-rays of his teen taken.

    How do dental x-rays help diagnosis?

    An x-ray is a diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film. An x-ray helps a dentist determine precisely which teeth are affected by periodontal disease and determine treatment.

    What are the different types of periodontal disease?

    The different types of periodontal disease are often classified by the stage the disease has advanced to at the time of evaluation, including:

    Gingivitis

    With gingivitis, the mildest form of periodontal disease, the gums are likely to become red, swollen and tender, causing them to bleed easily during daily cleanings and flossing.

    Gingivitis can be divided into four groups, including:

    • acute - gingivitis that has sudden onset, does not last long and is painful
    • subacute - a less severe form of acute gingivitis
    • recurrent - gingivitis that returns after treatment
    • chronic - gingivitis that has slow onset, lasts a long time and is usually painless

    Treatment by your child's dentist and proper, consistent care at home help resolve the problems associated with gingivitis. If the gingivitis is not treated, it may lead to periodontitis.

    Mild periodontitis

    Untreated gingivitis leads to mild periodontitis. This stage of gum disease shows evidence of the bone around the tooth starting to erode. The following are the most common symptoms of periodontitis:

    • red, bleeding gums
    • bad taste in the mouth
    • pockets around the bottom of the teeth in the gum line
    • the teeth may become loose and spread apart (as the disease worsens)
    • tooth loss

    Prompt medical attention is necessary to prevent further erosion and damage.

  • For moderate to advanced periodontitis

    Treatment may include any, or a combination of, the following:

    • plaque removal - Deep cleaning can help remove the plaque and infected tissue in the early
       stages of the disease, while smoothing the damaged root surfaces of the teeth. The gums can then be reattached to the teeth.
    • medication
    • surgery - When the disease is advanced, the infected areas under the gums will be cleaned,
       and the tissues will then be reshaped or replaced.

    Types of surgeries for periodontitis

    • pocket reduction
    • a regeneration procedure
    • a soft tissue graft
    • crown lengthening
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